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Baechle C, Eckert A, Kamrath C, Neu A, Manuwald U, Thiele-Schmitz S, Weidler O, Knauer-Fischer S, Rosenbauer J, Holl RW. Incidence and presentation of new-onset type 1 diabetes in children and adolescents from Germany during the COVID-19 pandemic 2020 and 2021: Current data from the DPV Registry. Diabetes Res Clin Pract 2023; 197:110559. [PMID: 36758641 DOI: 10.1016/j.diabres.2023.110559] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
AIMS To determine whether the incidence of type 1 diabetes mellitus (T1D), autoantibody-negative diabetes, and diabetic ketoacidosis (DKA) at diabetes onset in 2020 and 2021 changed when compared to long-standing trends. METHODS Our study is based on diabetes manifestation data of the 0.5-<18-year-old children/adolescents from the German multicenter Diabetes Prospective Follow-up Registry. Based on long-term pre-pandemic trends from 2011 to 2019, we estimated adjusted incidence rate ratios (IRR) for T1D and DKA, and prevalence rate ratios (PRR) regarding autoantibody status with 95 % confidence intervals (CI) for the years 2020 and 2021 (observed versus predicted rates), using multivariable negative binomial or beta-binomial regression, respectively. RESULTS We analyzed data of 30,840 children and adolescents with new-onset T1D. The observed incidences were significantly higher than the predicted incidences (IRR2020 1.13 [1.08-1.19]; IRR2021 1.20 [1.15-1.26]). The prevalence of autoantibody-negative diabetes did not change (PRR2020 0.91 [0.75-1.10]; PRR2021 1.03 [0.86-1.24]). The incidence of DKA during the pandemic was higher than predicted (IRR2020 1.34 [1.23-1.46]; IRR2021 1.37 [1.26-1.49]). CONCLUSIONS An increase in the incidences of T1D and DKA, but not of autoantibody-negative diabetes was observed during both pandemic years. Further monitoring and efforts for DKA prevention at onset are necessary.
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Affiliation(s)
- C Baechle
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
| | - A Eckert
- University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Albert-Einstein-Allee 41, D-89081 Ulm, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
| | - C Kamrath
- Justus Liebig University, Center of Child and Adolescent Medicine, Division of Paediatric Endocrinology and Diabetology, Feulgenstraße 10-12, D-35392 Giessen, Germany.
| | - A Neu
- University Hospital Tübingen, Clinic for Paediatrics and Youth Medicine, Hoppe-Seyler-Straße 1, D-72076 Tübingen, Germany.
| | - U Manuwald
- Technische Universität Dresden, Faculty of Medicine "Carl Gustav Carus", Institute and Policlinic of Occupational and Social Medicine, Health Sciences/Public Health, Fetscherstraße 74, D-01307 Dresden, Germany.
| | - S Thiele-Schmitz
- St. Louise Women's and Children's Hospital, Diabetes Center for Children and Adolescents, Husener Straße 81, D-33098 Paderborn, Germany.
| | - O Weidler
- Elbe Kliniken Stade - Buxtehude, Bremervörder Straße 111, D-21682 Stade, Germany.
| | - S Knauer-Fischer
- University Hospital Mannheim, Clinic for Pediatric and Adolescent Medicine, Division of Endocrinology and Diabetology, Theodor-Kutzer-Ufer 1, D-368167 Mannheim, Germany.
| | - J Rosenbauer
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
| | - R W Holl
- University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Albert-Einstein-Allee 41, D-89081 Ulm, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, D-85764 Munich-Neuherberg, Germany.
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2
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Svensson J, Ibfelt EH, Carstensen B, Neu A, Cinek O, Skrivarhaug T, Rami-Merhar B, Feltbower RG, Castell C, Konrad D, Gillespie K, Jarosz-Chobot P, Marčiulionytė D, Rosenbauer J, Bratina N, Ionescu-Tirgoviste C, Gorus F, Kocova M, de Beaufort C, Patterson CC. Age-period-cohort modelling of type 1 diabetes incidence rates among children included in the EURODIAB 25-year follow-up study. Acta Diabetol 2023; 60:73-82. [PMID: 36205797 DOI: 10.1007/s00592-022-01977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/15/2022] [Indexed: 01/07/2023]
Abstract
AIMS Specific patterns in incidence may reveal environmental explanations for type 1 diabetes incidence. We aimed to study type 1 diabetes incidence in European childhood populations to assess whether an increase could be attributed to either period or cohort effects. METHODS Nineteen EURODIAB centres provided single year incidence data for ages 0-14 in the 25-year period 1989-2013. Case counts and person years were classified by age, period and cohort (APC) in 1-year classes. APC Poisson regression models of rates were fitted using restricted cubic splines for age, period and cohort per centre and sex. Joint models were fitted for all centres and sexes, to find a parsimonious model. RESULTS A total of 57,487 cases were included. In ten and seven of the 19 centres the APC models showed evidence of nonlinear cohort effects or period effects, respectively, in one or both sexes and indications of sex-specific age effects. Models showed a positive linear increase ranging from approximately 0.6 to 6.6%/year. Centres with low incidence rates showed the highest overall increase. A final joint model showed incidence peak at age 11.6 and 12.6 for girls and boys, respectively, and the rate-ratio was according to sex below 1 in ages 5-12. CONCLUSION There was reasonable evidence for similar age-specific type 1 diabetes incidence rates across the EURODIAB population and peaks at a younger age for girls than boys. Cohort effects showed nonlinearity but varied between centres and the model did not contribute convincingly to identification of environmental causes of the increase.
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Affiliation(s)
- J Svensson
- Diabetes Technology Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
| | - E H Ibfelt
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - B Carstensen
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - A Neu
- University Children´S Hospital, Tübingen, Germany
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - T Skrivarhaug
- Division of Adolescent and Paediatric Medicine, Institute of Clinical Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - B Rami-Merhar
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - R G Feltbower
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - C Castell
- Department of Health, Government of Catalonia, Barcelona, Spain
| | - D Konrad
- Division of Paediatric Endocrinology and Diabetology and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - K Gillespie
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK
| | - P Jarosz-Chobot
- Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland
| | - D Marčiulionytė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Rosenbauer
- German Diabetes Center, Institute of Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - N Bratina
- Diabetes & Metabolic Diseases, Department of Endocrinology, University Children's Hospital, Ljubljana, Slovenia
| | - C Ionescu-Tirgoviste
- National Institute of Diabetes Nutrition and Metabolic Diseases, NC Paulescu, Bucharest, Romania
| | - F Gorus
- Diabetes Research Center, Brussels Free University - Vrije Universiteit Brussel, Brussels, Belgium
| | - M Kocova
- Department of Endocrinology and Genetics, University Children's Hospital, Skopje, North Macedonia
| | - C de Beaufort
- Department of Paediatric Diabetes and Endocrinology, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - C C Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Breakspear S, Frueh P, Neu A, Noecker B, Popescu C, Uellner Q. Learning from hair moisture sorption and hysteresis. Int J Cosmet Sci 2022; 44:555-568. [PMID: 35892223 DOI: 10.1111/ics.12806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The process of moisture sorption and desorption by human hair was analysed for extracting hints on the hair structure. METHODS The isotherms of moisture sorption and desorption by hair were recorded for untreated and chemically treated (permed and bleached) hair. Data of swelling were also considered. RESULTS By examining the swelling and moisture sorption of keratin fibres, it is possible to conclude that hysteresis is quite improbably caused by capillary condensation. The mobility of the protein chains and the strength of the bonds binding water molecules to the active sites inside the matrix are proposed as causes instead. The concept of "breaking symmetry", derived from moisture sorption-desorption data, and the method of evaluating this parameter, is proposed as a way of characterizing the chemical treatment of hair. The results show that bleaching produces a larger breaking of symmetry than perming, and this is suggested to be due to new hydrogen bonds, created as a result of the chemical treatment, replacing the original disulfide bonds, which are of different strength compared to the bonds of untreated hair. The quantitative sorption data matched well to the model of grains of matrix enveloped in layers of water molecules at increasing relative humidity, up to 100 %. The analysis suggested that, aside from the glass transition event occurring at around 60-70 % relative humidity, there is another, less examined, transition occurring at around 30 % relative humidity, assigned to the opening of the hair inner structure, and accommodation of more water molecules. Both transitions are reflected by corresponding changes in the fibre mechanical behaviour. CONCLUSION The moisture sorption-desorption by hair was shown not only to allow a quantitative differentiation among various cosmetic treatments of the hair, but also to provide valuable information on the structure of the fibre.
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Affiliation(s)
| | - P Frueh
- KAO Germany GmbH, Darmstadt, Germany.,KAO Corporation, Tokyo, Japan
| | - A Neu
- KAO Germany GmbH, Darmstadt, Germany
| | - B Noecker
- KAO Germany GmbH, Darmstadt, Germany
| | - C Popescu
- KAO Germany GmbH, Darmstadt, Germany
| | - Q Uellner
- KAO Germany GmbH, Darmstadt, Germany
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Stute F, Hauck PA, Woitschach R, Neu A, Kozlik-Feldmann R, Mir TS. Channelopathies in Pediatric Patients: Is It a Multidisciplinary Challenge? Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F. Stute
- Universitäres Herz- und Gefäßzentrum UKE, Hamburg, France
| | - P. A. Hauck
- Department of Pediatric Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Deutschland
| | - R. Woitschach
- Human Genetics, University Hospital Hamburg-Eppendorf, Hamburg, Deutschland
| | - A. Neu
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | | | - T. S. Mir
- Department of Pediatric Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Deutschland
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Storm Van's Gravesande K, Calabrese P, Blaschek A, Rostásy K, Huppke P, Rothe L, Mall V, Kessler J, Kalbe E, Dornfeld E, Elpers C, Lohmann H, Weddige A, Hagspiel S, Kirschner J, Brehm M, Blank C, Schubert J, Schimmel M, Pacheè S, Mohrbach M, Karenfort M, Kamp G, Lücke T, Neumann H, Lutz S, Gierse A, Sievers S, Schiffmann H, de Soye I, Trollmann R, Candova A, Rosner M, Neu A, Romer G, Seidel U, John R, Hofmann C, Schulz, Kinder S, Bertolatus A, Scheidtmann K, Lasogga R, Leiz S, Alber M, Kranz J, Bajer-Kornek B, Seidl R, Novak A. The Multiple Sclerosis Inventory of Cognition for Adolescents (MUSICADO): A brief screening instrument to assess cognitive dysfunction, fatigue and loss of health-related quality of life in pediatric-onset multiple sclerosis. Eur J Paediatr Neurol 2019; 23:792-800. [PMID: 31551133 DOI: 10.1016/j.ejpn.2019.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/23/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical. METHODS 106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL. RESULTS The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively. CONCLUSION The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.
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Affiliation(s)
- K Storm Van's Gravesande
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany.
| | - P Calabrese
- Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Birmannsgasse 8, 4055 Basel, Switzerland
| | - A Blaschek
- Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, 80337 Munich, Germany
| | - K Rostásy
- Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Dr. Friedrich Steiner Str. 5, 5711 Datteln, Germany
| | - P Huppke
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, University Medical Center Göttingen, Robert-Koch Strasse 40, 37075 Göttingen, Germany
| | - L Rothe
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - V Mall
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany
| | - J Kessler
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - E Kalbe
- Department of Medical Psychology ǀ, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
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Abstract
Patients with chronic diseases manifesting in childhood, such as type 1 diabetes, need to make an optimal transition from pediatric to adult medical care. This or transitionis a challenge for patients and their treatment teams, since metabolic control is often unstable at this time of life. Additional factors like the social environment, as well as concomitant diseases, also need to be taken into account and often represent hurdles to optimal therapy. Transition is an important process to guarantee good self-management of diabetes therapy and good outcomes in the long term. This review provides an overview and recommendations on the topic of transition in diabetes.
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Affiliation(s)
- B Gallwitz
- Medizinische Klinik IV, Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland.
| | - A Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen, Tübingen, Deutschland
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Neu A, Feldhahn L, Ehehalt S, Ziegler J, Rothe U, Rosenbauer J, Holl RW. No change in type 2 diabetes prevalence in children and adolescents over 10 years: Update of a population-based survey in South Germany. Pediatr Diabetes 2018; 19:637-639. [PMID: 29235225 DOI: 10.1111/pedi.12622] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/04/2017] [Accepted: 11/16/2017] [Indexed: 01/13/2023] Open
Abstract
Objective of this study was to analyze prevalence changes in type 2 diabetes (T2D) among children and adolescents over the last 10 years. We performed a cross-sectional survey in Baden-Württemberg (BW), Germany, by using a written questionnaire and comparing these results with T2D prevalence data from the same area retrieved in 2004/2005. In 2016, 50 patients with T2D under 20 years of age were registered in BW, Germany, which corresponds to a prevalence rate of 2.42 per 100 000 (95% confidence interval [CI]: 1.75-3.09). The prevalence rate found in the same geographic area 10 years prior was 2.30 per 100 000 (95% CI: 1.70-2.90). Overall, 70% of T2D patients of this age group were treated by adult diabetologists. Concisely the prevalence of T2D in children and adolescents is still low in South Germany, remaining practically unchanged over the past decade.
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Affiliation(s)
- A Neu
- University Children's Hospital Tübingen, Tübingen, Germany
| | - L Feldhahn
- Children's Hospital Böblingen, Böblingen, Germany
| | - S Ehehalt
- Department of Pediatrics, Public Health Department Stuttgart, Stuttgart, Germany
| | - J Ziegler
- University Children's Hospital Tübingen, Tübingen, Germany
| | - U Rothe
- Department for Epidemiology and Health Care Research, Technical University of Dresden, Dresden, Germany
| | - J Rosenbauer
- German Diabetes Centre and Leibniz Institute for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - R W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University Ulm, Ulm, Germany
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Rosenbauer J, Stahl-Pehe A, Neu A, Rothe U, Reuter HM, Siegel E, Badenhoop K, Seufert J, Holl RW. Prävalenz des Typ-1-Diabetes bei Erwachsenen in Deutschland – Schätzung auf der Basis von bundesweitem DPV-Register und NRW-Diabetesregister. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Rosenbauer
- Deutsches Diabetes-Zentrum, Leibniz-Institut an der Heinrich-Heine-Universität Düsseldorf, Institut für Biometrie und Epidemiologie, Düsseldorf, Germany
| | - A Stahl-Pehe
- Deutsches Diabetes-Zentrum, Leibniz-Institut an der Heinrich-Heine-Universität Düsseldorf, Institut für Biometrie und Epidemiologie, Düsseldorf, Germany
| | - A Neu
- Universitäts-Klinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - U Rothe
- Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Gesundheitswissenschaften/Public Health, Dresden, Germany
| | - HM Reuter
- Ambulantes Medizinisches Zentrum Jena, Diabetologische Schwerpunktpraxis, Jena, Germany
| | - E Siegel
- St. Josefkrankenhaus Heidelberg, Innere Medizin – Gastroenterologie, Diabetologie und Ernährungsmedizin, Heidelberg, Germany
| | - K Badenhoop
- Universitätsklinikum der Goethe-Universität Frankfurt, Medizinische Klinik 1 – SP Diabetologie und Endokrinologie, Frankfurt, Germany
| | - J Seufert
- Universitätsklinikum Freiburg, Klinik für Innere Medizin II – Abteilung Endokrinologie und Diabetologie, Freiburg, Germany
| | - RW Holl
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
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Schweizer R, Herrlich S, Lösch-Binder M, Glökler M, Heimgärtner M, Liebrich F, Messner K, Muckenhaupt T, Schneider A, Ziegler J, Neu A. Der Proteinfaktor: Verhinderung des Blutzuckeranstiegs nach Fett-Protein-reicher Mahlzeit (FPRM) durch zusätzliche Insulingabe. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R Schweizer
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - S Herrlich
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - M Lösch-Binder
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - M Glökler
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - M Heimgärtner
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - F Liebrich
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - K Messner
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - T Muckenhaupt
- Klinikum am Steinenberg Reutlingen, Klinik für Kinder- und Jugendmedizin, Reutlingen, Germany
| | - A Schneider
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - J Ziegler
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
| | - A Neu
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Tübingen, Germany
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Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl R, Holterhus PM, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-111213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - J. Bürger-Büsing
- Bund diabetischer Kinder und Jugendlicher e.V., Diabeteszentrum, Kaiserslautern
| | - T. Danne
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - A. Dost
- Universitätsklinikum Jena, Klinik für Kinder- und Jugendmedizin
| | | | - R. Holl
- Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm
| | - P.-M. Holterhus
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Allgemeine Pädiatrie
| | - T. Kapellen
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Kinder- und Jugendmedizin
| | - B. Karges
- RWTH Aachen, Universitätsklinikum, Sektion Endokrinologie und Diabetologie
| | - O. Kordonouri
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - S. Müller
- Praxis für Ernährungsberatung, Ennepetal
| | - K. Raile
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Schweizer
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin
| | - S. von Sengbusch
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder- und Jugendmedizin
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - V. Wagner
- Gemeinschaftspraxis für Kinder- und Jugendmedizin, Rostock
| | - S. Wiegand
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Ziegler
- Praxis für Kinder- und Jugendmedizin, Diabetologische Schwerpunktpraxis, Münster
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Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl R, Holterhus PM, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter – AWMF-Registernummer 057–016. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-100779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - J. Bürger-Büsing
- Bund diabetischer Kinder und Jugendlicher e.V., Diabeteszentrum, Kaiserslautern
| | - T. Danne
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - A. Dost
- Universitätsklinikum Jena, Klinik für Kinder- und Jugendmedizin
| | | | - R. Holl
- Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm
| | - P.-M. Holterhus
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Allgemeine Pädiatrie
| | - T. Kapellen
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Kinder- und Jugendmedizin
| | - B. Karges
- RWTH Aachen, Universitätsklinikum, Sektion Endokrinologie und Diabetologie
| | - O. Kordonouri
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - S. Müller
- Praxis für Ernährungsberatung, Ennepetal
| | - K. Raile
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Schweizer
- Universität Tübingen, Klinik für Kinder- und Jugendmedizin
| | - S. von Sengbusch
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder- und Jugendmedizin
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - V. Wagner
- Gemeinschaftspraxis für Kinder- und Jugendmedizin, Rostock
| | - S. Wiegand
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Ziegler
- Praxis für Kinder- und Jugendmedizin, Diabetologische Schwerpunktpraxis, Münster
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Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, Parslow RC, Joner G, Svensson J, Castell C, Bingley PJ, Schoenle E, Jarosz-Chobot P, Urbonaité B, Rothe U, Kržišnik C, Ionescu-Tirgoviste C, Weets I, Kocova M, Stipancic G, Samardzic M, de Beaufort CE, Green A, Soltész G, Dahlquist GG. Seasonal variation in month of diagnosis in children with type 1 diabetes registered in 23 European centers during 1989-2008: little short-term influence of sunshine hours or average temperature. Pediatr Diabetes 2015; 16:573-80. [PMID: 25316271 DOI: 10.1111/pedi.12227] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/11/2014] [Accepted: 09/11/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The month of diagnosis in childhood type 1 diabetes shows seasonal variation. OBJECTIVE We describe the pattern and investigate if year-to-year irregularities are associated with meteorological factors using data from 50 000 children diagnosed under the age of 15 yr in 23 population-based European registries during 1989-2008. METHODS Tests for seasonal variation in monthly counts aggregated over the 20 yr period were performed. Time series regression was used to investigate if sunshine hour and average temperature data were predictive of the 240 monthly diagnosis counts after taking account of seasonality and long term trends. RESULTS Significant sinusoidal pattern was evident in all but two small centers with peaks in November to February and relative amplitudes ranging from ± 11 to ± 38% (median ± 17%). However, most centers showed significant departures from a sinusoidal pattern. Pooling results over centers, there was significant seasonal variation in each age-group at diagnosis, with least seasonal variation in those under 5 yr. Boys showed greater seasonal variation than girls, particularly those aged 10-14 yr. There were no differences in seasonal pattern between four 5-yr sub-periods. Departures from the sinusoidal trend in monthly diagnoses in the period were significantly associated with deviations from the norm in average temperature (0.8% reduction in diagnoses per 1 °C excess) but not with sunshine hours. CONCLUSIONS Seasonality was consistently apparent throughout the period in all age-groups and both sexes, but girls and the under 5 s showed less marked variation. Neither sunshine hour nor average temperature data contributed in any substantial way to explaining departures from the sinusoidal pattern.
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Affiliation(s)
- C C Patterson
- Centre of Excellence for Public Health Northern Ireland, Queen's University Belfast, Belfast, UK
| | - E Gyürüs
- Department of Paediatrics, Pécs University, Pecs, Hungary
| | - J Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - O Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - A Neu
- Pediatric Endocrinology & Diabetes, University Children's Hospital, Tübingen, Germany
| | - E Schober
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - R C Parslow
- Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK
| | - G Joner
- Department of Pediatrics, Ullevål University Hospital, Oslo, Norway
| | - J Svensson
- Department of Paediatrics, Herlev University Hospital, Copenhagen, Denmark
| | - C Castell
- Public Health Agency, Department of Health, Government of Catalonia, Barcelona, Spain
| | - P J Bingley
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - E Schoenle
- Department of Endocrinology and Diabetology, University Children's Hospital, Zurich, Switzerland
| | - P Jarosz-Chobot
- Department of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland
| | - B Urbonaité
- Institute of Endocrinology, Lithuanian University of Health Science, Kaunas, Lithuania
| | - U Rothe
- Department for Epidemiology and Health Care Research, Technical University of Dresden, Dresden, Germany
| | - C Kržišnik
- Department of Pediatrics, University Children's Hospital, Ljubljana, Slovenia
| | - C Ionescu-Tirgoviste
- Nutrition and Metabolic Diseases Clinic, N Paulescu Institute of Diabetes and Metabolic Diseases, Bucharest, Romania
| | - I Weets
- Diabetes Research Center, Brussels Free University, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Kocova
- Department of Endocrinology and Genetics, University Children's Hospital, Skopje, Macedonia
| | - G Stipancic
- Department of Paediatrics, University Hospital Sestre Milosrdnice, Zagreb, Croatia
| | - M Samardzic
- Department of Endocrinology and Diabetes, University Children's Hospital, Podgorica, Montenegro
| | - C E de Beaufort
- Department of Paediatric Diabetes and Endocrinology, Centre Hospitalier de Luxembourg, Luxembourg
| | - A Green
- Odense Patient data Exploratory Network, University of Southern Denmark, Odense, Denmark
| | - G Soltész
- Department of Paediatrics, Pécs University, Pecs, Hungary
| | - G G Dahlquist
- Department of Clinical Science, University of Umeå, Umeå, Sweden
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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Neu A, Lange K, Barrett T, Cameron F, Dorchy H, Hoey H, Jarosz-Chobot P, Mortensen HB, Robert JJ, Robertson K, de Beaufort C. Classifying insulin regimens--difficulties and proposal for comprehensive new definitions. Pediatr Diabetes 2015; 16:402-6. [PMID: 25865149 DOI: 10.1111/pedi.12275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 11/29/2022] Open
Abstract
Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.
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Affiliation(s)
- A Neu
- Children's Hospital, University Hospital Tuebingen, Germany
| | - K Lange
- Department of Medical Psychology OE5430, Hannover Medical School, Germany
| | - T Barrett
- Institute of Child Health, University of Birmingham, UK
| | - F Cameron
- Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Australia
| | - H Dorchy
- Clinique de Diabetologie, Hopital Universitaire des Enfants, Brussels, Belgium
| | - H Hoey
- Department of Paediatrics, University of Dublin, Trinity College, Ireland
| | - P Jarosz-Chobot
- Department of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland
| | - H B Mortensen
- Faculty of Health Science, University of Copenhagen, Denmark
| | - J-J Robert
- Department of Diabetes in Children and Adolescents, Hôpital Necker - Enfants Malades, Paris, France
| | - K Robertson
- Department of Paediatrics, DCRTD, Kuwait.,Department of Diabetes, Royal Hospital for Sick Children, Glasgow, UK
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Skoda E, Keifenheim K, Holl R, Rapps N, Neu A, Junne F, Teufel M. Komorbidität von Essstörungen und Diabetes mellitus Typ 1: Genese, Prävalenz und Interventionsmöglichkeiten. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1399311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- E. Skoda
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - K. Keifenheim
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - R. Holl
- Universität Ulm, Institut für Epidemiologie und medizinische Biometrie
| | - N. Rapps
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - A. Neu
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin
| | - F. Junne
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
| | - M. Teufel
- Universitätsklinikum Tübingen, Medizinische Klinik, Abteilung Psychosomatische Medizin und Psychotherapie
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16
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1385412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnosis, Therapy and Control of Diabetes Mellitus in Children and Adolescents. Exp Clin Endocrinol Diabetes 2014; 122:425-34. [DOI: 10.1055/s-0034-1366384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | - B. Karges
- Sektion Endokrinologie und Diabetologie, RWTH Aachen
| | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Podeswik
- Bundesverband Bunter Kreis e. V., Institut für Sozialmedizin in der Pädiatrie, Augsburg
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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Schweizer R, Herrlich S, Lösch-Binder M, Braun R, Behret F, Schneider A, Neu A. Anstieg des Blutzuckers nach fett- und proteinreichen Mahlzeiten: Die Tübinger Grill Studie, eine Pilotstudie bei Jugendlichen mit Typ 1 Diabetes. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1350564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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Choe CU, Nabuurs C, Stockebrand MC, Neu A, Nunes P, Morellini F, Sauter K, Schillemeit S, Hermans-Borgmeyer I, Marescau B, Heerschap A, Isbrandt D. L-arginine:glycine amidinotransferase deficiency protects from metabolic syndrome. Hum Mol Genet 2013. [DOI: 10.1093/hmg/ddt320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rajab JM, Schweizer R, Liebrich F, Braun R, Kranz J, Serra E, Lösch-Binder M, Neu A. Geringe Alltagsbelastung bei heranwachsenden Patienten durch Typ 1 Diabetes. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1325581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, Parslow RC, Joner G, Svensson J, Castell C, Bingley PJ, Schoenle E, Jarosz-Chobot P, Urbonaité B, Rothe U, Krzisnik C, Ionescu-Tirgoviste C, Weets I, Kocova M, Stipancic G, Samardzic M, de Beaufort CE, Green A, Dahlquist GG, Soltész G. Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: evidence of non-uniformity over time in rates of increase. Diabetologia 2012; 55:2142-7. [PMID: 22638547 DOI: 10.1007/s00125-012-2571-8] [Citation(s) in RCA: 310] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 04/02/2012] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS The aim of the study was to describe 20-year incidence trends for childhood type 1 diabetes in 23 EURODIAB centres and compare rates of increase in the first (1989-1998) and second (1999-2008) halves of the period. METHODS All registers operate in geographically defined regions and are based on a clinical diagnosis. Completeness of registration is assessed by capture-recapture methodology. Twenty-three centres in 19 countries registered 49,969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studied. RESULTS Ascertainment exceeded 90% in most registers. During the 20-year period, all but one register showed statistically significant changes in incidence, with rates universally increasing. When estimated separately for the first and second halves of the period, the median rates of increase were similar: 3.4% per annum and 3.3% per annum, respectively. However, rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods; five registers showed significantly higher rates of increase in the first half, and four significantly higher rates in the second half. CONCLUSIONS/INTERPRETATION The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum, but the increase is not necessarily uniform, showing periods of less rapid and more rapid increase in incidence in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions is warranted.
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Affiliation(s)
- C C Patterson
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science Block B, Grosvenor Road, Belfast, BT12 6BJ, UK.
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Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect almost any organ system, including the kidneys. Using a large national dataset, our goal was to compare the morbidity as measured by hospitalization and mortality rates between hemodialysis patients with end-stage renal disease (ESRD) secondary to SLE to those with ESRD due to other causes. METHODS The risk of hospitalization was calculated by Poisson regression with clustering for repeated measures using the United States Renal Data System (USRDS) Hospitalization Analytic File in strata of pediatric and adult patients. Cox proportional hazard ratio was used to assess the mortality risk in hospitalized patients. Subjects were censored at transplantation or end of follow-up. RESULTS Adult patients with ESRD secondary to SLE were hospitalized more frequently than other adults (incidence rate ratio (IRR): 1.43, 95% confidence interval (CI): 1.15-1.77) and had a higher risk of death (hazard ratio (HR): 1.89, 95% CI: 1.66-2.5). Mortality was higher in hospitalized pediatric patients with SLE compared to pediatric patients with other causes of ESRD (HR: 2.01, 95% CI: 1.75-2.31) and adults with SLE (HR: 2.05, 95% CI: 1.79-2.34). CONCLUSION Our study demonstrates that there is a trend toward increased hospitalization rates in pediatric and adult patients with SLE. Among these hospitalized patients with SLE, there is an increased risk of death due to cardiovascular disease.
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Affiliation(s)
- S Sule
- Johns Hopkins University, Maryland, USA.
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Ehehalt S, Neu A, Michaelis D, Heinke P, Willasch AM, Dietz K. Incidence of type 1 diabetes in childhood before and after the reunification of Germany--an analysis of epidemiological data, 1960-2006. Exp Clin Endocrinol Diabetes 2012; 120:441-4. [PMID: 22576256 DOI: 10.1055/s-0032-1309045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To examine the impact of rapidly changing environmental factors on the incidence of type 1 diabetes mellitus (T1D). METHOD We compared the frequency of T1D in children before and after the reunification of Germany by means of the registries of the German Democratic Republic (GDR, 1960-1989) and of Baden-Wuerttemberg (BW, 1987-2006). The number of cases of diabetes onset in East Germany after the reunification was predicted by a mathematical model. The observed incidence rate in the Eastern part of Germany after the reunification was taken from the literature 1. RESULTS In Germany, the incidence rate of T1D in children aged 0-14 was 7.2/100 000/year (95%-CI 6.9-7.5, GDR, 1980-1987), and 10.4/100 000/year (95%-CI 9.5-11.4, BW, 1987-1994). For the whole observation period (1960-2006), the observed incidence rates y could be described by the square of a linear function [GDR: y=(1.86 + 0.040 * (year - 1960))²; r²=0.85; BW: y=(3.03 + 0.085 * (year - 1987))², r²=0.89]. The mean rise in incidence before the reunification was less than half the mean rise after the reunification (mean slope: BW 0.085, 95%-CI 0.080-0.090 vs. GDR 0.040, 95% CI 0.036-0.044). The observed incidence for East Germany after 1989 was higher than the prediction on the basis of the GDR -registry (GDR 12.3/100 000/year vs. Saxony 15.7/100 000/year, 95%-CI 14.2-17.3, n=412; 1999-2003). CONCLUSION We conclude that the basis for the disease progress is a genetic predisposition. Environmental factors may modify changes in incidence of type 1 diabetes but do not determine the overall risk.
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Affiliation(s)
- S Ehehalt
- Paediatric Endocrinology and Diabetes, University Children's Hospital Tuebingen, Germany
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Ehehalt S, Dietz K, Neu A. Prognose der Häufigkeitsentwicklung des Typ-1-Diabetes – Daten zur Prävalenz im Kindes- und Jugendalter aus Baden-Württemberg. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Karges B, Neu A, Hofer SE, Rosenbauer J, Kiess W, Rütschle H, Dost A, Kentrup H, Holl RW. [Frequency and influencing factors of ketoacidosis at diabetes onset in children and adolescents--a long-term study between 1995 and 2009]. Klin Padiatr 2011; 223:70-3. [PMID: 21271502 DOI: 10.1055/s-0030-1269884] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Diabetic ketoacidosis (DKA) is a frequent acute complication at onset of type 1 diabetes. It is assumed that increased public awareness about diabetes symptoms may reduce DKA rate at diabetes onset. To investigate the time-dependent trend in DKA prevalence we analysed the frequency and determinants of DKA at disease onset over 15 years in pediatric patients. PATIENTS AND METHODS The prevalence of DKA at disease onset was analysed in individuals aged ≤18 years treated for the first time from 1995-2009 within 7 days after diagnosis in pediatric centers. Simple and multiple logistic regression analysis was performed to investigate influencing factors on DKA prevalence. Change of the probability of ketoacidosis over years were modelled in the logistic regression as linear trend. RESULTS 16 562 individuals from 170 institutions were studied with a mean age of 9.2 ± 4.2 years. DKA (pH <7.3) was present in 20.8% of patients without a significant trend between 1995 and 2009 (p=0.222). DKA prevalence was higher in children ≤5 years (26.3%) and in the age group 10-15 years (21.7%) than in individuals aged 5-10 years (16.4%) and 15-18 years (16.9%, p<0.001). Girls had DKA more often than boys (21.2% vs. 19.3%, p=0.002). DKA frequency was increased in individuals with migration background (26.5% vs. 19.2%, p<0.001). CONCLUSIONS DKA prevalence at diabetes onset was constant at about 21% during the last 15 years. Very young children, pubertal adolescents, girls and individuals with migration background are at higher risk for DKA at diagnosis. To prevent DKA earlier diagnosis of type 1 diabetes is warranted especially in these patient groups.
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Affiliation(s)
- B Karges
- Sektion Endokrinologie und Diabetologie, Universitätsklinikum Aachen, RWTH Aachen.
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1262636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Blohm M, Lehmberg K, Hillebrand G, Neu A, Ridderbusch I, Schneppenheim R, Singer D. Unterarmgangrän und Hirninfarkt bei „normaler“ Gerinnung: Homozygoter Antithrombin III – Mangel Typ II (Budapest). Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gocz A, Neu A, Lange K. Struktur und Qualität der pädiatrischen Diabetesversorgung 1998–2008 in Deutschland: Zentralisierung und steigende Qualifizierung bei unzureichender Finanzierung. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Karges B, Kapellen T, Neu A, Hofer SE, Rohrer T, Rosenbauer J, Wolf J, Holl RW. Langwirkende Insulinanaloga und Häufigkeit der diabetischen Ketoazidose bei Kindern und Jugendlichen mit Typ 1 Diabetes: Eine prospektive Studie in 10.682 Patienten von 271 Institutionen. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ehehalt S, Gauger N, Blumenstock G, Feldhahn L, Scheffner T, Schweizer R, Neu A. HbA1c als zuverlässiges Diagnosekriterium des Typ-1-Diabetes im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ehehalt S, Michaelis D, Dietz K, Heinke P, Neu A. Häufigkeit des Typ-1-Diabetes im Kindes- und Jugendalter vor und nach der Wende – Ergebnisse aus dem DDR- und dem Baden-Württemberger Diabetesinzidenzregister. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Neu A, Lösch-Binder M, Ehehalt S, Schweizer R, Hub R, Serra E. Follow-up of adolescents with diabetes after transition from paediatric to adult care: results of a 10-year prospective study. Exp Clin Endocrinol Diabetes 2010; 118:353-5. [PMID: 20140851 DOI: 10.1055/s-0029-1246215] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Our main objective in this study was to identify the type of clinical care received by young type 1 diabetic patients who have made the transition from paediatric to adult care, and to assess the metabolic status of long-term treatment after the transition. METHODS A standardized questionnaire was used prospectively to follow 99 patients with type 1 diabetes mellitus after their transition to adult care. This survey was done once a year, from 1998 to 2008. RESULTS Directly after transition from paediatric care 38.4% of patients were found at specialised outpatient units; whereas 41.1% received care at a diabetes centre and 20.5% were monitored by general practitioners or specialists in internal medicine. Five-year results showed that 25.0% had continued to visit an outpatient unit; 41.7% were still visiting a diabetes centre; and 33.3% had remained in the care of general practitioners or internal specialists. We observed a trend showing slight improvements in the HbA1c values over time, however no major changes in metabolic control were observed after transition. CONCLUSIONS Transition marks a critical phase for young, diabetic patients as they may frequently switch from one physician or centre to another. The individual optimization of therapy, established during paediatric care, provides the decisive groundwork for disease control in young adults.
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Affiliation(s)
- A Neu
- University Children's Hospital, Tübingen, Germany.
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, Sengbusch SV, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1224581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ehehalt S, Dietz K, Willasch AM, Neu A. Epidemiologie des Typ-1-Diabetes in Baden-Württemberg: Kein Zusammenhang zwischen Inzidenzrate und Bevölkerungsdichte. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fine RN, Becker Y, De Geest S, Eisen H, Ettenger R, Evans R, Rudow DL, McKay D, Neu A, Nevins T, Reyes J, Wray J, Dobbels F. Nonadherence consensus conference summary report. Am J Transplant 2009; 9:35-41. [PMID: 19133930 DOI: 10.1111/j.1600-6143.2008.02495.x] [Citation(s) in RCA: 201] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This report is a summary of a 'Consensus Conference' on nonadherence (NA) to immunosuppressants. Its aims were: (1) to discuss the state-of-the-art on the definition, prevalence and measurement of NA, its risk factors and impact on clinical and economical outcomes and interventions and (2) to provide recommendations for future studies. A two-day meeting was held in Florida in January 2008, inviting 66 medical and allied health adherence transplant and nontransplant experts. A scientific committee prepared the meeting. Consensus was reached using plenary and interactive presentations and discussions in small break-out groups. Plenary presenters prepared a summary beforehand. Break-out group leaders initiated discussion between the group members prior to the meeting using conference calls and e-mail and provided a summary afterward. Conclusions were that NA: (a) is more prevalent than we assume; (b) is hard to measure accurately; (c) tends to confer worse outcomes; (d) happens for a number of reasons, and system-related factors including the patient's culture, the healthcare provider and the setting and (e) it is not currently known how to improve adherence. This consensus report provided some roadmaps for future studies on this complicated, multifaceted problem.
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Affiliation(s)
- R N Fine
- Stony Brook University Medical Center, Stony Brook, NY, USA.
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Neu A, Ehehalt S, Feldhahn L, Kehrer M, Willasch A, Hub R, Ranke M. Diabeteshäufigkeit bei Kindern und Jugendlichen in Deutschland – 20 Jahre Diabetes-Inzidenzregister Baden-Württemberg. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
AIMS To assess the incidence and the trend in incidence of Type 1 diabetes (T1DM) in children and adolescents < 15 years of age in Baden-Württemberg (BW), Germany. METHODS BW is Germany's third largest federal state. All 31 paediatric departments in BW and one diabetes centre participated in the study. Case registration was done according to the EURODIAB criteria. The degree of ascertainment was 97.2%. RESULTS From 1987 to 2003, the age- and sex-standardized incidence rate was 14.1/100,000 per year [95% confidence interval (CI) 13.7, 14.6, n = 4017]. The estimated annual increase in incidence was 3.8% (95% CI 1.1, 6.6). Compared with the first years of our registry, the current mean number of new cases of T1DM has doubled (1987-1989, n = 153; 2000-2003, n = 302). Generally, the highest rise in incidence occurred in the youngest age group of 0-4-year-old patients (5.8%; 95% CI 2.5, 9.3), followed by the age groups 5-9 (3.4%; 95% CI 0.8, 6.0) and 10-14 (2.7%; 95% CI 0.3, 5.1). CONCLUSIONS In Germany, the number of children and adolescents with new-onset T1DM has been rising at a faster pace than expected. A distinct shift to younger age at onset has been observed in Germany.
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Affiliation(s)
- S Ehehalt
- University Children's Hospital, Eberhard-Karls-University, Tübingen, Germany
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Danne T, Beyer P, Etspüler J, Heidtmann B, Holl R, Holterhus P, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Neu A, Petersen M, Ziegler R. Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1004683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Neu A, Ehehalt S, Willasch A, Hub R, Ranke MB. Diabeteshäufigkeit gestern – heute – morgen. Zwanzig Jahre Diabetes-Inzidenzregister (DIARY) Baden-Württemberg. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ehehalt S, Willasch A, Hub R, Ranke MB, Neu A. Epidemiologie des Typ-1-Diabetes im Kindes- und Jugendalter in Deutschland – aktuelle Daten aus dem Baden-Württemberger Diabetes-Inzidenzregister. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Danne T, Beyer P, Etspüler J, Heidtmann B, Holl R, Holterhus P, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Neu A, Petersen M, Ziegler R. Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-960641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lange K, Kleine T, Dunstheimer D, Etspüler J, Paape D, Lauterborn R, Jorch N, Kapellen T, Petersen M, Ludwig KH, Neu A, Danne T. Gute Lebensqualität von Kindern mit Typ 1 Diabetes und hohe Belastung der Eltern im ersten Jahr nach Diabetesdiagnose: Ergebnisse einer multizentrischen prospektiven Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lösch-Binder M, Hub R, Serra E, Ehehalt S, Ranke MB, Neu A. Transfer junger Patienten aus der pädiatrischen Diabetologie in die Erwachsenenmedizin – eine Herausforderung. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Karges B, Muche R, Knerr I, Ertelt W, Wiesel T, Hub R, Neu A, Klinghammer A, Aufschild J, Rapp A, Schirbel A, Boehm BO, Debatin KM, Heinze E, Karges W. L-Thyroxin bei euthyreoter Autoimmunthyreoiditis und Typ 1 Diabetes: eine randomisierte, kontrollierte multizentrische Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Janssen GMC, Neu A, 't Hart LM, van de Sande CMT, Antonie Maassen J. Novel Mitochondrial DNA Length Variants and Genetic Instability in a Family with Diabetes and Deafness. Exp Clin Endocrinol Diabetes 2006; 114:168-74. [PMID: 16705548 DOI: 10.1055/s-2006-924066] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We have identified two locations with novel multiplasmic length variants in the mitochondrial DNA of a family with diabetes and deafness. At nt568 in the D-loop, the 6-bp polycytidine tract was found to be variable in length up to a total of 12 residues. A second region with length variants was found at nt8281 in the intergenic COII-tRNA(Lys) region, which consists of two copies of the 9-bp repeat CCCCCTCTA. Only the second repeat occurs in a heteroplasmic C(9-14)A form with both T residues largely deleted. In addition, the mtDNA contained a number of new homoplasmic point mutations. Both length variants are stably inherited in a maternal way with no major changes in their length distribution. In contrast, during culture of fibroblasts from the proband the average length of the polycytidine tracts is increased at both locations indicating a fibroblast-specific genetic instability. Cybrid cells containing mtDNA from the proband proliferate less efficient than cybrids with wild-type mtDNA in co-culture experiments, suggesting functional consequences of the mtDNA length variants or the additional homoplasmic point mutations. Since oxygen consumption was not severely affected, these mutation seem less detrimental for mitochondrial function than the A3243G diabetogenic mutation and most other pathogenic mtDNA mutations. The contribution of mtDNA length variants to the phenotype of members of this family is discussed.
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Affiliation(s)
- G M C Janssen
- Department of Molecular Cell Biology, Leiden University Medical Centre, Leiden, The Netherlands.
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Danne T, Beyer P, Etspüler J, Heidtmann B, Holl R, Holterhus P, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Neu A, Petersen M, Ziegler R. Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-941469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hub R, Ehehalt S, Busch A, Ranke MB, Neu A. Diabetes mellitus Typ 3 als Folge angeborener Pankreasaplasie – eine Kasuistik. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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