Adolescent Diabetes

ISPAD Clinical Practice Consensus Guidelines 2014. Assessment and monitoring of glycemic control in children and adolescents with diabetes.

Marian J Rewersa, Kuben Pillayb, Carine de Beaufortc, Maria E Craigd, Ragnar Hanase, Carlo L Acerinif and David M Maahsa aBarbara Davis Center, University of Colorado Denver, Aurora, CO, USA; bWestville Hospital, Durban, South Africa; cDECCP, Clinique Pediatrique/CHL, Luxembourg, Luxembourg; dInstitute of Endocrinology and Diabetes, Westmead, Australia; eDepartment of Pediatrics, Uddevalla Hospital, Uddevalla, Sweden and fDepartment of Pediatrics, University of Cambridge, Cambridge, UK

ISPAD Clinical Practice Consensus Guidelines 2014. Type 2 diabetes in the child and adolescent.

Phil Zeitlera, Junfen Fub, Nikhil Tandonc, Kristen Nadeaua, Tatsuhiko Urakamid, Timothy Barrette and David Maahsf aThe Children’s Hospital Colorado, Aurora, CO, USA; bThe Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China; cAll India Institute of Medical Sciences, New Delhi, India; dNihon University School of Medicine, Tokyo, Japan; eBirmingham Children’s Hospital, Birmingham, UK and fThe Barbara Davis Center for Childhood Diabetes, Aurora, CO, USA

ISPAD Clinical Practice Consensus Guidelines 2014. Assessment and management of hypoglycemia in children and adolescents with diabetes.

Trang T Lya,b, David M Maahsc, Arleta Rewersd, David Dungere, Abiola Oduwolef and Timothy W Jonesb,g,h aDepartment of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA, USA; bSchool of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia; cBarbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; dDepartment of Pediatrics, University of Colorado, Denver, CO, USA; eDepartment of Paediatrics, University of Cambridge, Cambridge, UK; fCollege of Medicine, University of Lagos, Lagos, Nigeria; gDepartment of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, WA, Australiaand hTelethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia

ISPAD Clinical Practice Consensus Guidelines 2014. Nutritional management in children and adolescents with diabetes.

Carmel E Smarta, Francesca Annanb, Luciana PC Brunoc, Laurie A Higginsd and Carlo L Acerinie aDepartment of Endocrinology, John Hunter Children’s Hospital, Newcastle, Australia; bDepartment of Nutrition and Dietetics, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK; cDepartment of Endocrinology, University Federal of Sao Paulo, Sao Paulo, Brazil; dPediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA and eDepartment of Paediatrics, University of Cambridge, Cambridge, UK

ISPAD clinical practice consensus guidelines 2006-2007. Diabetes education.

Education is the keystone of diabetes care and structured self-management eduction is the key to a successful outcome. Adapted from ISPAD Consensus Guidelines 2000 (1). National pediatric guidelines emphasize the importance of education but do not include specific chapters on education and educational principles (2–5). Publications that provide useful guidelines on education in diabetes include National Standards for Diabetes Self-management Education (6), Position Statement on Structured Education (7), Guidance on the Use of Patient-Education Models for Diabetes (8), and the International Curriculum for Diabetes Health Professional Education (9). A definition of Diabetes Education has been proposed: ‘The process of providing the person with the knowledge and skills needed to perform diabetes selfcare, manage crises and to make lifestyle changes to successfully manage the disease.’ (10) Education may be seen as an interface between clinical practice and research. Research into diabetes and educational methods is important in improving clinical practice (2, 5, 6, 10, 11), and this should be the responsibility of each nation/state and be a national priority (7, 12). Educational programs must be carefully planned and have specific aims and learning objectives, which are shared with people with diabetes, carers, and their families (8). It has remained contentious whether educational interventions per se are beneficial in diabetes care, particularly in children and adolescents because ‘educational, psychosocial and psychotherapeutic interventions are frequently combined for the purpose of improving knowledge, skills and self-efficacy across various aspects of diabetes self-management’ (13). Nevertheless, systematic reviews of psychoeducational interventions conclude that they have small to medium beneficial effects on glycemic control (13, 14) and somewhat greater effect on psychological outcomes (15). The effects are greater for children than for adults (15) and are most effective when integrated into routine care, when parents are involved, empowerment principles are involved, and problem solving, goal setting, and self-efficacy are promoted (14, 16). The Diabetes Control and Complications Trial provided unequivocal evidence that intensification of management reduces microvascular complications and that intensification requires effective diabetes selfmanagement. Most importantly, effective self-management requires frequent and high levels of educational input and continuing support (6, 10, 11, 17, 18). Related to this is evidence that health care professionals engaged in education who are perceived by young people as being ‘motivating’ may encourage greater adherence to therapy (19). This high level of motivation and enthusiasm in educational intervention is likely to improve biomedical outcomes by itself and makes interpretation of educational research a complex science (20). In contrast, those people who do not receive education or do not continue to have educational contacts are more likely to suffer diabetes-related complications (6, 18, 21, 22). It is a concern, however, that parents and adolescents often express satisfaction about services received (5) even when there may be large gaps in education, psychological support, and self-management techniques accounting for relatively unsatisfactory and variable metabolic control (23).

ISPAD Clinical Practice Consensus Guidelines 2006-2007. Insulin treatment.

Department of Pediatrics, Ulleval University Hospital, Oslo, Norway Kinderkrankenhaus auf der Bult, Diabetes-Zentrum fur Kinder und Judendliche, Hannover, Germany Department of Pediatrics, University of Florida College of Medicine, Tallahassee, FL, USA Department of Pediatric Endocrinology and Diabetes, Katowice, Poland Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan Department of Pediatrics, Uddevalla Hospital, Uddevalla, Sweden

ISPAD Clinical Practice Consensus Guidelines 2014. Diabetes in adolescence.

Fergus J Camerona, Rakesh Aminb, Carine de Beaufortc, Ethel Codnerd and Carlo L Acerinie aRoyal Children’s Hospital, Murdoch Children’s Research Institute, University of Melbourne, Melbourne, Australia; bUniversity College London, Institute of Child Health, London, UK; cClinique Pédiatrique, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg; dInstitute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile and eDepartment of Paediatrics, University of Cambridge, Cambridge, UK

ISPAD Clinical Practice Consensus Guidelines 2014. Other complications and diabetes-associated conditions in children and adolescents.

Olga Kordonouria, Georgeanna Klingensmithb, Mikael Knipc, Reinhard W Holld, Henk-Jan Aanstoote, Puthezhath SN Menonf and Maria E Craigg,h,i aDiabetes Centre for Children and Adolescents, Children’s Hospital auf der Bult, Hannover, Germany; bDepartment of Pediatrics, The Children’s Hospital and Barbara Davis Centre, University of Colorado, Aurora, CO, USA; cHospital for Children and Adolescents, University of Helsinki, Helsinki, Finland; dInstitute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; eDiabeter Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, the Netherlands; fDepartment of Pediatrics, Jaber Al-Ahmed Armed Forces Hospital, Kuwait, Kuwait; gInstitute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, Australia; hDiscipline of Pediatrics and Child Health, University of Sydney, Sydney, Australia and iSchool of Women’s and Children’s Health, University of New South Wales, Sydney, Australia

ISPAD Clinical Practice Consensus Guidelines 2014. Management of children and adolescents with diabetes requiring surgery.

Erinn T Rhodesa,b, Chunxiu Gongc, Julie A Edged, Joseph I Wolfsdorfa,b and Ragnar Hanase,f aDivision of Endocrinology, Boston Children’s Hospital, Boston, MA, USA; bDepartment of Pediatrics, Harvard Medical School, Boston, MA, USA; cEndocrinology, Genetics and Metabolism, The Capital Medical University, Beijing Children’s Hospital, Beijing, China; dDepartment of Paediatric Endocrinology and Diabetes, Oxford Children’s Hospital, Oxford, UK; eThe Sahlgrenska Academy, University of Gothenburg, Institute of Clinical Sciences, Gothenburg, Sweden and fDepartment of Pediatrics, NU Hospital Group, Uddevalla Hospital, Uddevalla, Sweden

Comprehensive screening for monogenic diabetes in 89 Japanese children with insulin-requiring antibody-negative type 1 diabetes

Mutations in causative genes for neonatal diabetes or maturity‐onset diabetes of the young have been identified in multiple patients with autoantibody‐negative type 1 diabetes (T1D).