Pediatric diabetes training for healthcare professionals in Europe: Time for change

Kime, Nicky; Waldron, Sheridan; Webster, Elizabeth; Lange, Karin; Zinken, Katarzyna; Danne, Thomas; Aschemeier, B; Šumnı́k, Zdenĕk; Cinek, Ondřej; Raposo, João Filipe; Vazeou, Andriani; Bratina, Nataša; Campbell, Fiona

doi:10.1111/pedi.12573

Cited by 7 publications

(14 citation statements)

References 17 publications

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“…The reports of the Dose Adjustment for Normal Eating (DAFNE) study emphasised the positive effect of CC on the quality of life [ 58 ]. So far, many kinds of structural education programs for T1D have been reported [ 59 , 60 ]. Most of these programs included CC and showed the improvement of patients’ adherence, as well as motivation.…”

Section: Insulin-to-carb Ratio (Icr) Insulin Sensitivity Factor (mentioning

confidence: 99%

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Carbohydrate Counting in Children and Adolescents with Type 1 Diabetes

et al. 2018

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Carbohydrate counting (CC) is a meal-planning tool for patients with type 1 diabetes (T1D) treated with a basal bolus insulin regimen by means of multiple daily injections or continuous subcutaneous insulin infusion. It is based on an awareness of foods that contain carbohydrates and their effect on blood glucose. The bolus insulin dose needed is obtained from the total amount of carbohydrates consumed at each meal and the insulin-to-carbohydrate ratio. Evidence suggests that CC may have positive effects on metabolic control and on reducing glycosylated haemoglobin concentration (HbA1c). Moreover, CC might reduce the frequency of hypoglycaemia. In addition, with CC the flexibility of meals and snacks allows children and teenagers to manage their T1D more effectively within their own lifestyles. CC and the bolus calculator can have possible beneficial effects in improving post-meal glucose, with a higher percentage of values within the target. Moreover, CC might be integrated with the counting of fat and protein to more accurately calculate the insulin bolus. In conclusion, in children and adolescents with T1D, CC may have a positive effect on metabolic control, might reduce hypoglycaemia events, improves quality of life, and seems to do so without influencing body mass index; however, more high-quality clinical trials are needed to confirm this positive impact.

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Section: Insulin-to-carb Ratio (Icr) Insulin Sensitivity Factor (mentioning

confidence: 99%

“…Therefore, CC has a positive effect on patients’ adherence and motivation too. In addition, it has been observed that CC also has a positive effect on the parents and caregivers, who are the key persons for the treatment of infants and young children with T1D [ 59 , 60 ].…”

Section: Insulin-to-carb Ratio (Icr) Insulin Sensitivity Factor (mentioning

confidence: 99%

Carbohydrate Counting in Children and Adolescents with Type 1 Diabetes

et al. 2018

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“…The intestinal bacterial imbalance (dysbiosis) and the enteropathogenic parasites that affect the gut barrier, have been independently associated with increased risk of developing T1D or CD in genetically predisposed children [ 9 , 23 , 35 ]. However, there is no information regarding the effect of enteropathogenic parasites’ infections on bacterial dysbiosis or vice versa, in children developing autoimmunity.…”

Section: Introductionmentioning

confidence: 99%

Enteric parasitic infection disturbs bacterial structure in Mexican children with autoantibodies for type 1 diabetes and/or celiac disease

et al. 2020

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Background Intestinal bacterial dysbiosis and increased gut permeability are associated with higher risk of developing type 1 diabetes (T1D) or celiac disease (CD). There is a lack of information on parasitism involved in gut disturbance of predisposed children. We evaluated the effect of enteropathogenic parasites ( Cryptosporidium spp., Cyclospora spp. G. lamblia , and Blastocystis spp.) on the bacterial structure of feces from children with autoantibodies for T1D or CD. Participants included 37 children under 18 years of age, from whom stools were analyzed for enteric parasites by qPCR and 22/37 for bacterial profile by sequencing the V3–V4 region of the 16s rRNA gene. Dietary, clinical, and socioeconomic data was recorded. Results Pathogens parasitized 28/37 participants, Cryptosporidium spp. was the most prevalent (62.2%), followed by both Cyclospora cayetanensis and Blastocystis spp (37.8%). There were no dietary differences ( p > 0.05) attributable to parasitism. Co-infected participants with Cryptosporidium and Cyclospora did not differ (p = 0.064) from non-infected participants in bacterial alpha phylogenetic diversity. The same parasites’ co-infection was associated with a decreased abundance of the Ruminococaceae (p = 0.04) and Verrucomicrobioceae families, of the Akkermansia genus (p = 0.009). There was a lower Firmicutes/Bacteroidetes ratio (p = 0.02) in infected than in uninfected participants. Conclusions Cryptosporidium and Cyclospora affected the bacterial structure at family and genus levels, decreasing the ratio between Firmicutes and Bacteroidetes in children with auto-antibodies for T1D or CD, which could increase the risk of illness onset.

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“…Especially considering that diabetes care is unequal worldwide, these Schools could play a major role as a diabetes care and research training program for early-career physicians and healthcare professionals. [2][3][4][5] Therefore, we designed retrospective qualitative surveys to evaluate the perceived impact of the ISSPs and ISSHPs on aspects related to participants' career development, scientific skills, and networking over the last 20-and 16-years, respectively.…”

Section: Introductionmentioning

confidence: 99%

“…The assessment of the impact of both courses on professionals' career in diabetes care and research holds particular interest for the validation and future of both Schools. Especially considering that diabetes care is unequal worldwide, these Schools could play a major role as a diabetes care and research training program for early‐career physicians and healthcare professionals 2–5 …”

Section: Introductionmentioning

confidence: 99%