The reactive aldehydes methylglyoxal and glyoxal, arise from enzymatic and non-enzymatic degradation of glucose, lipid and protein catabolism, and lipid peroxidation. In Type 1 diabetes mellitus (T1DM) where hyperglycemia, oxidative stress, and lipid peroxidation are common, these aldehydes may be elevated. These aldehydes form advanced glycation end products (AGEs) with proteins that are implicated in diabetic complications. We measured plasma methylglyoxal and glyoxal in young, complication-free T1DM patients and assessed activity of the ubiquitous membrane enzyme, Na+/K+ ATPase. A total of 56 patients with TIDM (DM group), 6-22 years, and 18 non-diabetics (ND group), 6-21 years, were enrolled. Mean plasma A1C (%) was higher in the DM group (8.5+/-1.3) as compared to the ND group (5.0+/-0.3). Using a novel liquid chromatography-mass spectrophotometry method, we found that mean plasma methylglyoxal (nmol/l) and glyoxal levels (nmol/l), respectively, were higher in the DM group (841.7+/-237.7, 1051.8+/-515.2) versus the ND group (439.2+/-90.1, 328.2+/-207.5). Erythrocyte membrane Na+/K+ ATPase activity (nmol NADH oxidized/min/mg protein) was elevated in the DM group (4.47+/-0.98) compared to the ND group (2.16+/-0.59). A1C correlated with plasma methylglyoxal and glyoxal, and both aldehydes correlated with each other. A high correlation of A1C with Na+/K+ ATPase activity, and a regression analysis showing A1C as a good predictor of activity of this enzyme, point to a role for glucose in membrane alteration. In complication-free patients, increased plasma methylglyoxal, plasma glyoxal, and erythrocyte Na+/K+ ATPase activity may foretell future diabetic complications, and emphasize a need for aggressive management.

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OBJECTIVE -The aim of this study was to determine the incidence of type 1 diabetes among children aged 0 -14 years in the Avalon Peninsula in the Canadian Province of Newfoundland.RESEARCH DESIGN AND METHODS -This was a prospective cohort study of the incidence of childhood type 1 diabetes in children aged 0 -14 years who were diagnosed with type 1 diabetes from 1987 to 2002 on the Avalon Peninsula. Identified case subjects during this time period were ascertained from several sources and verified using the capture-recapture technique. Data were obtained from the only pediatric diabetes treatment center for children living on the Avalon Peninsula.RESULTS -Over the study period, 294 children aged 0 -14 years from the Avalon Peninsula were diagnosed with type 1 diabetes. The incidence of type 1 diabetes in this population over the period 1987-2002 inclusive was 35.93 with a 95% CI of 31.82-40.03. The incidence over this period increased linearly at the rate of 1.25 per 100,000 individuals per year.CONCLUSIONS -The Avalon Peninsula of Newfoundland has one of the highest incidences of type 1 diabetes reported worldwide. The incidence increased over the 16-year study period. Diabetes Care 27:885-888, 2004T ype 1 diabetes, the most common form of diabetes in childhood, is a T-cell-mediated autoimmune disease in which both genetic and environmental factors play roles in the etiology (1,2). The incidence of childhood type 1 diabetes is known to vary widely between and within countries. The incidence of type 1 diabetes (Յ14 years) varies from 0.1/100,000 per year in China (1990China ( -1994 and Venezuela (1992) to 36.8/ 100,000 per year in Sardinia (1990Sardinia ( -1994) and 36.5/100,000 per year in Finland (1990Finland ( -1994. In most populations the incidence has been increasing (4). The incidence of type 1 diabetes in Canada is available from only a few studies, which were carried out over the past 25 years (3,5-7). Two Canadian provinces have also reported a high incidence of the disease. A 6-year study (1990 -1995) reported a mean incidence of 25.7/ 100,000 in children Ͻ15 years of age who lived in the city of Edmonton (5). A 4-year study from the province of Prince Edward Island reported a mean incidence of 24.5/ 100,000 in children Ͻ15 years of age (1990 -1993) (3). The reported mean incidence for Montreal (1971Montreal ( -1985 among children 0 -14 years was 10.1/ 100,000 (6). The lowest reported incidence was from Toronto (1976Toronto ( -1978 with a mean incidence of 9.0/100,000 per year in children Ͻ19 years of age (7).The study we are reporting was performed at the Janeway Child Health Care Centre (JCHCC), which is the only tertiary care children's hospital servicing the Province of Newfoundland and Labrador. All children with type 1 diabetes who live on the Avalon Peninsula are referred to one of the diabetologists at the JCHCC and are followed from the time of diagnosis by the Janeway Pediatric Diabetes Team. The Avalon Peninsula was chosen for a study of the incidence of diabetes because it is well def...

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BackgroundDiabetic ketoacidosis (DKA) is the most common cause of morbidity and mortality for youth with type 1 diabetes mellitus (T1DM). This article reports qualitative data from focus groups with youth and parents of youth with T1DM on the barriers that they identify to DKA prevention and resources that may aid youth better manage their diabetes.MethodsFour focus groups were held in three communities, two rural and one urban, in the Canadian province of Newfoundland and Labrador (NL) with adolescents and parents of youth with diabetes. Open-ended questions focused on knowledge of DKA, diabetes education, personal experiences with DKA, barriers to diabetes self-management, situations which put them at risk for DKA and resources that could be developed to aid youth in preventing DKA.ResultsThere were 19 participants (14 parents and 5 youth). Participants identified factors which increased their risk of DKA as difficulty in distinguishing cases of DKA from other illnesses; variations in diabetes education received; information overload about their condition; the long period from initial diagnosis, when most education about the condition was received; and stress regarding situations where youth are not in the direct care of their parents. Participants from rural areas reported geographical isolation and lack of regular access to specialist health care personnel as additional barriers to better diabetes management.ConclusionsThe project identified barriers to DKA prevention for youth which were not previously identified in the medical literature, e.g., the stress associated with temporary guardians, risk of information overload at initial diagnosis and the long period from initial diagnosis when most diabetes education is received. Families from rural areas do report additional burdens, but in some cases these families have developed community supports to help offset some of these problems. Mobile and online resources, educational refreshers about DKA, concise resources for teachers and other temporary guardians, and DKA treatment kits for parents may help improve diabetes management and prevent future episodes of DKA.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1358-7) contains supplementary material, which is available to authorized users.