Pediatric Diabetes[JOURNAL]
Sun
200 papers
Mapping Lifestyle Factors in Blood Glucose Variability in Adolescents With Type 1 Diabetes Mellitus: A Pilot Study.
Cronin A, Dunne T, Gorman CO … +1 more , Cremona A
Pediatr Diabetes · 2026 · PMID 41970147 · Full text
INTRODUCTION: Optimal glycaemic control in adolescents with type 1 diabetes (T1D) is essential to prevent complications but remains challenging due to changing lifestyle behaviours. OBJECTIVE: This pilot study aims to as...
INTRODUCTION: Optimal glycaemic control in adolescents with type 1 diabetes (T1D) is essential to prevent complications but remains challenging due to changing lifestyle behaviours. OBJECTIVE: This pilot study aims to assess whether adolescents with T1D in Ireland meet current nutrition and physical activity (PA) guidelines and to explore the impact of nutrition and PA on glycaemic variability (GV). METHODS: Seven adolescents with T1D recorded their PA, diet and blood glucose levels over seven consecutive days. GV was determined using continuous glucose monitoring (CGM) data. RESULTS: The majority of participants demonstrated low levels of PA, with 72% falling below recommended levels, and 86% consuming excessive amounts of saturated fat. Blood glucose levels were in the very high and high ranges for 23.6% ± 25.2% and 22.6% ± 7.3% of the time, respectively, with only 52.6% ± 21.8% of the time spent within the target range. Although no significant associations were found between PA or nutrition and GV, participants who met or exceeded PA and protein guidelines and consumed less fat exhibited better GV parameters. CONCLUSION: Adolescents with T1D in Ireland are not meeting recommended PA and nutrition guidelines and show poor glycaemic control. As a pilot study, the small sample size limited statistical power, but observed trends suggest that adhering to lifestyle recommendations could improve glycaemic control in this population.
Achieving Glycemic Targets in and out-of-School: Real-World Data From 1341 Italian Children Using the MiniMed 780G System During Auto Mode.
McVean J, Schiaffini R, Bassi M … +5 more , Piccini B, Voelker B, Smaniotto V, van den Heuvel T, Cohen O
Pediatr Diabetes · 2026 · PMID 41959591 · Full text
In this real-world analysis, we evaluated glycemia and insulin delivery in Italian children using the MiniMed 780G system during auto mode use, comparing days with a school routine to out-of-school (OOS) days. Data from...
In this real-world analysis, we evaluated glycemia and insulin delivery in Italian children using the MiniMed 780G system during auto mode use, comparing days with a school routine to out-of-school (OOS) days. Data from 1341 users, self-reported under 16 years old and with type 1 diabetes (T1D), showed no meaningful difference in time in range (TIR) between school days (73.4%) and OOS days (72.4%), and international targets were met on average during both types of day. Minor sensor glucose variations were observed during school hours, such as a more pronounced glucose peak after breakfast and a clearer dip before lunch on school days. The insulin delivery algorithm effectively managed these fluctuations. Maintaining optimized glycemia during both school and OOS days may enhance learning and support cognitive and brain development.
Sex-Specific BMI Trajectories in Young People With Type 1 Diabetes: A 20-Year Retrospective Regional Audit.
Oliver-Rose C, Lagera LM, Cooper A … +3 more , Hofman PL, Derraik JGB, Anderson YC
Pediatr Diabetes · 2026 · PMID 41953514 · Full text
BACKGROUND: The rates of obesity and type 1 diabetes (T1D) in children and adolescents are increasing in many settings worldwide, but data on weight gain in this group are limited in New Zealand. We examined temporal bod...
BACKGROUND: The rates of obesity and type 1 diabetes (T1D) in children and adolescents are increasing in many settings worldwide, but data on weight gain in this group are limited in New Zealand. We examined temporal body mass index (BMI) changes and associated factors in young people with T1D in a mixed urban-rural region. METHODS: This study was a 20-year retrospective audit of clinical data from a regional paediatric diabetes service (June 2000-March 2021). The primary outcome was BMI standard deviation score (BMI SDS), whose trajectories from diagnosis were examined in association with demographic and clinical factors. RESULTS: A total of 106 young people with T1D (56% male) were followed for a median of 8.3 years [Q1 = 6.1, Q3 = 11.0; maximum 15.1 years] and attended a median of 21 multidisciplinary clinic visits [Q1 = 12, Q3 = 30; range 1-56 visits]. In females, age at diagnosis modified the association between diabetes duration and BMI SDS (interaction = 0.0009). Girls diagnosed at 4.0 years (age at diagnosis 25 percentile for girls in our cohort) had no statistically significant change in BMI SDS over the first 5 years after diagnosis [-0.13 SDS (95% confidence interval [CI] -0.32 to 0.06); = 0.18], while those diagnosed at 9.5 years (75 percentile) experienced an increase of ≈0.39 SDS (0.08-0.70; = 0.014). Among males, increasing age at diagnosis was associated with lower BMI SDS ( < 0.0001), whereas there was no statistically significant association with diabetes duration ( = 0.087). At any given duration, boys diagnosed at 11.1 years (age at diagnosis 75 percentile for boys) had a BMI SDS approximately 0.70 lower (95% CI -1.02 to -0.45; < 0.0001) than those diagnosed at 4.7 years (25 percentile). CONCLUSIONS: We observed sex-specific BMI trajectories in young people with T1D, with age at diagnosis exerting variable influences on BMI SDS trajectory in boys and girls. These findings support individualised T1D management strategies within multidisciplinary care.
Treatment of Youth-Onset Type 2 Diabetes: Focus on SGLT-2 Inhibitor Use.
Arslanian S, Barrett T, Shehadeh N
Pediatr Diabetes · 2026 · PMID 41930239 · Full text
The upward trajectory of childhood and adolescent type 2 diabetes (T2D; youth-onset T2D) is a global health issue, disproportionately affecting non-white, ethnically diverse, and socioeconomically disadvantaged subgroups...
The upward trajectory of childhood and adolescent type 2 diabetes (T2D; youth-onset T2D) is a global health issue, disproportionately affecting non-white, ethnically diverse, and socioeconomically disadvantaged subgroups. Youth-onset T2D displays a more aggressive phenotype, with faster disease progression and earlier onset of severe complications when compared to adult-onset T2D. Despite this, the therapeutic options for the management of youth-onset T2D have historically been limited. Over the last few years, multiple new therapies across a range of drug classes, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, have been approved for use in youth-onset T2D. Despite this, patient recruitment to pediatric and adolescent trials remains a major challenge in youth-onset T2D, and there is currently a lack of large-scale, long-term clinical evidence for new treatment classes in this patient population. In this review, we provide an overview of the current treatment landscape in youth-onset T2D and summarize the available clinical data for SGLT-2 inhibitors in patients with youth-onset T2D, based on a targeted literature search.
Pediatric Hepatocyte Nuclear Factor 1B () Disease: Diabetes and Endocrine Manifestations.
Craven M, Bamba V, Calabria AC … +1 more , Pinney SE
Pediatr Diabetes · 2025 · PMID 41809577 · Full text
Mutations in hepatocyte nuclear factor 1B () are rare but they are known to cause structural renal disease and diabetes mellitus. There is limited data on pediatric disease. To analyze the clinical characteristics of -...
Mutations in hepatocyte nuclear factor 1B () are rare but they are known to cause structural renal disease and diabetes mellitus. There is limited data on pediatric disease. To analyze the clinical characteristics of -related disease in a cohort of children identified at a single pediatric tertiary medical center, with a specific focus on endocrine-related disease. Subjects with genetic variants were identified from the Children's Hospital of Philadelphia Atypical Diabetes Registry between 2013 and 2022. Of the 11 pediatric subjects with mutations or deletions, 7 (64%) initially presented with diabetes, sometimes referred to as MODY5, while 4 (36%) were diagnosed based on family history or a genetic evaluation of renal disease. Only one patient presented with diabetic ketoacidosis, and three presented with diabetic ketosis. Of the four children with mutations identified by familial mutation analysis or based on renal disease, two developed diabetes during the course of the study. Abnormalities in fasting lipid profiles were common: 10 with triglycerides >90 mg/dL, 5 with LDL-C >110 mg/dL, 5 with HDL-C <45, and 7/11 with non-HDL cholesterol >120 mg/dL. Over half of the subjects had hyperparathyroidism with PTH (>65 pg/mL) and a calcium concentration >9 mg/dL. This case series represents one of the largest pediatric -related disease cohorts at a single center. The majority of patients with diabetes presented with clinical features distinct from Type 1 or Type 2 diabetes. Pediatricians should consider genetic testing for mutations when children are diagnosed with diabetes and have renal abnormalities, hyperlipidemia, and hyperparathyroidism.
Epidemiological Trends and Seasonal Patterns in Childhood Type 1 Diabetes: Insights From 2001 to 2024 in Lithuania.
Stankute I, Marciulionyte D, Ostrauskas R … +6 more , Cemerkaite A, Leonaviciute G, Kemezys R, Vainiene S, Smigelskas K, Verkauskiene R
Pediatr Diabetes · 2026 · PMID 41800356 · Full text
BACKGROUND: Type 1 diabetes (T1D) incidence is rising globally, with significant regional variation. Data from highly homogeneous populations, such as Lithuanian, may contribute to a better understanding of contributing...
BACKGROUND: Type 1 diabetes (T1D) incidence is rising globally, with significant regional variation. Data from highly homogeneous populations, such as Lithuanian, may contribute to a better understanding of contributing T1D factors. This study examines 24-year trends in childhood T1D incidence and seasonal patterns in Lithuania. METHODS: The annual incidence rates (IRs) were computed utilizing established methodologies per 100,000 children <15 years. The study included 2369 (1181 boys) patients with T1D. RESULTS: During 2001-2024, the mean IR was 21.4 per 100,000 < 15 years (95% CI: 20.89, 27.28). The incidence rose from 10.8 to 36.4 per 100,000 children under 15 years of age, with notable peaks observed in 2021 and 2022, temporally aligning with the highest COVID-19 infection waves. Subgroup analysis showed the most rapid increase in young teenagers (10-14 years). Most new cases (63.5%) were diagnosed from September to March. CONCLUSIONS: This study demonstrates a rapidly increasing incidence of T1D in Lithuanian children over a 24-year period and is one of the highest in European countries. The seasonal distribution of new cases has been speculated to be due to reduced sunlight exposure and lower vitamin D levels, as well as increased school related stress and viral infections during autumn and winter months. However, additional contributing factors are likely involved, underscoring the need for further research.
Long-Term Growth Outcomes of Children With Type 1 Diabetes According to Glycemic Control and Use of Continuous Glucose Monitoring: A Retrospective Cohort Study.
Kim S, Kim SJ, Cho KW … +4 more , Song K, Choi Y, Chae HW, Suh J
Pediatr Diabetes · 2026 · PMID 41778062 · Full text
BACKGROUND: Chronic diseases such as type 1 diabetes mellitus (T1DM) may alter linear growth; however, reports regarding growth in children with T1DM have been inconsistent. This study aimed to investigate the height and...
BACKGROUND: Chronic diseases such as type 1 diabetes mellitus (T1DM) may alter linear growth; however, reports regarding growth in children with T1DM have been inconsistent. This study aimed to investigate the height and growth velocity of patients with T1DM, and whether they were affected by various factors 5 years after the diagnosis. METHODS: This retrospective study included patients with T1DM between October 2005 and May 2022, with a follow-up period of at least 1 year. Patients with diabetes, thyroid disease, celiac disease, or any other chronic disease were excluded. We compared the mean height standard deviation score (H-SDS) and growth velocity between groups divided based on glycosylated hemoglobin (HbA1c) levels and use of continuous glucose monitoring (CGM) systems. RESULTS: Among the 150 patients, 45.3% were male, with a mean age at diagnosis of 7.8 ± 3.6 years. At diagnosis, the mean H-SDS was 0.38 ± 1.11. In males, H-SDS significantly decreased overtime, with an estimated slope () of -0.054 (standard error [SE] = 0.013, 95% confidence interval [CI]: -0.079 to -0.029, < 0.01). The decline in H-SDS was more pronounced in the poorly-controlled group (mean HbA1c ≥7.0%) compared to the well-controlled group (mean HbA1c <7.0%; = -0.081, SE = 0.016, 95% CI: -0.112 to -0.050 vs. = -0.007, SE = 0.020, 95% CI: -0.047 to -0.033, < 0.01). Among males using CGM, the decrease in H-SDS over the 5-year follow-up was significantly less than that observed in the non-CGM group ( = -0.012, SE = 0.023, 95% CI: -0.057 to -0.034 vs. = -0.072, SE = 0.015, 95% CI: -0.101 to -0.042, = 0.03). In the multivariable linear mixed model analysis, younger age at diagnosis ( = -0.009, 95% CI: -0.017 to -0.002, = 0.02), female ( = 0.067, 95% CI: 0.033 to 0.100, < 0.01) and lower HbA1c levels ( = -0.026, 95% CI: -0.038 to -0.015, < 0.01) were significantly associated with greater improvement in H-SDS over 5 years. CONCLUSION: Glycemic control and CGM use positively affected linear growth in children with T1DM, especially in males. CGM use was associated with improved growth outcomes, which suggests that glucose monitoring may help mitigate the adverse effects of poor glycemic control on growth.
Real-World Experience With Control-IQ Technology in Saudi Children With Insulin-Dependent Diabetes: A Single-Center Observational Study.
Alsagheir A, Bin-Abbas B, Alsagheir R … +4 more , Alhuthil R, Aljuwair A, Alobailly NH, Almoaily S
Pediatr Diabetes · 2026 · PMID 41778061 · Full text
OBJECTIVES: The Tandem t:slim X2 insulin pump with the Control-IQ technology (Control-IQ) is an automated insulin delivery (AID) system for glycemic control but has limited data in Saudi pediatric and young adult populat...
OBJECTIVES: The Tandem t:slim X2 insulin pump with the Control-IQ technology (Control-IQ) is an automated insulin delivery (AID) system for glycemic control but has limited data in Saudi pediatric and young adult populations. We aim to evaluate the efficacy and safety of Control-IQ therapy in children with insulin-dependent diabetes and previously treated with multiple daily injections (MDIs). The primary outcome is to assess the change in HbA1c 6 months after initiating Control-IQ technology. METHODS: This prospective observational study evaluated children aged 2-14 years with insulin-dependent diabetes who transitioned from treatment with MDI to the Control-IQ technology in the diabetes clinic at the King Faisal Specialist Hospital and Research Centre (KFSHRC) in Saudi Arabia. RESULTS: A total of 100 patients (44 boys and 56 girls; median age was 11 years) were included. Most (82%) had a history of severe hypoglycemia. Following Control-IQ initiation, median HbA1c significantly decreased from 9.2% to 6.9% at 6 months (-25.0%; < 0.001), accompanied by a 24.4% reduction in the daily insulin dose. Time in range (TIR) (70-180 mg/dL) improved from 45.6% to 68.8% (+23.2%; < 0.001), while time in significant hypoglycemia (<54 mg/dL) decreased by 88.9% ( < 0.001). At 6 months, 83% achieved ≥60% TIR, and 54% reached ≥70%. Adherence and engagement were high, with no severe hypoglycemia or discontinuations. Only 3% experienced mild/moderate ketoacidosis due to technical issues in the Control-IQ. CONCLUSIONS: The findings demonstrated that Control-IQ technology is both effective and safe in improving glycemic outcomes in children with insulin-dependent diabetes in a real-world clinical setting. However, successful implementation requires comprehensive training and continuous support.
The Mediating Effects of Diabetes Self-Management on the Relationship Between Diabetes Distress and Quality of Life Among School-Age Children With Type 1 Diabetes Mellitus During the COVID-19 Pandemic.
Luo J, Li Q, Gao Y … +5 more , Liu F, Zhong J, Ho KY, Whittemore R, Guo J
Pediatr Diabetes · 2026 · PMID 41726151 · Full text
BACKGROUND: Diabetes distress is prevalent among youth with type 1 diabetes mellitus (T1DM) and can negatively impact their quality of life and metabolic control. Identifying modifiable factors to reduce this distress is...
BACKGROUND: Diabetes distress is prevalent among youth with type 1 diabetes mellitus (T1DM) and can negatively impact their quality of life and metabolic control. Identifying modifiable factors to reduce this distress is crucial. This study investigates the interplay between diabetes distress, self-management, and quality of life in school-aged children with T1DM amidst the COVID-19 pandemic. Its primary objective is to identify modifiable factors that can assist these children as they navigate the challenges associated with transitioning into adolescence. METHODS: A cross-sectional study with data from 341 Chinese school-age children aged 8-12 was conducted. Data were collected through an online self-report survey during the COVID-19 pandemic (June-December 2022). The data included sociodemographic and clinical characteristics, diabetes distress, diabetes care activities and diabetes problem solving of diabetes self-management and quality of life. Structural equation modeling assessed relationships and mediation effects. RESULTS: All four domains of diabetes distress exhibited negative associations with quality of life ( = -0.74 to -0.77, < 0.01). Care activities and problem-solving related to diabetes self-management mediated the associations of emotional burden and regimen-related distress with quality of life (both < 0.05). Conversely, neither diabetes care activities nor diabetes problem-solving mediated the relationship between physician-related distress and quality of life. CONCLUSIONS: Our findings indicate that problem-solving techniques related to diabetes self-management might be more effective at alleviating various aspects of diabetes distress-such as emotional burden, regimen-related distress, and interpersonal distress-compared to diabetes care activities. Interventions that teach structured problem-solving strategies could be beneficial. Given the ongoing pandemic, these findings could also serve as useful guidance for developing support strategies for school-age children with chronic conditions during future public health emergencies.
Association Between Celiac Disease and Uncontrolled Hemoglobin A1c Levels in Type 1 Diabetes Pediatric Patients.
Lin A, Jankowski M, Qu S … +3 more , Uhley V, Brennan M, Homayouni R
Pediatr Diabetes · 2026 · PMID 41695839 · Full text
BACKGROUND: Celiac disease (CD) occurs in ~6% of individuals with type 1 diabetes (T1D) and may complicate glycemic control due to conflicting dietary needs. Prior studies show mixed results regarding the impact of CD on...
BACKGROUND: Celiac disease (CD) occurs in ~6% of individuals with type 1 diabetes (T1D) and may complicate glycemic control due to conflicting dietary needs. Prior studies show mixed results regarding the impact of CD on Hemoglobin A1c (HbA1c), especially in pediatric populations. This study evaluates whether CD is associated with suboptimal glycemic control in pediatric patients with T1D. METHODS: This retrospective chart review analyzed pediatric patients (<18 years) diagnosed with T1D between 2012 and 2023 across Corewell Health East. Patients were identified via ICD-10 codes and stratified by CD status and glycemic control (controlled HbA1c <7% vs. uncontrolled HbA1c ≥7%). Statistical analyses include chi-square or Fisher's exact tests for categorical variables, Wilcoxon tests for continuous variables, and logistic regression for multivariable analysis. RESULTS: Among 2,203 pediatric patients with T1D, 101 (4.6%) had CD. Patients with both conditions were younger at T1D diagnosis (median age 9 vs. 12 years, < 0.0001) and had more HbA1c measurements. A higher proportion of CD patients had uncontrolled diabetes (89.1% vs. 73.8%, = 0.0006). CD was independently associated with uncontrolled HbA1c (adjusted OR: 2.59; 95% CI: 1.37-4.90; = 0.003) after adjusting for age, sex, and race. Younger age and Black race were also associated with higher odds of uncontrolled diabetes. CONCLUSION: CD is significantly associated with poorer glycemic control in pediatric patients with T1D, independent of age, race, and sex. These findings suggest the need for closer monitoring, individualized dietary counseling, and targeted interventions in this high-risk group.
Is the Current Screening Availability for Early Stages of Type 1 Diabetes in Germany Related to the Population-Based Frequency of Diabetic Ketoacidosis at Clinical Manifestation in Children and Adolescents.
Eckert AJ, Rosenbauer J, Kamrath C … +18 more , Sindichakis M, Thimm A, Holder M, Weiskorn J, Lorenz DP, Gonzalves S, Gemulla G, Golembowski S, Ohlenschläger U, Hüseman D, Palm K, Lemmer A, Lahn V, Müller A, Wurm D, Wütherich M, Holl RW, DPV-Wiss-Initiative
Pediatr Diabetes · 2026 · PMID 41669248 · Full text
AIMS: Is the current screening for early-stage type 1 diabetes (T1D) associated with the rate of diabetic ketoacidosis (DKA) at T1D manifestation at population level? MATERIALS AND METHODS: Children with T1D manifestatio...
AIMS: Is the current screening for early-stage type 1 diabetes (T1D) associated with the rate of diabetic ketoacidosis (DKA) at T1D manifestation at population level? MATERIALS AND METHODS: Children with T1D manifestation in 2015-2023 in Germany, aged 0.5 to <15 years from the multicenter diabetes registry (DPV) were included and allocated to federal states (FSs) based on their residential postal code. The relative risk (RR) with 95% confidence interval for DKA at manifestation of T1D by FS with vs. without screening, and demographic/context factors was calculated using logistic regression models. RESULTS: 24,408 children (54.3% males) were included with median onset age of 8.8 (quartiles: 5.3; 11.8) years. The RR for DKA was not significantly lower in FS with vs. without screening (RR: 0.96 [0.93-1.03], = 0.393) overall, but in the sub-group of children with the highest probability of being screened (age 1.75-10.99 years, manifestation in Bavaria from 2020 to 2023, RR: 0.88 [0.80-0.97], = 0.012). The most important predictor for DKA was manifestation age <3 years (RR: 1.83, [1.66-2.03], < 0.001). CONCLUSIONS: Until 2023, current regional screening initiatives for early-stage T1D were not associated with lower frequency of DKA at population level, but might be helpful in the future if the coverage can be markedly increased.
Apelin and Myostatin Levels in Adolescents With Type-1-Diabetes.
Cohen M, Weiss L, Weiss R … +2 more , Shehadeh N, Khamaisi M
Pediatr Diabetes · 2025 · PMID 41585414 · Full text
Myokines are secreted by skeletal muscle and play a role in their metabolic function and crosstalk with various tissues. Myokines appear to be involved in the pathogenesis of obesity and type 2 diabetes (T2D), yet little...
Myokines are secreted by skeletal muscle and play a role in their metabolic function and crosstalk with various tissues. Myokines appear to be involved in the pathogenesis of obesity and type 2 diabetes (T2D), yet little is known regarding their function in type 1 diabetes (T1D). To assess the levels and clinical correlates of a panel of five myokines, comparing adolescents with recent-onset T1D, prolonged disease, and healthy controls. Fifty-eight adolescents participated; 20 with recent-onset T1D, 20 with over 7 years of T1D, and 18 healthy controls were included. Clinical and laboratory data were collected, including levels of Apelin, Irisin, Interleukin-6 (IL-6), Fibroblast growth factor 21 (FGF21), and Myostatin. Apelin levels were lower in patients with prolonged T1D compared with patients with recent-onset T1D and controls, (117.9 ± 94.3, 228.3 ± 181.6, and 224.4 ± 138.4 pg/ml, respectively; analysis of variance (ANOVA) = 0.029). Other myokines did not differ significantly between groups. Apelin levels correlated with fasting C-peptide levels ( 0.337, = 0.010). In patients with prolonged T1D, myostatin positively correlated with insulin doses (total daily dose 0.590, = 0.006 and basal daily dose 0.645, = 0.002). Both apelin and myostatin levels negatively correlated with the diastolic blood pressure (BP) percentile ( - 0.324, = 0.013; = - 0.302, = 0.024, respectively). Our results demonstrate lower levels of apelin, a myokine related to the beneficial metabolic effects of skeletal muscle, in prolonged T1D. The correlations of apelin with C-peptide and myostatin with insulin doses may reflect a relationship with beta-cell function and insulin sensitivity.
Maternal Autoimmune Disease and Childhood-Onset Type 1 Diabetes: A Nationwide Population-Based Nested Case-Control Study.
Yen HC, Lin CH, Lin MC
Pediatr Diabetes · 2026 · PMID 41573056 · Full text
INTRODUCTION: Type 1 diabetes mellitus (T1DM) is an autoimmune disease that damages insulin-producing pancreatic cells, often appearing in childhood. Global incidence is rising at 2%-3% yearly. Its exact cause is unclear...
INTRODUCTION: Type 1 diabetes mellitus (T1DM) is an autoimmune disease that damages insulin-producing pancreatic cells, often appearing in childhood. Global incidence is rising at 2%-3% yearly. Its exact cause is unclear. Prenatal exposures and maternal autoimmune disorders have been reported as potential risk factors. This study aimed to explore how maternal autoimmune conditions might correlate with the onset of T1DM, employing a population-focused approach. METHODS: This is a retrospective population-based cohort study with a nested case-control analysis. Primary data were derived from the Maternal and Child Health Database (MCHD) and the National Health Insurance Research Database (NHIRD). This study enrolled a total of 2,036,051 newborns born between 2004 and 2014. They were followed up until the end of 2020. A total of 1273 children under the age of 17 with T1DM were identified from 2004 to 2020. A 1:10 control group, matched by birth date and sex, was selected for comparison. T1DM patients were identified through the Catastrophic Illness Registry Database. Maternal autoimmune diseases were determined using the primary diagnosis codes for hospitalizations and outpatients' visits. RESULTS: After adjusting for cofactors, the offspring of mothers with an autoimmune disease had a higher risk of T1DM (adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI]: 1.45-2.63, < 0.001). For individual autoimmune diseases, T1DM (aOR: 6.81, 95% CI: 2.30-20.16, < 0.001), Hashimoto thyroiditis (aOR: 3.75, 95% CI: 1.85-7.60, < 0.001), rheumatoid arthritis (aOR: 2.49, 95% CI: 1.08-5.77, = 0.033), and Graves' disease (aOR: 1.85, 95% CI: 1.14-2.99, = 0.013) significantly increase the risk of developing T1DM in their children. CONCLUSIONS: Offspring of mothers diagnosed with autoimmune disease, notably T1DM, autoimmune thyroiditis, and rheumatoid arthritis, may indeed have a heightened likelihood of developing T1DM. These findings underscore the importance of targeted screening programs for T1DM in children of affected mothers.
From Pathophysiology to Treatment: Contemporary Approaches to CFRD in the Pediatric and Adolescent Population.
Vuralli D
Pediatr Diabetes · 2026 · PMID 41552835 · Full text
Cystic fibrosis-related diabetes (CFRD) is the most prevalent nonrespiratory complication of cystic fibrosis (CF), with its prominence growing as survival rates improve due to advances in CFTR modulator therapies. Its pr...
Cystic fibrosis-related diabetes (CFRD) is the most prevalent nonrespiratory complication of cystic fibrosis (CF), with its prominence growing as survival rates improve due to advances in CFTR modulator therapies. Its prevalence increases with age, affecting nearly 50% of patients with CF (PwCF) over 30 years old. CFRD primarily results from progressive pancreatic fibrosis leading to insulin deficiency, further compounded by intermittent insulin resistance during pulmonary exacerbations and systemic inflammation. Key risk factors include pancreatic insufficiency, female sex, severe genotypes (such as p.F508del homozygosity), CF-related liver disease, and family history of type 2 diabetes. The early stages of CFRD are often asymptomatic, necessitating proactive screening. Annual oral glucose tolerance tests (OGTT) beginning at age 10 are challenging to perform but remain the gold standard for early detection, while continuous glucose monitoring (CGM) is increasingly recognized as a valuable complementary tool. Diagnosis is based on standard OGTT criteria, with indeterminate glycemia (INDET) and impaired glucose tolerance (IGT) recognized as prediabetic stages requiring close monitoring. Even early abnormalities in glucose metabolism may be associated with declines in pulmonary function and nutritional status, underscoring the need for rigorous surveillance and timely therapeutic intervention. Early initiation of insulin treatment can substantially mitigate these complications and improve clinical outcomes. Insulin remains the cornerstone of CFRD management, is recommended as the primary treatment for patients with CFRD (PwCFRD) rather than dietary modification alone. While pilot studies and observational cohorts have suggested potential benefits of early insulin treatment in individuals with early glycemic abnormalities such as INDET or IGT, findings from randomized controlled trials do not provide evidence to justify initiating insulin before CFRD is established. Management strategies should be individualized, with personalized glycemic targets. Insulin dosing aims to achieve the maximum tolerable dose to maintain a low HbA1c, control postprandial hyperglycemia without inducing hypoglycemia, minimize catabolism, and preserve optimal nutrition and pulmonary health without restricting carbohydrate intake. Regular glucose monitoring, quarterly HbA1c measurements, and annual screening for microvascular complications starting 5 years after diagnosis are essential to optimize outcomes. The advent of CFTR modulator therapies has revolutionized CF care, significantly improving outcomes and quality of life for PwCF. These therapies also show promise in improving glucose regulation and may impact the prevalence, onset, and course of CFRD. However, current data remain inconclusive, and the long-term effects are still being elucidated. Future directions in CFRD research include refining screening protocols, exploring adjunctive noninsulin therapies, and developing predictive biomarkers. This review summarizes the current understanding of CFRD pathophysiology, diagnosis, and management strategies, emphasizing the importance of early intervention and personalized care in the context of evolving CF treatment approaches and their potential to improve prognosis for PwCF.
The Use of Dapagliflozin in the Treatment of Children With Severe Insulin Resistance.
Attia N, Al Noaim K, Mustafa M … +4 more , Al Fifi SH, Al Alwan I, Thalange N, Babiker A
Pediatr Diabetes · 2025 · PMID 41424588 · Full text
BACKGROUND: Managing severe insulin resistance (IR) is challenging, necessitating a multifaceted approach, including dietary restriction, exercise, and pharmacotherapy. This paper will detail our utilization of dapaglifl...
BACKGROUND: Managing severe insulin resistance (IR) is challenging, necessitating a multifaceted approach, including dietary restriction, exercise, and pharmacotherapy. This paper will detail our utilization of dapagliflozin in a series of cases involving patients with severe IR of various etiology and inadequate glycemic control. CASE STUDIES: We describe six cases of extreme IR with distinct clinical diagnoses: four with Rabson-Mendenhall syndrome (RMS), one with IR type 1A, and a patient with type 1 diabetes mellitus (T1DM) and severe subcutaneous (SC) IR. These cases exhibit the observable characteristics of IR, characterized by an inability to effectively manage blood glucose (BG) with a standard treatment plan. Every case had a remarkable response to dapagliflozin. Subsequent assessment demonstrated improved HgbA1C, fasting glucose, insulin, and C-peptide concentrations. Furthermore, several cases demonstrated improvement in the clinical manifestations of IR following the administration of dapagliflozin, while others showed a reduction in the frequency of diabetic ketoacidosis (DKA). There were no documented adverse reactions with the use of dapagliflozin for a duration of 2-4 years in these patients. CONCLUSION: Dapagliflozin appeared both safe and effective as a standalone treatment or when used alongside other antidiabetes medications such as insulin in a case series of children with T1DM and severe IR or IR syndromes (IRS).
Examining the Cognitive, Practical, and Emotional Demands of Managing Physical Activity in Adolescents With Type 1 Diabetes: A Qualitative Study With Adolescents, Parents, and Healthcare Professionals.
Cockcroft EJ, Smith JR, Lloyd J … +8 more , Johnson L, Pulsford R, Clarke R, Narendran P, Gardener G, Ngamy T, Dias RP, Andrews RC
Pediatr Diabetes · 2025 · PMID 41424587 · Full text
OBJECTIVE: Adolescents with type 1 diabetes (T1D) face unique barriers to physical activity (PA), and most do not meet recommended targets despite its recognised health benefits. To address the lack of tailored, evidence...
OBJECTIVE: Adolescents with type 1 diabetes (T1D) face unique barriers to physical activity (PA), and most do not meet recommended targets despite its recognised health benefits. To address the lack of tailored, evidence-based support for this group, this study explores how adolescents manage PA and how it is influenced by the wider support system, including parents, carers, and healthcare professionals (HCPs). RESEARCH DESIGN AND METHODS: Semi-structured interviews were conducted with adolescents with T1D ( = 11), parents/carers ( = 15), and HCPs ( = 11). Adolescents were aged between 12 and 18 (64% female). HCPs were dieticians ( = 7), nurses ( = 2), a doctor ( = 1) and a health and wellbeing practitioner ( = 1). Interviews explored practical, emotional, and contextual factors influencing PA. Data were analysed using thematic analysis. RESULTS: Participants described cognitive, emotional, and practical demands of managing T1D during PA. Thematic analysis identified three overarching themes: (1) the mental effort required to manage diabetes with PA, including parental anxiety, desire for normality, and unpredictability of glucose responses; (2) practical and organisational challenges, such as access to supportive environments, technology, and activity-specific logistics; and (3) adaptive management strategies, including trial and error, parental involvement, peer learning, and variable clinical support. Current support was often generic, leading families to rely on self-devised strategies and informal networks to support their individual needs. CONCLUSION: Enhanced, youth-friendly, and activity-specific guidance is needed for adolescents with T1D. This should include training for healthcare professionals, teachers, and coaches. Future work should prioritise the co-design of resources and interventions with young people and families, integrating structured peer support.
The Effect of COVID-19 on Incident Diabetes in Pediatric Patients: Findings From the National COVID-19 Cohort Collaborative (N3C).
Wong R, Wiggen T, Hall MA … +11 more , Johnson SG, Huling JD, Turner LE, Wilkins KJ, Yeh HC, Stürmer T, Bramante CT, Butzin-Dozier Z, Buse JB, Reusch J, N3C Consortium
Pediatr Diabetes · 2025 · PMID 41409341 · Full text
OBJECTIVE: Studies showing increased diabetes incidence in pediatric patients after COVID-19 are from data early in the pandemic, and some studies found conflicting results. Our objective was to evaluate trends in pediat...
OBJECTIVE: Studies showing increased diabetes incidence in pediatric patients after COVID-19 are from data early in the pandemic, and some studies found conflicting results. Our objective was to evaluate trends in pediatric diabetes incidence and whether COVID-19 was associated with increased risk across viral variant periods. RESEARCH DESIGN AND METHODS: We conducted a retrospective cohort study using National COVID-19 Cohort Collaborative data to evaluate incident diabetes risk among COVID-19-positive pediatric patients compared to COVID-19-negative patients or controls with acute respiratory illness. Cohorts were weighted on demographics, data site, and body mass index percentile. The primary outcome was the cumulative incidence ratio (CIR) of incident diabetes for each viral variant era. RESULTS: There was no difference in the risk of incident diabetes in pediatric patients after COVID-19 compared to patients in COVID-19 negative or ARI control groups during any of the viral variant periods (e.g., ancestral period CIR 1.03, 95% CI 0.65-1.41). The predominant subtype of incident diabetes was T2D. Incidence rates over time followed a U-shaped curve, with the highest incidence in the ancestral variant period. CONCLUSIONS: COVID-19 was not associated with an increased risk of diabetes in pediatric patients. Incidence rates were highest early in the pandemic, and mirrored patterns of pandemic-era healthcare utilization. The predominance of incident T2D subtype is concerning for the adverse effects of pandemic-related lifestyle changes among pediatric patients.
Exploring the Influence of a Diabetes Specialty Outpatient Clinic on Adolescents With Type 1 Diabetes in Barbados: A Qualitative Study.
Benskin GA, Lashley PM
Pediatr Diabetes · 2025 · PMID 41383447 · Full text
OBJECTIVES: This study explored the perceptions of adolescents with type 1 diabetes mellitus (T1DM) regarding their self-management and the impact of a diabetes specialty outpatient clinic on their quality of life (QOL)...
OBJECTIVES: This study explored the perceptions of adolescents with type 1 diabetes mellitus (T1DM) regarding their self-management and the impact of a diabetes specialty outpatient clinic on their quality of life (QOL) in Barbados. DESIGN: A qualitative, descriptive-interpretive study using semi-structured online interviews. SETTING: Paediatric diabetes specialty outpatient clinic at the Queen Elizabeth Hospital (QEH), Barbados. PARTICIPANTS: Twelve adolescents aged 13-17 years with T1DM for > 1 year who attended the diabetes specialty outpatient clinic for at least 6 months. METHODS: Interviews were transcribed verbatim, coded using ATLAS.ti 23, and analysed thematically using a constant comparison approach. RESULTS: Three organising themes-autonomy, internal resilience and clinic and social support-contributed to the global theme of diabetic health literacy. Participants demonstrated varied levels of diabetes self-management confidence. Clinic interactions, family support and peer understanding were key influences on autonomy and resilience. Adolescents identified a need for age-appropriate communication and psychosocial support. CONCLUSIONS: Diabetic health literacy among Barbadian adolescents is influenced by clinical support, psychosocial resources, and educational strategies. Adolescents' autonomy should be fostered through youth-centred approaches that enhance self-efficacy and support transition readiness.
Revealing Monogenic Diabetes: Clinical and Genetic Features of Pediatric MODY Cases in Türkiye: Single Center Experience.
Sanri A, Cetin TK, Acikgoz EG … +2 more , Mutlu MB, Sezer O
Pediatr Diabetes · 2025 · PMID 41367630 · Full text
OBJECTIVE: Maturity-onset diabetes of the young (MODY) represents a genetically and clinically heterogeneous form of monogenic diabetes caused by defects in pancreatic β-cell function. Accurate molecular diagnosis is ess...
OBJECTIVE: Maturity-onset diabetes of the young (MODY) represents a genetically and clinically heterogeneous form of monogenic diabetes caused by defects in pancreatic β-cell function. Accurate molecular diagnosis is essential for distinguishing MODY from type 1 and type 2 diabetes, enabling precision-based management and targeted therapy. This study aimed to evaluate the genetic and clinical features of pediatric patients with MODY, to assess the prevalence of common and rare subtypes, and to report novel pathogenic variants identified in a Turkish cohort. METHODS: This single-center, retrospective cohort study evaluated 81 pediatric patients with suspected MODY followed between 2022 and 2025. Genetic analysis was performed using targeted next-generation sequencing (NGS) panels, including , , , , , , , , , , and . Patients were selected based on the presence of at least two clinical features suggestive of MODY, as defined by the 2022 International Society for Pediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines. Demographic, biochemical, and clinical data were extracted from hospital records and analyzed descriptively. RESULTS: Genetic variants were identified in 25 of 81 patients (30.9%), including pathogenic, likely pathogenic, and variants of uncertain significance (VUS). Of these, 22 variants were classified as pathogenic or likely pathogenic, corresponding to a diagnostic yield of 27.2%. The most frequently affected gene was (72.0%), followed by (8.0%), with single cases identified in , , , , . Rare MODY subtypes collectively accounted for 20.0%. Three novel variants c.1055T >C, c.1229A >C, and c.185_186insA were identified. One patient with syndromic features harbored a heterozygous 17q12 microdeletion encompassing , approximately 1.5 Mb in size, and presented with global developmental delay, intellectual disability, epilepsy, dysmorphic facial features, persistent hypomagnesemia, and a bicornuate uterus with normal renal structure. Following genetic analysis, two patients had therapy adjustments based on the identified variants. CONCLUSION: This study underscores the clinical and genetic heterogeneity of MODY in the pediatric population and reinforces the value of comprehensive NGS panels for accurate diagnosis, even in patients who do not fully meet classical MODY criteria. The identification of novel variants and the detection of rare subtypes further expand the mutational and phenotypic spectrum of pediatric monogenic diabetes. These findings highlight the importance of incorporating population-specific genomic data into clinical practice and of periodically re-evaluating gene-disease associations as new molecular and functional evidence emerges. Ultimately, the integration of molecular diagnostics into routine pediatric diabetes care will enhance diagnostic yield, optimize management, and improve long-term outcomes for affected families.
Global Prevalence of Microvascular Complications in Children and Adolescents With Type 1 and Type 2 Diabetes: A Systematic Review and Meta-Analysis.
Ezzatvar Y, Hormazábal-Aguayo I, Muñoz-Pardeza J … +3 more , Páez-Herrera J, Yáñez-Sepúlveda R, García-Hermoso A
Pediatr Diabetes · 2025 · PMID 41346657 · Full text
AIM: To quantify the prevalence of microvascular complications of children and adolescents with type 1 and type 2 diabetes by performing a meta-analysis of observational studies. METHODS: A systematic search in PubMed, E...
AIM: To quantify the prevalence of microvascular complications of children and adolescents with type 1 and type 2 diabetes by performing a meta-analysis of observational studies. METHODS: A systematic search in PubMed, EMBASE, and Web of Science was performed from 2000 to August 2025. Studies that reported the prevalence of microvascular complications in children and adolescents with diabetes were included. Study characteristics and prevalence estimates were extracted from each study. Pooled prevalence rates for microvascular complications were calculated using a random-effects model with Freeman-Tukey double arcsine transformation to stabilize variance. RESULTS: A total of 57 studies were included, comprising 51,819 children and adolescents diagnosed with diabetes (type 1: = 44,150 and type 2: = 7,669), with a mean age of 14.5 and 15.2 years old, respectively. Pooled prevalence of complications in youth with type 1 vs. type 2 diabetes was 22.07% (95% CI: 16.86-27.75) vs. 11.04% (95% CI: 2.73-23.45) for peripheral neuropathy, 31.98% (95% CI: 11.13-57.44) vs. 15.37% (95% CI: 3.09-34.29) for autonomic neuropathy, 13.76% (95% CI: 6.43-23.24) vs. 2.97% (95% CI: 0.00-10.33) for retinopathy, and 13.70% (95% CI: 10.25-17.54) vs. 12.63% (95% CI: 7.99-18.07) for nephropathy, with high heterogeneity across studies and no significant differences between diabetes types. Meta-regression analyses showed no significant associations between complication prevalence and HbA1c, diabetes duration, lipid levels, cohort year, or age. CONCLUSIONS/INTERPRETATION: Microvascular complications affect at least one in 10 youths with diabetes before age 20, with similar prevalence in type 1 and type 2 diabetes. Given the high rates and early onset, routine screening and early intervention are essential for all young people with diabetes to prevent or limit progression of vascular damage, regardless of diabetes type, glycemic stability, or disease duration.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe