ISPAD Clinical Practice Consensus Guidelines 2006-2007.

Department of Pediatrics, Uddevalla Hospital, Sweden.
Pediatric Diabetes (Impact Factor: 2.13). 01/2007; 7(6):341-2. DOI: 10.1111/j.1399-5448.2006.00218.x
Source: PubMed
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    Enfermería Clínica 01/2009; 19(1). DOI:10.1016/j.enfcli.2008.10.002
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    ABSTRACT: The aim was to assess whether temporal changes in the initial management for children diagnosed with type 1 diabetes over a ten year period affected metabolic control two years after diagnosis. A further aim was to investigate if social factors, registered at diagnosis, had an impact on metabolic control two years after diagnosis. During the years 1997-2006, 247 children and adolescents were diagnosed with type 1 diabetes at a University Hospital in Sweden. The analysed data included HbA1c, pH at diagnosis, initial intravenous insulin infusion and length of hospital stay at diag-nosis, subcutaneous insulin type, number of diabetes check-up visits, emergency visits, re-admissions and social factors. Length of hospital stay decreased significantly over the ten year period. Neither hospital stay nor differences in insulin treatment was significantly correlated with children's metabolic control over time. Length of hospital stay was not re-lated with families' social stress situation. However, girls in families with more family stress at the time of diagnosis had higher HbA1c during follow-up than girls with less family stress or boys. Factors of importance for the child's long-term metabolic control need to be further investigated so the initial management can be tailored to each individual family's needs. This would imply an effective utilization of both families' and health care resources.
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    ABSTRACT: The application of autologous cord blood in children with type 1 diabetes has been found to be safe, but not to preserve beta-cell function in a previous study, which, however, had not included a control group. To compare the changes of metabolic and immune function over time between cord blood infused children and natural controls. Seven children with newly diagnosed type 1 diabetes underwent a single autologous cord blood infusion and 10 children were enrolled as natural controls in a non-randomized, controlled, open label intervention trial. Primary analyses were performed 1 year following cord blood infusion. Cases and controls were compared regarding metabolic [area under the curve (AUC) and peak C-peptide, insulin use, and HbA1c] and immune outcome (islet autoantibody titer and T-cell response), adjusted for age, gender, diabetes duration, and baseline levels. There were no significant adverse events related to the infusion. Metabolic and immune outcomes were not significantly different at 12 months follow-up between infused children and controls (e.g., adjusted p = 0.244 for AUC C-peptide, adjusted p = 0.820 for insulin use, adjusted p = 0.772 for peripheral regulatory T cells). Six-month change of AUC C-peptide correlated significantly with the number of infused CD34+ cells (r = 0.931, p = 0.002). An autologous cord blood infusion does not change the natural course of metabolic and immune parameters after disease onset. However, the content of CD34+ cells in the stored blood sample might offer potential for improvement of future cell therapies.
    Pediatric Diabetes 09/2013; DOI:10.1111/pedi.12072 · 2.13 Impact Factor