Muna Sunni

Exogenous insulin requirements do not differ between youth and adults with cystic fibrosis related diabetes

To examine whether insulin requirements and diabetes control differ between adolescents and adults with cystic fibrosis related diabetes (CFRD).

Childhood diabetes in Africa.

Purpose of reviewThis review summarizes the current state of diabetes in African children. Recent findingsType 1 diabetes is the most common form of pediatric diabetes in Africa. Significant improvements have been achieved over the last 6 years, including the training of more than 60 pediatric endocrinologists who are now practicing in 14 African nations, greater training of other healthcare providers, increased availability of insulin through the efforts of philanthropic organizations and industry, modestly better availability of testing supplies, and the introduction of patient education materials in native languages. However, there is still a long way to go before the standard-of-care available to children in resource-rich nations is available to children with diabetes in Africa. SummaryHere, we review the known epidemiology, pathophysiology, complications, and treatment of diabetes in children in Africa.

Meal replacements followed by topiramate for the treatment of adolescent severe obesity: A pilot randomized controlled trial.

To assess the safety and efficacy of short‐term meal replacement therapy followed by topiramate for body mass index (BMI) reduction in adolescents with severe obesity.

Two case reports of retained steel insulin pump infusion set needles

Insulin pumps are common in the management of type 1 diabetes (T1D). We report two cases of metal insulin infusion set needles which broke off the tubing and remained embedded in the soft tissue of two boys with T1D (five needles in one case, and one needle in the other). The patient with five retained needles was asymptomatic and had a normal physical examination, and the missing needles were only detected using pelvic X‐ray; the second patient had only mild discomfort. While these are the first such cases reported in the medical literature, there may be other cases which have gone unnoticed, suggesting the potential need to explore the safety of this product further.

Addressing Food Insecurity in a Pediatric Weight Management Clinic: A Pilot Intervention

INTRODUCTION Our objectives were to (a) identify rates of food insecurity among patients seen in a pediatric weight management clinic and (b) test a pilot intervention to address food insecurity in the identified patients. METHODS All new patients seen in the clinic were screened for food insecurity and Supplemental Nutrition Assistance Program (SNAP) benefit status. Families with food insecurity and no SNAP benefits were asked if they wanted SNAP enrollment assistance from a partnering food bank. Those agreeing to assistance were connected to the food bank. RESULTS A total of 116 new patients were evaluated in the clinic during the intervention; 28 (24%) endorsed food insecurity, and 40 (34%) were eligible for SNAP enrollment assistance. Three (8%) of the eligible patients completed the SNAP enrollment process. DISCUSSION Food insecurity in this pediatric weight management clinic was common. However, even when given direct access to SNAP enrollment assistance, only a small minority of patients matriculated into this program.

Predominance of DR3 in Somali children with type 1 diabetes in the twin cities, Minnesota

Minnesota is home to the largest Somali population in USA, and pediatric diabetes teams are seeing increasing numbers of Somali children with diabetes.

A picture-based carbohydrate-counting resource for Somalis:

Objective Carbohydrate counting is essential for effective management of type 1 diabetes (T1D). Somali diet-specific carbohydrate-counting references are lacking, creating an additional barrier to effective diabetes control. We developed a picture-based carbohydrate-counting resource for Somalis with T1D. Methods Traditional Somali foods were selected using a variety of methods. Serving sizes and carbohydrate calculations were tabulated using the United States Department of Agriculture National Nutrient Database for Standard Reference. Carbohydrate contents of home-prepared foods were calculated by measuring the total yield and total carbohydrates of ingredients in the recipe divided by the number of servings to be consumed. When available, recipes were used for food preparation and analysis for more accurate carbohydrate estimation. Results Photographs of prepared Somali foods were compiled into a PDF file. While introductions are written in text, the resource is primarily picture-based to bypass limited literacy. The resource is shared free of charge via the following link: http://journals.sagepub.com/doi/suppl/10.1177/0300060517718732. The link will be updated annually with new information. Conclusion There is a necessity to tailor educational materials to address the needs of Somalis with diabetes. We have created a picture-based nutrition resource for carbohydrate counting of traditional Somali foods and have made this freely available to individuals worldwide.

Is insulin diluted when stored in water

Insulin storage is a challenge in resource‐poor countries. In Uganda, patients were noted to store insulin vials by submerging them in water.