Explore the vast range of titles available.

This trial assessed the efficacy and safety of liraglutide as compared with placebo, added to metformin (with or without basal insulin treatment), in children and adolescents with type 2 diabetes. The addition of liraglutide was efficacious and relatively safe in improving glycemic control over 52 weeks.

Background Partial remission (PREM) by the insulin dose‐adjusted HbA1c (IDAA1c) method has not been evaluated for the combined associations of ethnicity and socioeconomic status in children and adolescents with type 1 diabetes (T1D). Objective To investigate prevalence and predictors of PREM defined by IDAA1c. Methods Six hundred fourteen of 678 children (aged <15 years) with new‐onset T1D (2000‐2013) from a regional pediatric diabetes service (Auckland, New Zealand). Results Overall rate of PREM at 3 months was 42.4%, and lower in Māori/Pacific children (28.6%; P = .006) and those of other ethnicities (28.8%; P = .030) compared with New Zealand Europeans (50.4%). Comparing the most and least deprived socioeconomic quintiles, the odds of PREM were lower among the most deprived (adjusted odds ratio [aOR] 0.44; P = .019). Lower rates of PREM were seen in children aged 0 to 4.9 years (23.8%) and 10 to 14 years (40.9%) than in children aged 5 to 9.9 years (57.4%; P < .05). Further predictors of lower rates of PREM were ketoacidosis at diagnosis (aOR 0.54 with DKA; P = .002) and diabetes duration (aOR 0.84 per month; P < .0001). Patient's sex, body mass index standard deviation score, or autoantibodies were not associated with PREM. PREM at 3 months was associated with lower HbA1c over 18 months compared with children not in PREM (65.0 vs 71.3 mmol/mol; P < .0001), independent of ketoacidosis. Conclusions This study on a regional cohort of youth with T1D showed social and ethnic disparities in rates of PREM defined by IDAA1c. Further research into reducing ketoacidosis rates at diagnosis and addressing factors associated with lower rates of PREM in non‐European children are important health priorities.

C Objectives of ambulatory care The ultimate goal is to provide care that results in “on target” glucose profiles, good quality of life, normal growth and development, and lowest possible risk of acute and long-term diabetes complications. E Additional psychosocial evaluation and support for children who are at high-risk of acute and/or chronic complications due to suboptimal glycemic management, frequent utilization of emergency departments/hospital, other social considerations and/or mental health needs. Evaluation of growth and physical development, and general health (including concomitant medical conditions and medications) Physical examination with inspection of glucose monitoring sites and injection sites Nutrition consultation Options to communicate between visits, for example, for insulin dose adjustments, should be provided, including text messages or virtual visits via video, telephone, or live chat. Expanded physical assessments (such as pubertal staging, foot examination) Additional self-management assessments, such as dietary knowledge (ability to estimate carbohydrate consumption and accurately determine insulin doses), glucose data interpretation, autonomy in diabetes management, knowledge about sick day rules Psychosocial assessment Screening for comorbidities, long-terms complications, and related risk factors Other key aspects of ambulatory care Identification of barriers to care.

Background: With increased awareness of type 2 diabetes (T2D) in children and adolescents, an overview of country-specific differences in epidemiology data is needed to develop a global picture of the disease development. Summary: This study examined country-specific prevalence and incidence data of youth-onset T2D published between 2008 and 2019, and searched for national guidelines to expand the understanding of country-specific similarities and differences. Of the 1,190 articles and 17 congress abstracts identified, 58 were included in this review. Our search found the highest reported prevalence rates of youth-onset T2D in China (520 cases/100,000 people) and the USA (212 cases/100,000) and lowest in Denmark (0.6 cases/100,000) and Ireland (1.2 cases/100,000). However, the highest incidence rates were reported in Taiwan (63 cases/100,000) and the UK (33.2 cases/100,000), with the lowest in Fiji (0.43 cases/100,000) and Austria (0.6 cases/100,000). These differences in epidemiology data may be partly explained by variations in the diagnostic criteria used within studies, screening recommendations within national guidelines and race/ethnicity within countries. Key Messages: Our study suggests that published country-specific epidemiology data for youth-onset T2D are varied and scant, and often with reporting inconsistencies. Finding optimal diagnostic criteria and screening strategies for this disease should be of high interest to every country. Trial Registration: Not applicable.

The median age at diagnosis was 7.6 (interquartile range: 4.6-10.8) years and the majority of patients (58.3%) presented with diabetic ketoacidosis (DKA). [...]children with T1DM should be identified early, ideally before the development of DKA as this acute condition is associated with high morbidity and mortality. Symptoms of T1DM may be misinterpreted leading to delayed diagnosis (Table 3). [...]healthcare providers should have a high index of suspicion of DM/DKA when managing such sick children. Diagnostic criteria of DM: * Classic symptoms of diabetes or hyperglycaemic crisis, with plasma glucose concentration >11.1 mmol/L OR * Fasting plasma glucose (no caloric intake for at least 8 hours) >7.0 mmol/L OR * 2-hour post-load glucose >11.1 mmol/L in oral glucose tolerance test OR * HbAlc >6.5% (HbAlc alone in the diagnosis of DM remains unclear and cannot exclude DM when the value is <6.5%) * The diagnosis must be confirmed by repeat blood glucose (BG) testing in the absence of unequivocal hyperglycaemia. * Biochemical features to support the diagnosis of T1DM includes: * low or undetectable (fasting) C-peptide levels ° presence of diabetes-associated autoantibodies (GAD/IAA/ICA512/ IA2/ZnT8)

Background Obesity and metabolic syndrome is prevalent among Malaysian adolescents and has been associated with certain behavioural factors such as duration of sleep, screen time and physical activity. The aim of the study is to report the prevalence of overweight/obesity, metabolic syndrome and its risk factors among adolescents. Methods A multi-staged cluster sampling method was used to select participants from urban and rural schools in Selangor, Perak and Wilayah Persekutuan Kuala Lumpur. Participants underwent anthropometric measurement and physical examination including blood pressure measurement. Blood samples were taken for fasting glucose and lipids and participants answered a self-administered questionnaire. Overweight and obesity was defined using the extrapolated adult body mass index (BMI) cut-offs of >25 kg/m 2 and >30 kg/m 2 , according to the International Obesity Task Force (IOTF) criteria. Metabolic syndrome was defined based on International Diabetes Federation (IDF) 2007 criteria. Results Data were collected from 1361 participants. After excluding incomplete data and missing values for the variables, we analysed a sample of 1014 participants. Prevalence of overweight and obesity in this population was 25.4% (N = 258). The prevalence of metabolic syndrome was 2.6% in the population and 10% among the overweight and obese adolescents. Participants who slept between 7 and 9 hours a day has a lower risk of developing metabolic syndrome OR 0.38(0.15-0.94). Conclusion Our results provide the prevalence of metabolic syndrome in Malaysian adolescents. Adequate sleep between 7 and 9 hours per day reduces the risk of developing metabolic syndrome.

Type 1 diabetes mellitus (DM) accounts for more than 90% of childhood and adolescent diabetes. Of the estimated 479,600 type 1 diabetic children worldwide, 24% were from the South-East Asian region and 6.4% from the Western Pacific region.2–3 The annual incidence for childhood type 1 DM (0–14 year age group) ranged from 0.1 per 100,000 in China to 57.6 per 100,000 in Finland.3–5 The incidence of type 1 DM appeared to be low in the Western Pacific region with the exception of Australia and New Zealand. In Malaysia, type 1 DM was estimated to account for 69.2% of children and adolescents with diabetes.