Abstract:
BACKGROUND:The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. METHODS:The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. RESULTS:Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. CONCLUSIONS:Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system.
journal_name
Pediatr Diabetesjournal_title
Pediatric diabetesauthors
Guttmann-Bauman I,Thornton P,Adhikari S,Reifschneider K,Wood MA,Hamby T,Rubin Kdoi
10.1111/pedi.12677subject
Has Abstractpub_date
2018-08-01 00:00:00pages
859-865issue
5eissn
1399-543Xissn
1399-5448journal_volume
19pub_type
杂志文章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:BACKGROUND/OBJECTIVE:Type 2 Diabetes (T2DM) is increasing in childhood especially among females and South-Asians. Our objective was to report outcomes from a national cohort of children and adolescents with T2DM 1 year following diagnosis. METHODS:Clinician reported, 1-year follow-up of a cohort of children (<17 years...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12761
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Obesity and pubertal insulin resistance worsen cardiovascular (CV) risk factors in youth. It is unclear how the relationships of obesity and insulin resistance with CV risk compare to adults. SUBJECTS AND METHODS:We evaluated 66 pubertal youth (mean ± SD: age 14.2 ± 2.0 years, body mass index [BMI] 36.6 ± 6...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12883
更新日期:2019-11-01 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:OBJECTIVE:Mechanisms underlying the role of non-human leukocyte antigen (HLA) genetic risk variants in type 1 diabetes (T1D) are poorly understood. We aimed to test the association between methylation and non-HLA genetic risk. METHODS:We conducted a methylation quantitative trait loci (mQTL) analysis in a nested case-...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12995
更新日期:2020-06-01 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:Identify and evaluate current treatment recommendations in Europe for the care of children with diabetes in view of the European Union (EU) recommendations for Reference Centers. METHODS:A questionnaire was sent in 2008 to representatives of all EU countries and Norway, all known to be actively involved in p...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2012.00908.x
更新日期:2012-09-01 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:OBJECTIVE:The primary objective of this trial was to evaluate the feasibility, safety, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system vs predictive low glucose suspension (PLGS) alone in optimizing overnight glucose control in children 6 to 14 years old. RESEARCH DESIGN AND METH...
journal_title:Pediatric diabetes
pub_type: 杂志文章,随机对照试验
doi:10.1111/pedi.12603
更新日期:2018-05-01 00:00:00
abstract:UNLABELLED:Previous studies have shown that vigorous aerobic training programs for obese children result in minimal weight changes, and concluded that they may not be beneficial. Weight change alone may not detect important beneficial changes in body composition associated with vigorous training in these children. Fift...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1034/j.1399-5448.2000.010202.x
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVES:We assessed pubertal development, height, weight, and waist-to-hip ratio (WHR), an index of central adiposity during puberty, in girls with type-1 diabetes mellitus (T1DM), compared to a contemporary control group. METHODS:Pubertal development, weight, height and WHR were studied in 100 pubertal girls with ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-543X.2004.00059.x
更新日期:2004-12-01 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:BACKGROUND:Adults with type 2 diabetes mellitus (T2DM) have broad impairments in beta-cell function, including severe attenuation of the first-phase insulin response to glucose, and reduced beta-cell mass. In adolescents with T2DM, there is some evidence that beta-cell dysfunction may be less severe. Our objective was ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2009.00601.x
更新日期:2010-08-01 00:00:00
abstract::Neonatal diabetes mellitus is a rare (1/400 000 newborns) but potentially devastating condition, which may be transient or permanent; typical symptoms occur within the first 4 wk of life. The transient form is a developmental insulin production disorder that resolves postnatally. Fifty to 60% of cases can be seen as t...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2006.00201.x
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:Type 1 diabetes (T1D) develops in distinct stages, before and after disease onset. Whether the natural course translates into different immunologic patterns is still uncertain. This study aimed at identifying peripheral immune patterns at key time-points, in T1D children undergoing remission phase. METHODS:C...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12671
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Diabetes ketoacidosis (DKA) is a common presentation and complication of type 1 diabetes (T1D). While intravenous insulin is typically used to treat acute metabolic abnormalities, the transition from intravenous to subcutaneous treatment can present a challenge. We hypothesize that co-administration of glarg...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12462
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Health inequities persist in youth and young adults (YYA) with type 1diabetes in achieving optimal glycemic control. The purpose of this study was to assess the contribution of multiple indicators of social need to these inequities. RESEARCH DESIGN AND METHODS:Two hundred and twenty two YYA withtype 1 diabet...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.13112
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Trials in adults have demonstrated that interventions targeting lifestyle are effective in preventing or delaying type 2 diabetes (T2D). To address this need in youth, we developed ENCOURAGE Healthy Families (ENCOURAGE), based on the US Diabetes Prevention Program (DPP). STUDY DESIGN:Here, we present resu...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12692
更新日期:2018-05-20 00:00:00
abstract:AIMS:Intravenous glucose tolerance testing (IVGTT) is a common test of β-cell function in which a glucose load is administered and insulin and/or C-peptide responses are monitored. Since the first IVGTT may be more stressful and stress may alter β-cell secretion or hepatic insulin extraction, we asked whether there was...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12064
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To compare outcomes of diabetic ketoacidosis (DKA) 6 yrs before and 6 yrs after changing rehydration fluids from ½ normal saline to Lactated Ringer's and decreasing the total intended fluid volume administered in the first 24 hrs from 3500 mL/m(2) /d to ≤ 2500 mL/m(2) /d at Texas Children's Hospital (TCH) in ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12268
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Higher birthweight is associated with increased type 1 diabetes mellitus (T1DM) risk, but the contribution of higher adiposity or lean mass is unclear. In this Tasmanian infant cohort, early upper respiratory infection has been associated with higher asthma risk. PATIENTS AND METHODS:Eligible infants repres...
journal_title:Pediatric diabetes
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1399-5448.2010.00693.x
更新日期:2011-06-01 00:00:00
abstract::This study aimed to analyse the impact of the disease and treatment on health-related quality of life (HRQOL) in intensively treated young patients with diabetes. Our main hypothesis was that metabolic control, gender, age and socio-economic status predict HRQOL. All children and adolescents (n = 400, 191 girls) and p...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/j.1399-5448.2008.00496.x
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:While insulin resistance (IR) is associated with specific metabolite signatures in adults, there have been few truly longitudinal studies in healthy children, either to confirm which abnormalities are present, or to determine whether they precede or result from IR. Therefore, we investigated the association ...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12884
更新日期:2019-11-01 00:00:00
abstract::Families of children with diabetes increasingly obtain health information from a variety of sources. Doctor-patient relationships have accordingly become more fluid and dynamic with input from other parties. These outside parties include representatives from the diabetes health care industry-industry third parties (IT...
journal_title:Pediatric diabetes
pub_type: 杂志文章,评审
doi:10.1111/pedi.12786
更新日期:2019-02-01 00:00:00
abstract::Data on cardiovascular disease (CVD) risk in adolescents with type 2 diabetes (T2D) are limited. Echocardiography was performed in the last year of the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial (median 4½ yr from diagnosis of T2D, average age 18 yr), including MMode and 2D m...
journal_title:Pediatric diabetes
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/pedi.12119
更新日期:2015-02-01 00:00:00
abstract:AIMS:To design, develop, and evaluate the feasibility of delivering a multi-component community based intervention to parents and primary health care professionals to raise awareness of the symptoms of Type 1 diabetes (T1D) in childhood in 3 adjoining borough counties of South Wales. MATERIALS AND METHODS:Parent and p...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12516
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To investigate carbohydrate (CARB) and supplementary fat/protein (CFP) counting using normal and dual-wave bolus in pump therapy of children and young people with type 1 diabetes (T1D). STUDY DESIGN AND METHODS:A randomized clinical trial was conducted in 42 patients (age 6-21 yr) with T1D for at least 1 yr ...
journal_title:Pediatric diabetes
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-5448.2012.00880.x
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Continuous subcutaneous insulin infusion (CSII) is commonly used in patients with diabetes. Accurate and reliable delivery by insulin pumps is essential for a safe and effective therapy, particularly when using small doses. In this study, accuracy of bolus and basal rate delivery of various available insulin...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.12993
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To determine reliability and validity of the acceptance and action diabetes questionnaire (AADQ) and the diabetes acceptance and action scale for children and adolescents (DAAS), measures of diabetes-specific psychological flexibility. METHODS:One hundred and eight-one youth with type 1 diabetes completed th...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.13110
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Pediatric diabetes clinics around the world rapidly adapted care in response to COVID-19. We explored provider perceptions of care delivery adaptations and challenges for providers and patients across nine international pediatric diabetes clinics. METHODS:Providers in a quality improvement collaborative com...
journal_title:Pediatric diabetes
pub_type: 杂志文章
doi:10.1111/pedi.13180
更新日期:2021-01-19 00:00:00