CD is a common comorbidity in youth with type 1 diabetes. Differences in CD prevalence may reflect international variation in screening and diagnostic practices, and/or CD risk. Although glycemic control was not different, the lower height SDS supports close monitoring of growth and nutrition in this population.

Background Fear of hypoglycemia is common in parents of young children with type 1 diabetes (T1D), but little is known about the specific fears that parents most often experience. Hypoglycemia fear has been associated with poorer glycemic control in older children, though not yet studied in a large cohort of very young children. Materials and Methods Parents of 549 children <7 years (mean 5.2 ± 1.2 years [19% <3 years]) with a mean diabetes duration of 2.4 ± 1.0 years (range 1‐6 years) and mean HbA1c 8.2% ± 1.1% (66 ± 12 mmol/mol) registered in the T1D Exchange completed the worry scale of the Hypoglycemia Fear Survey modified for parents (HFS‐P). Results Mean parental fear of hypoglycemia worry score was 36.1 ± 23.1 (possible range 0‐100), with most frequent worries related to the child having a low while asleep and the child not recognizing a low. The mean worry score was not associated with the child's age, glycemic control, or recent severe hypoglycemic event. Parental worries about lows while sleeping were significantly higher in pump users than non‐users (61% vs. 45%; P < .001), and tended to be higher in CGM users than non‐users (62% vs 51%; P = .02). Conclusions The greatest worries of parents of young children with T1D were related to hypoglycemia during sleep and other times/circumstances during which it would be difficult to detect hypoglycemia. Using advanced diabetes technologies may be an effort to temper fears about hypoglycemia during sleep, though the directionality of this relationship is undetermined. Additional studies can clarify this association and leverage use of diabetes technologies to improve glycemic control.

These findings provide an opportunity to address potentially modifiable parent-reported barriers to pump uptake through education and behavioral intervention.

Substantial burdens remain for parents of young children with type 1 diabetes, despite the availability of advanced technologies for diabetes management.

The purpose of this study is to examine timing of meal insulin and further determine whether an association exists between timing of meal insulin and missed meal insulin doses. The cohort included 4768 T1D Exchange clinic registry participants <26 years with type 1 diabetes ≥1 year. Chi-square tests, t-tests, and regression were used to assess the relationship between participant characteristics and timing of meal insulin and missed meal doses, respectively. Timing of meal insulin and association with missed meal doses was analyzed using logistic regression. In all, 21% reported administering insulin several minutes before, 44% immediately before, 10% during, and 24% after meal. Participants who gave insulin prior to a meal had significantly lower HbA1c than those who gave insulin during or after meal (8.4% ± 1.5% vs 8.8% ± 1.6%, adjusted P < .001), but no significant association was observed regarding DKA events. Those who reported missing ≥1 insulin dose per week had higher HbA1c (9.8% ± 1.9% vs 8.3% ± 1.3%, adjusted P < .001) and were more likely to experience at least one DKA event (9% vs 5%, adjusted P = .001) compared with those who rarely missed a meal insulin dose. Participants who reported administering insulin during or after a meal were more likely to report missing ≥1 meal insulin dose per week compared with those who administered insulin before a meal (28% vs 14%, adjusted P < .001). Premeal insulin was associated with lower HbA1c and fewer missed meal insulin doses. Providers may use this information to discuss the benefits of premeal insulin on glycemic control and adherence to therapy.

No abstract

Diabetic peripheral neuropathy (DPN) is a major cause of disability, mortality and poor quality of life in patients with T1D, with prior reported prevalence rates of up to 35%. The contemporary prevalence of DPN in T1D patients was evaluated in T1D Exchange Registry centers throughout the United States. The Michigan Neuropathy Screening Instrument (MNSI), a validated 15-item self-administered questionnaire, was used to assess DPN in adults ≥18 years with ≥ 5 years of T1D duration. A score of ≥4 was used to define DPN. Diabetes-related characteristics and laboratory data were obtained through the most recent clinic update. Chi-square and t-tests were used to compare demographic and diabetes-related characteristics between those with and without DPN. Linear regression was used to determine the effect of DPN on HbA1c, adjusted for possible confounders. In preliminary analyses of 5,058 participants across 62 sites (mean age 39±18 years, T1D duration 22±14 years, 56% female, 88% non-hispanic white, mean HbA1c 8.1±1.6%), the prevalence of DPN was 10%. Those with DPN were older (52±17 vs. 37±18 years), more likely to be female (61% vs. 55%), had longer T1D duration (32±16 vs. 21±13 years), lower annual household income (37% vs. 59% earning ≥$75K), and lower education level (55% vs. 69% with college degree) than those without DPN (all p&lt;0.001). They also had higher systolic blood pressure (126±17 vs. 123±14 mmHg), triglycerides (117±89 vs. 95±62 mg/dL), tobacco use (9% vs. 4%) and prevalence of established CVD (26% vs. 6%), despite higher use of CVD-modifying agents such as statins (64% vs. 31%) and ACE-inhibitors/ARBs (45% vs. 23%) (all p&lt;0.001). Participants with DPN had higher HbA1c (8.4±1.7% vs. 8.1±1.6%), even after adjusting for multiple confounders (p &lt;0.01). The prevalence of DPN in this national T1D cohort is lower than prior published reports, reflecting current clinical care practices, and highlighting other non-glycemic risk factors for DPN including CVD risk factors and socioeconomic status. Disclosure K.R. Mizokami-Stout: None. C.T. Boyle: None. V.N. Shah: None. G. Aleppo: Research Support; Self; AstraZeneca, Novo Nordisk Inc.. Consultant; Self; Dexcom, Inc.. Advisory Panel; Self; Novo Nordisk Inc. J.B. McGill: Research Support; Self; AstraZeneca. Consultant; Self; Boehringer Ingelheim GmbH. Speaker's Bureau; Self; Aegerion Pharmaceuticals. Consultant; Self; Bayer AG, Dexcom, Inc., Intarcia Therapeutics, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., MannKind Corporation. Research Support; Self; Novartis Pharmaceuticals Corporation. Consultant; Self; Novo Nordisk A/S. R. Pratley: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Inc., GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Pfizer Inc., Sanofi-Aventis, Takeda Development Center Americas, Inc.. E. Toschi: None. L. Ang: None. R. Pop-Busui: Research Support; Self; AstraZeneca.

For individuals aged 10 to <40 years with type 1 diabetes and dyslipidaemia, US national guidelines recommend consideration of statin therapy based on age, low-density lipoprotein cholesterol (LDL-C) level and other cardiovascular risk factors. We evaluated dyslipidaemia prevalence, statin therapy use, and associations between not meeting target LDL-C [<100 mg/dL (<5.55 mmol/L)] and other cardiovascular disease (CVD) risk factors in individuals aged 10 to <40 years in the T1D Exchange clinic registry. In 7223 participants, statin use was 2% in 10 to <18 year olds, 4% in 18 to <25 year olds, and 21% in 25 to <40 year olds. Individuals not on statin therapy with LDL-C above target were more likely to have ≥1 additional CVD risk factor(s) than those with LDL-C in the target range for all age groups (all P < 0.01). While most individuals not on statin therapy had LDL-C in the target range, those who did not were more likely to have ≥1 additional CVD risk factor(s), and therefore longitudinal study of lipid levels and statin use is needed to see if treatment of dyslipidaemia to target LDL-C levels may lower the risk of future CVD in individuals aged 10 to <40 years with type 1 diabetes.