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1. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial

Author

Mark D, Neuman, Rui, Feng, Susan S, Ellenberg, Frederick, Sieber, Daniel I, Sessler, Jay, Magaziner, Nabil, Elkassabany, Eric S, Schwenk, Derek, Dillane, Edward R, Marcantonio, Diane, Menio, Sabry, Ayad, Manal, Hassan, Trevor, Stone, Steven, Papp, Derek, Donegan, Mitchell, Marshall, J Douglas, Jaffe, Charles, Luke, Balram, Sharma, Syed, Azim, Robert, Hymes, Ki-Jinn, Chin, Richard, Sheppard, Barry, Perlman, Joshua, Sappenfield, Ellen, Hauck, Mark A, Hoeft, Ann, Tierney, Lakisha J, Gaskins, Annamarie D, Horan, Trina, Brown, James, Dattilo, Jeffrey L, Carson, Thomas, Looke, Sandra, Bent, Ariana, Franco-Mora, Pamela, Hedrick, Matthew, Newbern, Rafik, Tadros, Karen, Pealer, Kamen, Vlassakov, Carolyn, Buckley, Lauren, Gavin, Svetlana, Gorbatov, James, Gosnell, Talora, Steen, Avery, Vafai, Jose, Zeballos, Jennifer, Hruslinski, Louis, Cardenas, Ashley, Berry, John, Getchell, Nicholas, Quercetti, Gauasan, Bajracharya, Damien, Billow, Michael, Bloomfield, Evis, Cuko, Mehrun K, Elyaderani, Robert, Hampton, Hooman, Honar, Dilara, Khoshknabi, Daniel, Kim, David, Krahe, Michael M, Lew, Conjeevram B, Maheshwer, Azfar, Niazi, Partha, Saha, Ahmed, Salih, Robert J, de Swart, Andrew, Volio, Kelly, Bolkus, Matthew, DeAngelis, Gregory, Dodson, Jeffrey, Gerritsen, Brian, McEniry, Ludmil, Mitrev, M Kwesi, Kwofie, Anne, Belliveau, Flynn, Bonazza, Vera, Lloyd, Izabela, Panek, Jared, Dabiri, Chris, Chavez, Jason, Craig, Todd, Davidson, Chad, Dietrichs, Cheryl, Fleetwood, Mike, Foley, Chris, Getto, Susie, Hailes, Sarah, Hermes, Andy, Hooper, Greg, Koener, Kate, Kohls, Leslie, Law, Adam, Lipp, Allison, Losey, William, Nelson, Mario, Nieto, Pam, Rogers, Steve, Rutman, Garrett, Scales, Barbara, Sebastian, Tom, Stanciu, Gregg, Lobel, Michelle, Giampiccolo, Dara, Herman, Margit, Kaufman, Bryan, Murphy, Clara, Pau, Thomas, Puzio, Marlene, Veselsky, Kelly, Apostle, Dory, Boyer, Brenda Chen, Fan, Susan, Lee, Mike, Lemke, Richard, Merchant, Farhad, Moola, Kyrsten, Payne, Bertrand, Perey, Darius, Viskontas, Mark, Poler, Patricia, D'Antonio, Greg, O'Neill, Amer, Abdullah, Jamie, Fish-Fuhrmann, Mark, Giska, Christina, Fidkowski, Stuart Trent, Guthrie, William, Hakeos, Lillian, Hayes, Joseph, Hoegler, Katherine, Nowak, Jeffery, Beck, Jaslynn, Cuff, Greg, Gaski, Sharon, Haaser, Michael, Holzman, A Stephen, Malekzadeh, Lolita, Ramsey, Jeff, Schulman, Cary, Schwartzbach, Tangwan, Azefor, Arman, Davani, Mahmood, Jaberi, Courtney, Masear, Syed Basit, Haider, Carolyn, Chungu, Ali, Ebrahimi, Karim, Fikry, Andrew, Marcantonio, Anitha, Shelvan, David, Sanders, Collin, Clarke, Abdel, Lawendy, Gary, Schwartz, Mohit, Garg, Joseph, Kim, Juan, Caruci, Ekow, Commeh, Randy, Cuevas, Germaine, Cuff, Lola, Franco, David, Furgiuele, Matthew, Giuca, Melissa, Allman, Omid, Barzideh, James, Cossaro, Armando, D'Arduini, Anita, Farhi, Jason, Gould, John, Kafel, Anuj, Patel, Abraham, Peller, Hadas, Reshef, Mohammed, Safur, Fiore, Toscano, Tiffany, Tedore, Michael, Akerman, Eric, Brumberger, Sunday, Clark, Rachel, Friedlander, Anita, Jegarl, Joseph, Lane, John P, Lyden, Nili, Mehta, Matthew T, Murrell, Nathan, Painter, William, Ricci, Kaitlyn, Sbrollini, Rahul, Sharma, Peter A D, Steel, Michele, Steinkamp, Roniel, Weinberg, David Stephenson, Wellman, Antoun, Nader, Paul, Fitzgerald, Michaela, Ritz, Greg, Bryson, Alexandra, Craig, Cassandra, Farhat, Braden, Gammon, Wade, Gofton, Nicole, Harris, Karl, Lalonde, Allan, Liew, Bradley, Meulenkamp, Kendra, Sonnenburg, Eugene, Wai, Geoffrey, Wilkin, Karen, Troxell, Mary Ellen, Alderfer, Jason, Brannen, Christopher, Cupitt, Stacy, Gerhart, Renee, McLin, Julie, Sheidy, Katherine, Yurick, Fei, Chen, Karen, Dragert, Geza, Kiss, Halina, Malveaux, Deborah, McCloskey, Scott, Mellender, Sagar S, Mungekar, Helaine, Noveck, Carlos, Sagebien, Luat, Biby, Gail, McKelvy, Anna, Richards, Ramon, Abola, Brittney, Ayala, Darcy, Halper, Ana, Mavarez, Sabeen, Rizwan, Stephen, Choi, Imad, Awad, Brendan, Flynn, Patrick, Henry, Richard, Jenkinson, Lilia, Kaustov, Elizabeth, Lappin, Paul, McHardy, Amara, Singh, Joanne, Donnelly, Meera, Gonzalez, Christopher, Haydel, Jon, Livelsberger, Theresa, Pazionis, Bridget, Slattery, Maritza, Vazquez-Trejo, Jaime, Baratta, Michael, Cirullo, Brittany, Deiling, Laura, Deschamps, Michael, Glick, Daniel, Katz, James, Krieg, Jennifer, Lessin, Jeffrey, Mojica, Marc, Torjman, Rongyu, Jin, Mary Jane, Salpeter, Mark, Powell, Jeffrey, Simmons, Prentiss, Lawson, Promil, Kukreja, Shanna, Graves, Adam, Sturdivant, Ayesha, Bryant, Sandra Joyce, Crump, Michelle, Verrier, James, Green, Matthew, Menon, Richard, Applegate, Ana, Arias, Natasha, Pineiro, Jeffrey, Uppington, Phillip, Wolinsky, Amy, Gunnett, Jennifer, Hagen, Sara, Harris, Kevin, Hollen, Brian, Holloway, Mary Beth, Horodyski, Trevor, Pogue, Ramachandran, Ramani, Cameron, Smith, Anna, Woods, Matthew, Warrick, Kelly, Flynn, Paul, Mongan, Yatish, Ranganath, Sean, Fernholz, Esperanza, Ingersoll-Weng, Anil, Marian, Melinda, Seering, Zita, Sibenaller, Lori, Stout, Allison, Wagner, Alicia, Walter, Cynthia, Wong, Denise, Orwig, Maithri, Goud, Chris, Helker, Lydia, Mezenghie, Brittany, Montgomery, Peter, Preston, J Sanford, Schwartz, Ramona, Weber, Lee A, Fleisher, Samir, Mehta, Alisa J, Stephens-Shields, Cassandra, Dinh, Jacques E, Chelly, Shiv, Goel, Wende, Goncz, Touichi, Kawabe, Sharad, Khetarpal, Amy, Monroe, Vladislav, Shick, Max, Breidenstein, Timothy, Dominick, Alexander, Friend, Donald, Mathews, Richard, Lennertz, Robert, Sanders, Helen, Akere, Tyler, Balweg, Amber, Bo, Christopher, Doro, David, Goodspeed, Gerald, Lang, Maggie, Parker, Amy, Rettammel, Mary, Roth, Marissa, White, Paul, Whiting, Brian F S, Allen, Tracie, Baker, Debra, Craven, Matt, McEvoy, Teresa, Turnbo, Stephen, Kates, Melanie, Morgan, Teresa, Willoughby, Wade, Weigel, David, Auyong, Ellie, Fox, Tina, Welsh, Bruce, Cusson, Sean, Dobson, Christopher, Edwards, Lynette, Harris, Daryl, Henshaw, Kathleen, Johnson, Glen, McKinney, Scott, Miller, Jon, Reynolds, B Scott, Segal, Jimmy, Turner, David, VanEenenaam, Robert, Weller, Jineli, Lei, Miriam, Treggiari, Shamsuddin, Akhtar, Marcelle, Blessing, Chanel, Johnson, Michael, Kampp, Kimberly, Kunze, Mary, O'Connor, Jinlei, Li, Duminda N, Wijeysundera, Sachin, Kheterpal, Reneé H, Moore, Alexander K, Smith, Laura L, Tosi, Lee, Fleisher, Christine, Langlois, Samuel, Oduwole, and Thomas, Rose

Subjects
Male, Analgesics, Canada, Pain, Postoperative, Hip Fractures, Pain, General Medicine, Anesthesia, General, Anesthesia, Spinal, Patient Satisfaction, Internal Medicine, Humans, Female, Aged
Abstract

The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported.To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia.Preplanned secondary analysis of a pragmatic randomized trial. (ClinicalTrials.gov: NCT02507505).46 U.S. and Canadian hospitals.Patients aged 50 years or older undergoing hip fracture surgery.Spinal or general anesthesia.Pain on postoperative days 1 through 3; 60-, 180-, and 365-day pain and prescription analgesic use; and satisfaction with care.A total of 1600 patients were enrolled. The average age was 78 years, and 77% were women. A total of 73.5% (1050 of 1428) of patients reported severe pain during the first 24 hours after surgery. Worst pain over the first 24 hours after surgery was greater with spinal anesthesia (rated from 0 [no pain] to 10 [worst pain imaginable]; mean difference, 0.40 [95% CI, 0.12 to 0.68]). Pain did not differ across groups at other time points. Prescription analgesic use at 60 days occurred in 25% (141 of 563) and 18.8% (108 of 574) of patients assigned to spinal and general anesthesia, respectively (relative risk, 1.33 [CI, 1.06 to 1.65]). Satisfaction was similar across groups.Missing outcome data and multiple outcomes assessed.Severe pain is common after hip fracture. Spinal anesthesia was associated with more pain in the first 24 hours after surgery and more prescription analgesic use at 60 days compared with general anesthesia.Patient-Centered Outcomes Research Institute

Published
2022

2. Engaging patients as partners in a multicentre trial of spinal versus general anaesthesia for older adults

Author

Jennifer Hruslinski, Diane A. Menio, Robert A. Hymes, J. Douglas Jaffe, Christine Langlois, Lolita Ramsey, Lakisha J. Gaskins, Mark D. Neuman, Thomas Looke, Sandra Bent, Ariana Franco-Mora, Pamela Hedrick, Matthew Newbern, Rafik Tadros, Karen Pealer, Edward Marcantonio, Kamen Vlassakov, Carolyn Buckley, Svetlana Gorbatov, James Gosnell, Talora Steen, Avery Vafai, Jose Zeballos, Louis Cardenas, Ashley Berry, John Getchell, Nicholas Quercetti, Daniel I. Sessler, Sabry Ayad, Manal Hassan, Assad Ali, Gauasan Bajracharya, Damien Billow, Michael Bloomfield, Kavita Elliott, Robert Hampton, Linda He, Hooman Honar, Dilara Khoshknabi, Daniel Kim, Paul Minko, Adam Morris, Azfar Niazi, Tara Nutcharoen, Jeffrey Roberts, Partha Saha, Ahmed Salih, Alexis Skolaris, Taylor Stang, Victor Strimbu, Jesse Templeton, Andrew Volio, Jiayi Wang, Kelly Bolkus, Matthew DeAngelis, Gregory Dodson, Jeffrey Gerritsen, Brian McEniry, Ludmil Mitrev, Kwesi Kwofie, Flynn Bonazza, Vera Lloyd, Izabela Panek, Jared Dabiri, Chris Chavez, Jason Craig, Todd Davidson, Chad Dietrichs, Cheryl Fleetwood, Mike Foley, Chris Getto, Susie Hailes, Sarah Hermes, Andy Hooper, Greg Koener, Kate Kohls, Leslie Law, Adam Lipp, Allison Losey, William Nelson, Mario Nieto, Pam Rogers, Steve Rutman, Garrett Scales, Barbara Sebastian, Tom Stanciu, Gregg Lobel, Michelle Giampiccolo, Dara Herman, Margit Kaufman, Bryan Murphy, Clara Pau, Thomas Puzio, Marlene Veselsky, Trevor Stone, Kelly Apostle, Dory Boyer, Brenda Chen Fan, Susan Lee, Mike Lemke, Richard Merchant, Farhad Moola, Kyrsten Payne, Bertrand Perey, Darius Viskontas, Mark Poler, Patricia D'Antonio, Richard Sheppard, Amer Abdullah, Jamie Fish-Fuhrmann, Mark Giska, Christina Fidkowski, Trent Guthrie, William Hakeos, Lillian Hayes, Joseph Hoegler, Katherine Nowak, Robert Hymes, Jeffery Beck, Jaslynn Cuff, Greg Gaski, Sharon Haaser, Michael Holzman, A. Stephen Malekzadeh, Jeff Schulman, Cary Schwartzbach, Frederick Sieber, Tangwan Azefor, Charles Brown, Arman Davani, Mahmood Jaberi, Courtney Masear, Balram Sharma, Syed Basit Haider, Carolyn Chungu, Ali Ebrahimi, Karim Fikry, Kerri Gannon, Andrew Marcantonio, Meredith Pace, David Sanders, Collin Clarke, Abdel Lawendy, Gary Schwartz, Mohit Garg, Joseph Kim, Mitchell Marshall, Juan Caurci, Ekow Commeh, Randy Cuevas, Germaine Cuff, Lola Franco, David Furguiele, Matthew Giuca, Melissa Allman, Omid Barzideh, James Cossaro, Armando D'Arduini, Anita Farhi, Jason Gould, John Kafel, Anuj Patel, Abraham Peller, Hadas Reshef, Mohammed Safur, Fiore Toscano, Tiffany Tedore, Michael Akerman, Eric Brumberger, Sunday Clark, Rachel Friedlander, Anita Jegarl, Joseph Lane, John P. Lyden, Nili Mehta, Matthew T. Murrell, Nathan Painter, William Ricci, Kaitlyn Sbrollini, Rahul Sharma, Peter A.D. Steel, Michele Steinkamp, Roniel Weinberg, David Stephenson Wellman, Antoun Nader, Paul Fitzgerald, Michaela Ritz, Steven Papp, Greg Bryson, Alexandra Craig, Cassandra Farhat, Braden Gammon, Wade Gofton, Nicole Harris, Karl Lalonde, Allan Liew, Bradley Meulenkamp, Kendra Sonnenburg, Eugene Wai, Geoffrey Wilkin, Derek Donegan, Cassandra Dinh, Nabil Elkassabany, Annamarie Horan, Samir Mehta, Karen Troxell, Mary Ellen Alderfer, Jason Brannen, Christopher Cupitt, Stacy Gerhart, Renee McLin, Julie Sheidy, Katherine Yurick, Jeffrey Carson, Fei Chen, Karen Dragert, Geza Kiss, Halina Malveaux, Deborah McCloskey, Scott Mellender, Sagar S. Mungekar, Helaine Noveck, Carlos Sagebien, Barry Perlman, Luat Biby, Gail McKelvy, Anna Richards, Syed Azim, Ramon Abola, Brittney Ayala, Darcy Halper, Ana Mavarez, Stephen Choi, Imad Awad, Brendan Flynn, Patrick Henry, Richard Jenkinson, Lilia Kaustov, Elizabeth Lappin, Paul McHardy, Amara Singh, Ellen Hauck, Joanne Donnelly, Meera Gonzalez, Christopher Haydel, Jon Livelsberger, Theresa Pazionis, Bridget Slattery, Maritza Vazquez-Trejo, Eric Schwenk, Jaime Baratta, Brittany Deiling, Laura Deschamps, Michael Glick, Daniel Katz, James Krieg, Jennifer Lessin, Marc Torjman, Ki Jinn Chin, Rongyu Jin, Mary Jane Salpeter, Mark Powell, Jeffrey Simmons, Prentiss Lawson, Promil Kukreja, Shanna Graves, Adam Sturdivant, Ayesha Bryant, Sandra Joyce Crump, Derek Dillane, Michael Taylor, Michelle Verrier, Richard Applegate, Ana Arias, Natasha Pineiro, Jeffrey Uppington, Phillip Wolinsky, Joshua Sappenfield, Amy Gunnett, Jennifer Hagen, Sara Harris, Kevin Hollen, Brian Holloway, Mary Beth Horodyski, Trevor Pogue, Ramachandran Ramani, Cameron Smith, Anna Woods, Matthew Warrick, Kelly Flynn, Paul Mongan, Yatish Ranganath, Sean Fernholz, Esperanza Ingersoll-Weng, Anil Marian, Melinda Seering, Zita Sibenaller, Lori Stout, Allison Wagner, Alicia Walter, Cynthia Wong, Jay Magaziner, Denise Orwig, Trina Brown, Jim Dattilo, Susan Ellenberg, Rui Feng, Lee Fleisher, Lakisha Gaskins, Maithri Goud, Chris Helker, Lydia Mezenghie, Brittany Montgomery, Peter Preston, Alisa Stephens, J. Sanford Schwartz, Ann Tierney, Ramona Weber, Jacques Chelly, Shiv Goel, Wende Goncz, Touichi Kawabe, Sharad Khetarpal, Kevin King, Frank Kunkel, Charles Luke, Amy Monroe, Vladislav Shick, Anthony Silipo, Caroline Stehle, Katherine Szabo, Sudhakar Yennam, Mark Hoeft, Max Breidenstein, Timothy Dominick, Alexander Friend, Donald Mathews, Richard Lennertz, Helen Akere, Tyler Balweg, Amber Bo, Christopher Doro, David Goodspeed, Gerald Lang, Maggie Parker, Amy Rettammel, Mary Roth, Robert Sanders, Marissa White, Paul Whiting, Brian Allen, Tracie Baker, Debra Craven, Matt McEvoy, Teresa Turnbo, Stephen Kates, Melanie Morgan, Teresa Willoughby, Wade Weigel, David Auyong, Ellie Fox, Tina Welsh, Bruce Cusson, Sean Dobson, Christopher Edwards, Lynette Harris, Daryl Henshaw, Kathleen Johnson, Glen McKinney, Scott Miller, Jon Reynolds, Jimmy Turner, David VanEenenaam, Robert Weller, Shamsuddin Akhtar, Marcelle Blessing, Chanel Johnson, Michael Kampp, Kimberly Kunze, Jinlei Li, Mary O'Connor, and Miriam Treggiari

Subjects
medicine.medical_specialty, Canada, Research Subjects, Patient engagement, Hip fracture surgery, Patient Advocacy, Anesthesia, General, Patient advocacy, Anesthesia, Spinal, 03 medical and health sciences, 0302 clinical medicine, Nursing, 030202 anesthesiology, Fracture Fixation, Medicine, Humans, General anaesthesia, Cooperative Behavior, Geriatrics, Hip fracture, business.industry, Hip Fractures, Lived experience, Age Factors, Research process, medicine.disease, United States, Anesthesiology and Pain Medicine, Research Design, Patient Participation, business, Decision Making, Shared
Abstract

Summary Engaging patients—defined broadly as individuals with lived experience of a given condition, family members, caregivers, and the organisations that represent them—as partners in research is a priority for policymakers, funders, and the public. Nonetheless, formal efforts to engage patients are absent from most studies, and models to support meaningful patient engagement in clinical anaesthesia research have not been previously described. Here, we review our experience in developing and implementing a multifaceted patient engagement strategy within the Regional Versus General Anesthesia for Promoting Independence After Hip Fracture (REGAIN) surgery trial, an ongoing randomised trial comparing spinal vs general anaesthesia for hip fracture surgery in 1600 older adults across 45 hospitals in the USA and Canada. This strategy engaged patients and their representatives at both the level of overall trial oversight and at the level of individual recruiting sites. Activities spanned a continuum ranging from events designed to elicit patients' input on key decisions to longitudinal collaborations that empowered patients to actively participate in decision-making related to trial design and management. Engagement activities were highly acceptable to participants and led to concrete changes in the design and conduct of the REGAIN trial. The REGAIN experience offers a model for future efforts to engage patients as partners in clinical anaesthesia research, and highlights potential opportunities for investigators to increase the relevance of anaesthesia studies by incorporating patient voices and perspectives into the research process.

Published
2020

3. Creating coherence out of chaos? Children's narratives of emotionally positive and negative events

Author

Robyn Fivush, Trina Brown, Jessica M. Sales, Deborah Sarfati, and Ann Hazzard

Subjects
Autobiographical memory, Poison control, Human factors and ergonomics, Experimental and Cognitive Psychology, Suicide prevention, Disadvantaged, Developmental psychology, Arts and Humanities (miscellaneous), Injury prevention, Developmental and Educational Psychology, Narrative, Meaning (existential), Psychology, Social psychology
Abstract

The ways in which children narrate about emotionally negative events is intricately linked to the ways in which they create meaning and, ultimately, cope with such experiences. In this study we interviewed 5- to 12-year-old children growing up in violent communities about both emotionally positive and negative experiences. Children were able to report a great deal of information about both types of events, but they reported more objects and people, and used more descriptive detail, when narrating positive experiences. In contrast, children included more information about their thoughts and emotions when narrating negative experiences, and recounted these experiences more coherently. Few differences were found as a function of children's age, time since the events occurred, reported family discussion about the events, level of exposure to community violence or level of child behaviour problems. Implications of these findings for how children strive to create meaning out of the stressful events of their lives are discussed. Copyright © 2002 John Wiley & Sons, Ltd.

Published
2002
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4. Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States

Author

Stephanie N. DuBose, Julia M. Hermann, William V. Tamborlane, Roy W. Beck, Axel Dost, Linda A. DiMeglio, Karl Otfried Schwab, Reinhard W. Holl, Sabine E. Hofer, David M. Maahs, Steven Willi, Terri Lipman, Tammy Calvano, Olena Kucheruk, Pantea Minnock, Chau Nguyen, Georgeanna Klingensmith, Carolyn Banion, Jennifer Barker, Cindy Cain, Peter Chase, Sandy Hoops, Megan Kelsy, David Maahs, Cathy Mowry, Kristen Nadeau, Jennifer Raymond, Marian Rewers, Arleta Rewers, Robert Slover, Andrea Steck, Paul Wadwa, Philippe Walravens, Philip Zeitler, Heidi Haro, Katherine Manseau, Ruth Weinstock, Roberto Izquierdo, Umair Sheikh, Patricia Conboy, Jane Bulger, Suzan Bzdick, Robin Goland, Rachelle Gandica, Lindsay Weiner, Steve Cook, Ellen Greenberg, Kevin Kohm, Sarah Pollack, Joyce Lee, Brigid Gregg, Meng Tan, Kimberly Burgh, Ashley Eason, Satish Garg, Aaron Michels, Lisa Myers, Linda DiMeglio, Tamara Hannon, Donald Orr, Christy Cruz, Stephanie Woerner, Joseph Wolfsdorf, Maryanne Quinn, Olivia Tawa, Andrew Ahmann, Jessica Castle, Farahnaz Joarder, Chris Bogan, Nancy Cady, Jennifer Cox, Amy Pitts, Rebecca Fitch, Brad White, Bethany Wollam, Bruce Bode, Katie Lindmark, RaShonda Hosey, Kathleen Bethin, Teresa Quattrin, Michelle Ecker, Jamie Wood, Lily Chao, Clement Cheung, Lynda Fisher, Debra Jeandron, Francine Kaufman, Mimi Kim, Brian Miyazaki, Roshanak Monzavi, Payal Patel, Pisit Pitukcheewanont, Anna Sandstrom, Marisa Cohen, Brian Ichihara, Megan Lipton, Ayse Cemeroglu, Yaw Appiagyei-Dankah, Maala Daniel, Daniel Postellon, Michael Racine, Michael Wood, Lora Kleis, Irl Hirsch, Anthony DeSantis, D.C. Dugdale, R. Alan Failor, Lisa Gilliam, Carla Greenbaum, Mary Janci, Peggy Odegard, Dace Trence, Brent Wisse, Emily Batts, Angela Dove, Deborah Hefty, Dori Khakpour, Jani Klein, Kristen Kuhns, Marli McCulloch-Olson, Christina Peterson, Mary Ramey, Marissa St. Marie, Pam Thomson, Christine Webber, David Liljenquist, Mark Sulik, Carl Vance, Tiffany Coughenour, Chris Brown, Jean Halford, Andrea Prudent, Shanda Rigby, Brandon Robison, Harold Starkman, Tymara Berry, Barbara Cerame, Daisy Chin, Laurie Ebner-Lyon, Frances Guevarra, Kristen Sabanosh, Lawrence Silverman, Christine Wagner, Marie Fox, Bruce Buckingham, Avni Shah, Kimberly Caswell, Breanne Harris, Richard Bergenstal, Amy Criego, Greg Damberg, Glenn Matfin, Margaret Powers, David Tridgell, Cassie Burt, Beth Olson, LeeAnn Thomas, Sanjeev Mehta, Michelle Katz, Lori Laffel, Joanne Hathway, Roxanne Phillips, Eda Cengiz, William Tamborlane, Darryll Cappiello, Amy Steffen, Melinda Zgorski, Anne Peters, Valerie Ruelas, Robert Benjamin, Deanna Adkins, Juanita Cuffee, Amber Spruill, Grazia Aleppo-Kacmarek, Teresa Derby, Elaine Massaro, Kimberly Webb, Christine Burt Solorzano, Mark DeBoer, Helen Madison, Janet McGill, Lori Buechler, Mary Jane Clifton, Stacy Hurst, Sarah Kissel, Carol Recklein, Eva Tsalikian, Michael Tansey, Joanne Cabbage, Julie Coffey, Sarah Salamati, Mark Clements, Sripriya Raman, Angela Turpin, Jennifer Bedard, Cyndy Cohoon, Aliza Elrod, Amanda Fridlington, Lois Hester, Davida Kruger, Desmond Schatz, Michael Clare-Salzler, Kenneth Cusi, Colleen Digman, Becky Fudge, Mike Haller, Collette Meehan, Henry Rohrs, Janet Silverstein, Sujata Wagh, Miriam Cintron, Eleni Sheehan, Jamie Thomas, Mark Daniels, Susan Clark, Timothy Flannery, Nikta Forghani, Ajanta Naidu, Christina Reh, Peggy Scoggin, Lien Trinh, Natalie Ayala, Rebeca Quintana, Heather Speer, William Zipf, Diane Seiple, Julie Kittelsrud, Ashutosh Gupta, Vikki Peterson, Ashley Stoker, Michael Gottschalk, Marla Hashiguchi, Katheryn Smith, Henry Rodriguez, Craig Bobik, Danielle Henson, Jill Simmons, Amy Potter, Margo Black, Faith Brendle, Rose Gubitosi-Klug, Beth Kaminski, Susan Bergant, Wendy Campbell, Catherine Tasi, Kenneth Copeland, Joni Beck, Joane Less, Jill Schanuel, Jennifer Tolbert, Saleh Adi, Andrea Gerard-Gonzalez, Stephen Gitelman, Nassim Chettout, Christine Torok, Catherine Pihoker, Joyce Yi-Frazier, Susan Kearns, Ingrid Libman, Vicky Bills, Ana Diaz, Julie Duke, Brandon Nathan, Antoinette Moran, Melena Bellin, Shannon Beasley, Anne Kogler, Janice Leschyshyn, Kara Schmid, Anne Street, Bryce Nelson, Carrie Frost, Erin Reifeis, Morey Haymond, Fida Bacha, Maria Caldas-Vasquez, Sara Klinepeter, Maria Redondo, Rosa Berlanga, Teresa Falk, Elizabeth Garnes, Janette Gonzalez, Cecilia Martinez, Mariam Pontifes, Ronald Yulatic, Kathleen Arnold, Traci Evans, Sharon Sellers, Vandana Raman, Carol Foster, Mary Murray, Trina Brown, Hillarie Slater, Karen Wheeler, David Harlan, Mary Lee, John-Paul Lock, Celia Hartigan, Lisa Hubacz, John Buse, Ali Calikoglu, Joseph Largay, Laura Young, Helen Brown, Vinnie Duncan, Michelle Duclos, Julie Tricome, Verdayne Brandenburg, Julie Blehm, Julie Hallanger-Johnson, Dawn Hanson, Corliss Miller, Jennifer Weiss, Robert Hoffman, Monika Chaudhari, David Repaske, Elizabeth Gilson, Jesse Haines, Justen Rudolph, Charles McClave, Doris Biersdorf, Anthony Tello, Donna Amundson, Rhonda Ward, Michael Rickels, Cornelia Dalton-Bakes, Eileen Markman, Amy Peleckis, Nora Rosenfeld, Lawrence Dolan, Sarah Corathers, Jessica Kichler, Holly Baugh, Debbie Standiford, Jeanne Hassing, Jennifer Jones, Stephen Willis, Carol Wysham, Lisa Davis, Scott Blackman, Kimber-Lee Abel, Loretta Clark, Andrea Jonas, Ellie Kagan, Jay Sosenko, Carlos Blashke, Della Matheson, Rachel Edelen, Thomas Repas, Denise Baldwin, Trista Borgwardt, Christina Conroy, Kelly DeGrote, Rod Marchiando, Michelle Wasson, Larry Fox, Nelly Mauras, Ligeia Damaso, Kim Englert, Marwan Hamaty, Laurence Kennedy, Michelle Schweiger, Pantelis Konstantinopoulos, Carolyn Mawhorter, Amy Orasko, Denise Rose, Larry Deeb, Kim Rohrbacher, Leroy Schroeder, Amanda Roark, Omar Ali, Joanna Kramer, Donna Whitson-Jones, Heidi Gassner, Sobha Kollipara, Katerina Harwood, Vijaya Prasad, and Judy Brault

Subjects
Male, Pediatrics, medicine.medical_specialty, endocrine system diseases, Adolescent, MEDLINE, Hypoglycemia, Body Mass Index, Diabetes mellitus, Germany, medicine, Humans, Obesity, Registries, Child, Glycemic, Glycated Hemoglobin, Type 1 diabetes, business.industry, nutritional and metabolic diseases, medicine.disease, Institutional review board, United States, Diabetes Mellitus, Type 1, Austria, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, business, Body mass index, Demography
Abstract

To examine the current extent of the obesity problem in 2 large pediatric clinical registries in the US and Europe and to examine the hypotheses that increased body mass index (BMI) z-scores (BMIz) are associated with greater hemoglobin A1c (HbA1c) and increased frequency of severe hypoglycemia in youth with type 1 diabetes (T1D).International (World Health Organization) and national (Centers for Disease Control and Prevention/German Health Interview and Examination Survey for Children and Adolescents) BMI references were used to calculate BMIz in participants (age 2-18 years and ≥ 1 year duration of T1D) enrolled in the T1D Exchange (n = 11,435) and the Diabetes Prospective Follow-up (n = 21,501). Associations between BMIz and HbA1c and severe hypoglycemia were assessed.Participants in both registries had median BMI values that were greater than international and their respective national reference values. BMIz was significantly greater in the T1D Exchange vs the Diabetes Prospective Follow-up (P.001). After stratification by age-group, no differences in BMI between registries existed for children 2-5 years, but differences were confirmed for 6- to 9-, 10- to 13-, and 14- to 17-year age groups (all P.001). Greater BMIz were significantly related to greater HbA1c levels and more frequent occurrence of severe hypoglycemia across the registries, although these associations may not be clinically relevant.Excessive weight is a common problem in children with T1D in Germany and Austria and, especially, in the US. Our data suggest that obesity contributes to the challenges in achieving optimal glycemic control in children and adolescents with T1D.

Published
2014

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