Abstract:
OBJECTIVE:To describe insulin pump use by youth since introduction of universal funding in Ontario, Canada and to explore the relationship between pump use and pediatric diabetes center characteristics and the relationship between discontinuation and center and patient characteristics. RESEARCH DESIGN AND METHODS:Observational, population-based cohort study of youth with type 1 diabetes (<19 yr) who received pump funding from 2006 to 2013 (n = 3700). We linked 2012 survey data from 33 pediatric diabetes centers to health administrative databases. We tested the relationship between center-level pump uptake and center characteristics (center type, physician model, and availability of 24-h support) using an adjusted negative binomial model; we studied center- and patient-level factors (socioeconomic status and baseline glycemic control) associated with discontinuation using a Cox proportional hazards model with generalized estimating equations. RESULTS:Pump users were more likely to be in the highest income quintile than non-pump users (29.6 vs. 19.1%, p < 0.0001). In 2012, mean percent pump use was 38.0% with variability across centers. There was no association between uptake and center characteristics. Discontinuation was low (0.42/100 person-yr) and was associated with being followed at a small community center [hazard ratio (HR): 2.24 (1.05-4.76)] and being more deprived [HR: 2.36 (1.14-1.48)]. Older age was associated with a lower rate of discontinuation [HR: 0.31 (0.14-0.66)]. CONCLUSIONS:Rates of pump use have increased since 2006 and discontinuation is rare. Large variation in uptake across centers was not explained by the factors we examined but may reflect variation in patient populations or practice patterns, and should be further explored.
journal_name
Pediatr Diabetesjournal_title
Pediatric diabetesauthors
Shulman R,Stukel TA,Miller FA,Newman A,Daneman D,Guttmann Adoi
10.1111/pedi.12353subject
Has Abstractpub_date
2017-02-01 00:00:00pages
33-44issue
1eissn
1399-543Xissn
1399-5448journal_volume
18pub_type
杂志文章abstract:OBJECTIVE:To explore the outcomes of monthly video consultations for children with diabetes. METHODS:The Virtual Outpatient Diabetes Clinic for Children and Youth (VIDIKI) was a 6-month multicenter controlled clinical trial followed by an extension phase. The 240 participants (1-16 years), all using a CGM, were quasi-...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.13133
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Although insulin analogs have dramatically changed diabetes treatment, scarce evidence is available on those effects. We aimed to explore whether glycemic control had improved, the use of insulin analogs had been increased, and hypoglycemic events had decreased over time in Japanese pediatric patients with ty...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12409
更新日期:2017-09-01 00:00:00
abstract:AIMS:Children with type 1 diabetes (T1D) risk and islet autoantibodies are recruited to a secondary prevention study. The aims were to determine metabolic control in relation to human leukocyte antigen (HLA) genetic risk and islet autoantibodies in prepubertal children. METHODS:In 47 healthy children with GADA and at ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12023
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Type 1 diabetes (T1D) mellitus and obesity are recognized risk factors for cardiovascular disease (CVD). A common mechanism underlying an increased risk for endothelial dysfunction in these two metabolic diseases is oxidative stress. OBJECTIVE:To evaluate and compare the oxidant/antioxidant defense systems ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2009.00565.x
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:We set out to explore associations between the stool bacteriome profiles and early-onset islet autoimmunity, taking into account the interactions with the virus component of the microbiome. METHODS:Serial stool samples were longitudinally collected from 18 infants and toddlers with early-onset islet autoimm...
journal_title:Pediatric diabetes
pub_type: 杂志文章,多中心研究
doi:10.1111/pedi.12468
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Mild hypoglycemia is commonly observed in children treated for type 1 diabetes mellitus (T1DM). Hypoglycemia disturbs cognition and learning. OBJECTIVE:To describe how and to what extent hypoglycemia in young children with T1DM is detected in everyday life. To learn how parents and caregivers treat hypoglyc...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12057
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Type 1 diabetes is an autoimmune disease occurring in genetically susceptible individuals. The precipitating cause is unclear. Recently, the Second Lebanon War exposed a large civilian population in northern Israel to significant psychological stress in the form of repeated barrages of missile attacks. HYPO...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2011.00838.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:Mothers of youth with type 1 diabetes experience increased levels of stress and depression related to the burden of diabetes management, but the concept of diabetes distress, or distress linked specifically to diabetes and its management, has not been applied to mothers. The current study examined diabetes di...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12350
更新日期:2017-02-01 00:00:00
abstract:AIMS:The cardiovascular risk factor profile of a child as well as the development of body weight are influenced by genetic and childhood factors. Circulating insulin concentrations reflect the metabolic cardiovascular risk and may trigger weight gain. We aimed at identifying parental and childhood factors which may inf...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12109
更新日期:2014-09-01 00:00:00
abstract::Beta cell replacement is a valid alternative to exogenous insulin injections to treat type 1 diabetic patients. The rate of success obtained after whole-pancreas transplantation, performed alone or in combination with kidney, and, as shown recently, by islet transplantation, justifies optimism and sets the stage for a...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1034/j.1399-5448.2002.30408.x
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:Proinsulin is a marker of beta-cell distress and dysfunction in type 2 diabetes and transplanted islets. Proinsulin levels are elevated in patients newly diagnosed with type 1 diabetes. Our aim was to assess the relationship between proinsulin, insulin dose-adjusted haemoglobin A1c (IDAA1C), glucagon-like pep...
journal_title:Pediatric diabetes
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1399-5448.2011.00812.x
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Alterations in glucose metabolism that lead to the development of metabolic and cardiovascular disease may begin already in childhood. OBJECTIVE:This study aims to generate pediatric age and sex-specific reference values for fasting concentrations of glucose, hemoglobin A1c (HbA1c), insulin, C-peptide, and ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12859
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:Avoiding complications is paramount in diabetes management, but little is known about how, when, and what diabetes professionals disclose to parents and youths about this topic. RESEARCH DESIGN AND METHOD:Pediatric diabetes experts (n = 534) were surveyed about their practices and attitudes regarding informi...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2008.00438.x
更新日期:2009-02-01 00:00:00
abstract::Type 1 diabetes is the most common form of diabetes in most part of the world, although reliable data are still unavailable in several countries. Wide variations exist between the incidence rates of different populations, incidence is lowest in China and Venezuela (0.1 per 100,000 per year) and highest in Finland and ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2007.00280.x
更新日期:2007-10-01 00:00:00
abstract::This review highlights the evidence of linking small for gestational age (SGA) with metabolic/cardiovascular disturbances (dysmetabolic syndrome) in later life. The metabolic and cardiovascular complications associated with in utero undernutrition have been identified during the past 10 yr. Reduced fetal growth is ind...
journal_title:Pediatric diabetes
pub_type: 杂志文章,评审
doi:10.1111/j.1399-543X.2004.00057.x
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:The Environmental Determinants of Diabetes in the Young (TEDDY) study seeks to identify environmental triggers of autoimmunity and type 1 diabetes mellitus (T1DM) in children at increased human-leukocyte-antigen conferred genetic risk for this disease. The objective of this study was to identify predictors of...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2010.00686.x
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Treatments have failed to delay or stop the autoimmune process, preceding onset of type 1 diabetes. We investigated if autoantigen-specific treatment with alum-formulated glutamate decarboxylase (GAD-Alum) was safe and affected progression to type 1 diabetes in children with islet autoimmunity. METHODS:In an...
journal_title:Pediatric diabetes
pub_type: 杂志文章,随机对照试验
doi:10.1111/pedi.12611
更新日期:2018-05-01 00:00:00
abstract::The aim of this study was to examine secular trends in the incidence of type 1 diabetes in children aged 0-14 yr in Hungary over the period 1989-2009. Newly diagnosed children with type 1 diabetes aged 0-14 yr in Hungary were prospectively registered from 1989 to 2009. Primary ascertainment of cases was by prospective...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2011.00826.x
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To determine the HLA-DRB1, DQB1, DPB1, A, C, and B genotypes among Japanese children with autoimmune type 1 diabetes. METHODS:Four hundred and thirty patients who were GADAb and/or IA-2Ab-positive (Type 1A) were recruited from 37 medical centers as part of a nationwide multicenter collaborative study. DNA sa...
journal_title:Pediatric diabetes
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1399-5448.2011.00833.x
更新日期:2012-02-01 00:00:00
abstract::A subgroup of diabetic patients presents with features typical of type 1 diabetes, but over months to years has variable insulin requirements and develops features of type 2 diabetes. This subgroup is referred to as atypical diabetes mellitus (ADM). Over a span of 50 yr, reports on disease epidemiology, clinical chara...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1046/j.1399543x.2000.010409.x
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:The incidence of type 1 diabetes mellitus (T1DM) among children and adolescents increased during the last 50 yr. The T1DM incidence in Croatia was 8.87/100.000/yr over 1995-2003, with an annual increase of 9%, which placed Croatia among countries with moderate risk for T1DM. AIM:To investigate incidence rat...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12197
更新日期:2015-09-01 00:00:00
abstract::Although the factors responsible for the recent increase in the prevalence of diabetes worldwide are not entirely known, the morbidity associated with this disease results in substantial health and economic burden on society. Epigenetic modifications, including DNA methylation have been identified as one mechanism by ...
journal_title:Pediatric diabetes
pub_type: 杂志文章,评审
doi:10.1111/pedi.12521
更新日期:2017-05-01 00:00:00
abstract::Inactivating mutations in the pancreatic beta cell ATP-sensitive potassium (K(ATP) ) channel genes are identified by sequencing in approximately 80% of patients with diazoxide-unresponsive hyperinsulinaemic hypoglycaemia (HH). Genetic testing is clinically important as the mode of inheritance of a K(ATP) channel mutat...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2011.00821.x
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:The current study examined how a comprehensive set of variables from multiple domains, including at the adolescent and family level, were predictive of glycemic control in adolescents with type 1 diabetes (T1D). METHODS:Participants included 100 adolescents with T1D ages 10-16 yrs and their parents. Particip...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12331
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To evaluate an ambulatory, portable prototype, overnight automated closed-loop (CL) system and to explore optimal time of CL initiation. METHODS:We performed a randomized crossover study and compared automated overnight glucose control started at the time of an evening-meal or at bedtime. Eight young people ...
journal_title:Pediatric diabetes
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-5448.2012.00903.x
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:In the non-diabetic population, intramyocellular lipid (IMCL) accumulation is associated with obesity and poor muscle oxygen supply. IMCL levels are increased in type 1 diabetes, but their significance is less clear. METHODS:We studied a group of 16 prepubertal boys (age 6.4-9.9 yr) with type 1 diabetes and...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1034/j.1399-5448.2003.00021.x
更新日期:2003-09-01 00:00:00
abstract::Hypoglycemia is an inevitable consequence of the treatment of type 1 diabetes in childhood. Nocturnal hypoglycemia is often considered as merely the submerged part of this serious complication yet there are reasons to believe that hypoglycemia occurring during sleep may be different in physiological terms. Glucose hom...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1034/j.1399-5448.2002.30203.x
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:It is unknown whether measurement site of visceral adipose tissue (VAT) influences the relationship between VAT and associated health risk in youth and if so, whether ethnic differences exist in this relationship. We examined the influence of the measurement site of VAT on the relationships between VAT and me...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2010.00705.x
更新日期:2011-05-01 00:00:00
abstract:AIMS:We aimed to analyze the relationship between epilepsy and glutamic acid decarboxylase autoantibodies (GADA) in patients with type 1 diabetes mellitus (T1DM) and the impact of GADA on demographic, clinical, and metabolic data in T1DM patients with epilepsy. METHODS:We searched for patients with T1DM ≤20 years and ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.13034
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The global rise in incidence of type 1 diabetes (T1D) is too rapid to be attributed to susceptible genetic background, pinpointing a significant role for environmental factors. Unlike the theory that the need for genetic susceptibility has lessened over time, we hypothesized that the rise in T1D incidence is...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12617
更新日期:2018-06-01 00:00:00