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Global Idf Ispad Guideline For Diabetes In Childhood And Adolescence

Hypoglycemia In Children With Type 1 Diabetes: Unawareness Is A Concrete Risk

Hypoglycemia In Children With Type 1 Diabetes: Unawareness Is A Concrete Risk

Click to increase image sizeClick to decrease image size The incidence of type 1 diabetes (T1D) is increasing rapidly, especially in younger age groups. The data from Western European Diabetes Mellitus Centers suggest an annual rate increase of 34% in children and adolescents 1 Patterson CC, Dahlquist GG, Gyurus E, etal. Incidence trends for childhood type 1 diabetes in Europe during 19892003 and predicted new cases 200520: a multicentre prospective registration study. Lancet 2009;373:2027-33 [Crossref] , [PubMed] , [Web of Science ] [Google Scholar] . The latest worldwide estimates show 415 million of patients with diabetes overall, that would become 642 million around 2040; there are 86,000 new cases a year of T1D among children and 542,000 patients worldwide 2 International Diabetes Federation. IDF Diabetes Atlas, 7th edn. Brussels: IDF, 2015. Available at: [Last accessed 15 April 2016] [Google Scholar] . The incidence varies approximately 400-fold between nations, with wide variations among regions of the same state. For example, the incidence of T1D in Italy is significantly different from the observed rate in Sardinia 3 DIAMOND project group. Incidence and trends of childhood type 1 diabetes worldwide 19901999. Diabet Med 2006;23:857-66 [Crossref] , [PubMed] , [Web of Science ] [Google Scholar] (epidemiologic data in 2011: 45/100,000 new cases per year between 0 and 14 years of age), that has a trend of increase second only to Finland 2 International Diabetes Federation. IDF Diabetes Atlas, 7th edn. Brussels: IDF, 2015. Available at: [Last accessed 15 April 2016] [Google Scholar] , 4 Osservatorio Epidemiologico Regionale Regione Autonoma della Sardegna. Il registro del diabete di tipo 1 in et pediatrica in Sardegna. Available at: [Last accessed 15 April 2016] [Go Continue reading >>

How To Use Fast Acting Insulin

How To Use Fast Acting Insulin

Fast acting insulins, such as NovoRapid and Humalog, can be given in addition to your child’s normal insulin injections when the blood glucose level is high, especially when ketones are present. The following guide will help you decide how much extra fast acting insulin can be given. Please remember that when you have to give extra fast acting insulin it is always given as well as, not instead of, the normal insulin dose. Fast acting insulin can be given at breakfast time, lunchtime and before the evening meal. It is best not to give fast acting insulin to your child before they go to bed at night in order to reduce the possibility of hypoglycaemia (low blood glucose levels). The amount of fast acting insulin to give is based on your child’s normal total insulin dose for the day, including all rapid acting, long acting and mixed insulin. If the blood glucose level is between 15-20 mmol/L, but there are no ketones present, give a dose of fast acting insulin that is 5% of the total daily dose If the blood glucose level is between 15-20 mmol/L and there are ++ or +++ ketones present (i.e. moderate to large amounts) or blood ketones greater than 1.0mmol/l, give a dose of fast acting insulin that is 10% of the total daily dose. If the blood glucose level is over 20 mmol/L, but there are no ketones present or blood ketones less than 1 mmol/L give a dose of fast acting insulin that is 10% of the total daily dose. If the blood glucose level is over 20 mmol/L and there are ++ or +++ ketones present (i.e. moderate to large amounts) or blood ketones greater than 1.0 mmol/L, give a dose of fast acting insulin that is 15% of the total daily dose. Comparison of Blood Beta Ketone and Urine Ketone Readings The blood and urine ketone values do not always agree as the urine Continue reading >>

Idf/ispad Pocketbook For Management Of Diabetes In Childhood And Adolescence In Under-resourced Settings - 2nd Edition

Idf/ispad Pocketbook For Management Of Diabetes In Childhood And Adolescence In Under-resourced Settings - 2nd Edition

IDF/ISPAD Pocketbook for Management of Diabetes in Childhood and Adolescence in Under-Resourced Settings - 2nd Edition Target audience: All health professionals LFAC-ISPAD-Pocketbook-2nd-edition-final-web.pdf(1.05 MB) The International Society for Pediatric and Adolescent Diabetes (ISPAD) released comprehensive guidelines in 1995, 2000 and 2009. Using these guidelines, the International Diabetes Federation (IDF) and ISPAD published the "Global Guideline for Diabetes in Children and Adolescence" in 2011. The IDF Life for a Child Programme and ISPAD decided it was appropriate to develop a shortened version of these guidelines aimed to be of practical use in emergency situations and in clinics that are developing expertise in managing diabetes in children. The Pocketbook provides basic background on diabetes in children and clear advice for initial management of diabetic ketoacidosis, initiation of maintenance insulin therapy, complications screening, and other key components of care. The guidelines have been developed taking into account resource- and cost-related issues affecting care for children and youth with diabetes in developing countries. Healthcare funding and available expertise vary from country to country and also within a particular country, and therefore it is challenging to write a broad document to meet all needs. The information in these guidelines is aimed to assist healthcare professionals in developing countries to optimise the clinical practice they are able to give in their particular centre. In many cases, subsequent referral to a centre with greater expertise is appropriate. The 2nd edition expands on the contents of the 1st edition , published in 2013. Continue reading >>

Treatment Of Diabetic Ketoacidosis With Subcutaneous Insulin Lispro: A Review Of The Current Evidence From Clinical Studies

Treatment Of Diabetic Ketoacidosis With Subcutaneous Insulin Lispro: A Review Of The Current Evidence From Clinical Studies

Low-dose intravenous infusions of regular insulin, usually initiated in the emergency department and continued in the intensive care unit (ICU), are the standard care for patients with diabetic ketoacidosis (DKA) to ensure rapid resolution of hyperglycaemia and ketoacidosis. Several studies have evaluated whether subcutaneous injections of the rapid-acting analogue insulin lispro may be an alternative to intravenous insulin infusion for avoiding ICU admissions of uncomplicated DKA cases. This review summarizes the current clinical evidence for the effectiveness and safety of subcutaneous insulin lispro injections in non-severe DKA patients. Relevant studies were identified by a systematic literature search through the PubMed database. To date, four small randomized studies (156 patients overall; three studies in adults and one in paediatric patients with diabetes) have directly compared subcutaneous insulin lispro injections every 1–2h vs continuous intravenous infusions of regular insulin. Patients with severe complications were excluded. In all studies, the mean time to resolution of DKA was similar in both treatment groups [range (three studies): lispro 10–14.8h; regular insulin 11–13.2h]. The mean time to resolution of hyperglycaemia, total insulin doses required, number of hospitalization days and number of hypoglycaemic episodes were similar in both treatment groups; no severe complications or DKA recurrences were reported, and one study showed a 39% cost reduction for the insulin lispro group. In patients with mild-to-moderate DKA, subcutaneous injections of insulin lispro every 1–2h offer a feasible alternative to continuous intravenous infusions of regular insulin, and should now be evaluated in larger, more appropriately powered studies. The full text Continue reading >>

Type 1 Diabetic Camp: An Experience In Mauritius

Type 1 Diabetic Camp: An Experience In Mauritius

The aim of the nongovernmental organization Type 1 diabetes mellitus support (T1Diams) is to empower children, adolescents, and young adults with Type 1 diabetes to optimally manage their medical condition. In the Republic of Mauritius (an Island in the South-West of the Indian Ocean), since 2007, T1Diams has been organizing a yearly diabetic camp of 7-day duration during the winter season for its members and their families. Two age groups are present (0–11 years and 12–25 years). For the first group, the children are accompanied by their parents while the second group comes on their own. During the camp, therapeutic education is carried out. The acquisition of knowledge and self-care skills are ensured through pedagogical diabetes-related games and presentations. Physical activities as well as workshop on carbohydrate counting are also organized. Those activities help the participants acquire and maintain the skills that are sine qua non to live optimally with their disease. During the camp, there are also interventions from professionals (nutritionist, psychologist, social worker, endocrinologist, ophthalmologist, podiatrist, and dentist) so that they get a complete medicosocial follow-up. Self-monitoring of blood glucose and education on insulin injections are done on a regular basis (at least 4 times/day). Tests for glycated hemoglobin and microalbuminuria are performed with all the patients. Continue reading >>

Global Idf/ispad Guideline For Diabetes In Childhood And Adolescence Idf 2011

Global Idf/ispad Guideline For Diabetes In Childhood And Adolescence Idf 2011

Diet is integral to successful diabetes care, yet dietary educa- tion methods remain controversial and poorly evaluated. There is limited evidence regarding the effect of diet on glycemic control, serum lipids, cardiovascular (CV) out- comes, the incidence of hypoglycemia, weight management and adherence to medical recommendations in children with type 1 diabetes. Dietary education is concerned ... [Show full abstract] primarily with glycemic control, and rarely focuses on dietary factors in relation to CV risk. The 2000 International Society for Pediatric and Adolescent Diabetes Consensus Guidelines rec- ommend that nutritional strategies should place equal impor- tance upon glycemic control and reduction of CV risk. The paper is a review of various approaches to dietary education and their effect on glycemic control and CV risk factors. Une bonne alimentation est essentielle la russite des soins diabtologiques, mais les mthodes d'ducation en matire d'alimentation restent controverses et insuffisamment va- lues. Il existe peu de donnes sur l'effet de l'alimentation sur l'quilibre glycmique, les lipides sriques, les risques car- dio-vasculaires, l'incidence de l'hypoglycmie, la gestion du poids et la fidlit aux recommandations mdicales chez les enfants atteints de diabte de type 1. L'ducation en matire d'alimentation met surtout l'accent sur l'quilibre gly- cmique et porte rarement sur les facteurs dittiques lis au risque cardio-vasculaire. Le Consensus sur les lignes directri- ces 2000 de la Socit internationale du diabte chez les enfants et les adolescents recommande que les stratgies nutritionnelles accordent autant d'importance l'quilibre glycmique qu'au risque cardio-vasculaire. Ce compte rendu passe en revue divers modes d'approche de l'ducation en matire d'alime Continue reading >>

Sick Day Management In Patients With Diabetes

Sick Day Management In Patients With Diabetes

Your browser does not support the NLM PubReader view. Go to this page to see a list of supporting browsers. Sick Day Management in Patients with Diabetes J Korean Diabetes. 2012 Mar;13(1):44-47. Korean. Published online March 31, 2012. Copyright 2012 Korean Diabetes Association Sick Day Management in Patients with Diabetes Department of Nursing, Diabetes Education Team, Inje University Ilsan Paik Hospital, Goyang, Korea. Corresponding author (Email: [email protected] ) People whose diabetes is under good metabolic control should not experience more illness or infection than people without diabetes. However, when any illness occurs in someone with diabetes, the potential for hyperglycemia, hyperglycemia with ketosis, hyperglycemia with ketoacidosis, or hypoglycemia exists and requires education and treatment to prevent exacerbation or even possible death. In some parts of the world where access to medical care, insulin, or parenteral fluids is problematic, the added metabolic stress of an illness in someone with diabetes can be life threatening. Many illnesses are associated with higher levels of stress hormones which promote gluconeogenesis and insulin resistance. Education about the effects of concurrent illness ("sick days") is a critical component of diabetes management and must be adapted to the educational abilities and treatment possibilities of the particular situations in different parts of the world. Keywords: Sick leave; Sick day; Diabetes mellitus Sick-day management recommendations global IDF/ISPAD guidelines for diabetes in childhood and adolescence Adapted from International Diabetes Federation. Global IDF/ISPAD guideline for diabetes in childhood and adolescence 2011 [ 2 ]. Brink S, Laffel L, Likitmaskul S, Liu L, Maguire AM, Olsen B, Silink M, Hana Continue reading >>

International Diabetes Federation (2011) Global Idf/ispad Guideline For Diabetes In Childhood And Adolescence. - References - Scientific Research Publishing

International Diabetes Federation (2011) Global Idf/ispad Guideline For Diabetes In Childhood And Adolescence. - References - Scientific Research Publishing

International Diabetes Federation (2011) Global IDF/ISPAD Guideline for Diabetes in Childhood and Adolescence. JOURNAL NAME: Health , Vol.7 No.12 , December 11, 2015 ABSTRACT: Objectives: The purpose of this study is to analyse the practical implementation of regional and na-tional policies through the Protocol of Care of Children and Adolescents in School (2010) in Extremadura Region (Spain), and to compare its contents with the international standards of diabetes care at school defined by American Diabetes Association and International Diabetes Federation. The measures not only affect the security and diabetes care, but also inclusion and the right to health. Methods: A documental comparative analysis between the local and international standards about diabetes care in school setting is carried out. This analysis is framed in a larger project focused on the study of health promoting school and diabetes education, in which perceptions of children and adolescents with diabetes, their parents and school staff were studied. Results: The Protocol of Care of Children and Adolescents in School (2010) contains some international recommendations about the care of T1DM at school, but in other cases the measures are non-specific. The distribution of responsibilities for care at school is unclear and no monitoring and evaluation indicators are defined. Some elements are identified to be implemented in the tool to favour the security, management of T1DM care and wellbeing. In general, these elements refer to school plan for diabetes care, school organization and teachers, and school community training. Conclusion: It is required to develop specific policies and decisive action to ensure the right to health of children with diabetes and the full application of international standa Continue reading >>

Global Idf/ispad Guideline For Diabetes In Childhood And Adolescence

Global Idf/ispad Guideline For Diabetes In Childhood And Adolescence

Global IDF/ISPAD Guideline for Diabetes in Childhood and Adolescence Target audience: All health professionals This guideline was developed by ISPAD and the International Diabetes Federation. While there is extensive evidence on the optimal management of type 1 diabetes, unfortunately such care is not reaching many people who could benefit. In 1993, members of International Society for Pediatric and Adolescent Diabetes (ISPAD) formulated the Declaration of Kos, proclaiming their commitment to promote optimal health, social welfare and quality of life for all children with diabetes around the world by the year 2000. Although all the aims and ideals of the Declaration of Kos have not been reached by 2000, we feel that slowly, by small steps, the worldwide care of children with diabetes is improving. ISPAD published its first set of guidelines in 1995 and its second in 2000. Since then, the acceptance of intensive therapy, also for very young children, has increased around the world. Insulin pump usage has risen in all age groups in countries where this treatment modality can be afforded. Intensive therapy requires better and more comprehensive education for it to be successful. The ISPAD Consensus Guidelines 2000 edition has been translated into 11 languages, indicating the need for a truly international document. The 3rd edition of ISPADs Consensus Guidelines, now called Clinical Practice Consensus Guidelines was released in 2009. Continue reading >>

Welcome To Journal Of The Association Of Physicians Of India

Welcome To Journal Of The Association Of Physicians Of India

Special Issue on Consensus Statements on Insulin Therapy JULY 2014 VOL. 62 Consensus Evidence-based Guidelines for Insulin Therapy in Patients with Type 1 Diabetes Mellitus as per Indian Clinical Practice Alok Kanungo*, Ashok Jhingan**, Rakesh Kumar Sahay***, A Muruganathan****, Ashok Kumar Das***** *Kanungo Institute of Diabetes Specialities, Dumduma, Bhubaneshwar, Odisha; **Dehli Diabetes Research Centre, J-136, Rajouri Garden, Delhi; ***Department of Endocrinology, Osmania Medical College and Hospital, Hyderabad; ****A. G. Hospital, 34, K.P.N. Colony, Tirupur; *****Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry Type 1 diabetes mellitus (T1DM) is a chronic disease characterised by auto-immune destruction of insulin producing beta cells of the pancreas. Most cases of T1DM are diagnosed during childhood and adolescence, and it remains the predominant form of the disease in this population. Early identification and treatment of T1DM is important in reducing complications of this form of disease. Because individuals with T1DM lack endogenous insulin production, the current consensus guideline recommends administration of rapid-acting and long-acting analogues for all patients with T1DM to achieve glycaemic goals and reduce insulin-induced side effects like weight gain and hypoglycaemia. It also emphasises that effective use of insulin requires an understanding of various insulin treatment and regimens, sick-day management regarding insulin use, and ability to manage insulin-induced hypoglycaemia to achieve the individualised treatment goals established between the patient, family and diabetes care team. The current consensus guideline has been developed by a panel of experts based on the existing guidelines which Continue reading >>

Type 1 Diabetes Guidelines: Are They Enough?

Type 1 Diabetes Guidelines: Are They Enough?

Type 1 diabetes guidelines: Are they enough? Consultant Endocrinologist, Advanced Centre for Diabetes and Endocrine Care, Srinagar, Jammu and Kashmir, India Corresponding Author: Dr. Abdul Hamid Zargar, Advanced Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Chanapora, Srinagar - 190 015, Jammu and Kashmir, India. E-mail: [email protected] Author information Copyright and License information Disclaimer Copyright : Indian Journal of Endocrinology and Metabolism This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The discovery of insulin by Banting and Best in 1922 changed the landscape of type 1 diabetes mellitus (T1DM). Guidelines on T1DM should be evidence based and should emphasize comprehensive risk management. Guidelines would improve awareness amongst governments, state health care providers and the general public about the serious long-term implications of poorly managed diabetes and of the essential resources needed for optimal care. T1DM requires lifelong daily medication, regular control as well as access to facilities to manage acute and chronic complications. American Diabetes Association 2014 guidelines recommends annual nephropathy screening for albumin levels; random spot urine sample for albumin-to-creatinine ratio at start of puberty or age 10 years, whichever is earlier, once the child has had diabetes for 5 years. Hypertension should be screened for in T1DM patients by measuring blood pressure at each routine visit. Dyslipidemia in T1DM patients is important and patients should be screened if there is a family history Continue reading >>

Psychosocial Guidelines

Psychosocial Guidelines

On this site we have assembled international guidelines on psychosocial care in diabetes treatment. IDF Guidelines IDF – Global Guideline for Type 2 Diabetes There is now extensive evidence on the optimal management of diabetes, offering the opportunity of improving the immediate and long-term quality of life of those with the condition. Unfortunately such optimal management is not reaching many, perhaps the majority, of the people who could benefit. Reasons include the size and complexity of the evidence-base, and the complexity of diabetes care itself. One result is a lack of proven cost-effective resources for diabetes care. Another result is diversity of standards of clinical practice. Guidelines are one part of a process that seeks to address those problems. Many guidelines have appeared internationally, nationally, and more locally in recent years, but most of these have not used the rigorous new guideline methodologies for identification and analysis of the evidence. Accordingly the International Diabetes Federation (IDF) has developed a Global Guideline for Type 2 Diabetes (Download PDF) (Brussels: International Diabetes Federation, 2005). IDF Europe Guideline for Type 2 Diabetes This Guideline is available as an HTML version. IDF Europe Guideline for Type 1 Diabetes This Guideline is available as an HTML version. IDF – Clinical Guidelines for the Management of Type 1 Diabetes Mellitus in Childhood and Adolescence The ISPAD Consensus Guidelines for the Management of Type 1 Diabetes Mellitus in Children and Adolescence are aimed at health professionals and were formally launched on October 30, 2000. The Guidelines have been endorsed and adopted by IDF and are available as an HTML version. IDF – WPR Type 2 Diabetes Pratical Targets and Treatments The Asian P Continue reading >>

Guidelines

Guidelines

There is now extensive evidence on the optimal management of diabetes, offering the opportunity of improving the immediate and long-term quality of life of those living with the condition. Unfortunately such optimal management is not reaching many, perhaps the majority, of the people who could benefit. Reasons include the size and complexity of the evidence-base, and the complexity of diabetes care itself. One result is a lack of proven cost-effective resources for diabetes care. Another result is diversity of standards of clinical practice. Guidelines are part of the process which seeks to address those problems. IDF has produced a series of guidelines on different aspects of diabetes management, prevention and care. The Global IDF/ISPAD Guidelines for Diabetes in Childhood and Adolescence ISPAD published its first set of guidelines in 1995 and its second in 2000. Since then, the acceptance of intensive therapy, also for very young children, has increased around the world. Insulin pump usage has risen in all age groups in countries where this treatment modality can be afforded. Intensive therapy requires better and more comprehensive education for it to be successful. The 3rd edition of ISPADs Consensus Guidelines, now called Clinical Practice Consensus Guidelines was released in 2009. The current guideline has been developed by ISPAD and the International Diabetes Federation. While there is extensive evidence on the optimal management of type 1 diabetes, unfortunately such care is not reaching many people who could benefit. Continue reading >>

Effect Of A Residential Integrated Yoga Program On Blood Glucose Levels, Physiological Variables, And Anti-diabetic Medication Score Of Patients With Type 2 Diabetes Mellitus: A Retrospective Study

Effect Of A Residential Integrated Yoga Program On Blood Glucose Levels, Physiological Variables, And Anti-diabetic Medication Score Of Patients With Type 2 Diabetes Mellitus: A Retrospective Study

Effect of a Residential Integrated Yoga Program on Blood Glucose Levels, Physiological Variables, and Anti-Diabetic Medication Score of Patients with Type 2 Diabetes Mellitus: A Retrospective Study Singh A.a Tekur P.a Metri K.a Bhargav H.b Raghuram N.a HongasandraRamarao N.a aSwami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bengaluru, India bNational Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India # 19 Eknath Bhavan, Gavipuram circle, K G Nagar Background: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease characterized by chronic hyperglycemia. Yoga is a form of mind-body intervention shown to have a positive impact on several health conditions in both healthy and diseased patients. The present study is intended to assess the effects of the Residential Integrated Yoga Program (RIYP) on blood glucose levels in patients with T2DM. Material and Methods: Data of 598 (186 females) T2DM patients from a holistic health center in Bengaluru, India, who attended a 15-day RIYP between January 2013 and December 2015 was obtained retrospectively. Average age of the participants was 56.45 11.02 years. All subjects underwent a 15-day RIYP which involved yoga-based lifestyle changes with components of regulated sleep, balanced diet, asanas, pranayama, relaxation techniques, meditations, yogic cleaning procedures, and tuning to the nature. Fasting and post-prandial blood sugar, medication score, symptom score, systolic and diastolic blood pressure, pulse rate, and respiratory rate were assessed before and after intervention. Result: There was a significant decrease in fasting (p < 0.001) and post-prandial blood sugar levels (p < 0.001) along with a significant reduction in medication and symptom scores after 15 days of RIYP compared Continue reading >>

Caring Diabetes Type 1 In Somali Land

Caring Diabetes Type 1 In Somali Land

While this community is no longer active, we invite you to review and recommend past posts and resources. Membership for this community is closed, but we hope you'll join us in one of the many other communities on GHDonline. Moderators of Non-Communicable Diseases and GHDonline staff Our type 1 diabetic project is caring children living with diabetes and for sake of this we are looking a guideline contribution for setting up a diabetic clinic Menelas Nkeshimana Replied at 3:10 AM, 14 Sep 2013 Now speaking of type 1 diabetes, i recently had a headache to adjust insulin doses for a 14 yrs from a modest family, for whom it is quite impossible to come up with a fair insulin regimen without causing life threatening hypoglycemias (oftenly coma)... and the challenge is: if u are not sure the child is going to have his meals on time (sometimes NO means for regular timely meals), how comfortable do you prescribe the insuline (be it soluble or lente)??? Colleagues, kindly share your experiences! Thanks. Atieno Jalang'o Replied at 6:39 AM, 14 Sep 2013 DrMohamed Musse Replied at 6:45 AM, 14 Sep 2013 Gerald Bloomfield Replied at 12:19 PM, 14 Sep 2013 You may be interested in reading about a diabetes program that was set up in western Kenya as part of a N. American/Kenya collaboration - the AMPATH (Academic Model for Providing Access to Healthcare) program. I have attached an article that describes the history of the diabetes program and some of the innovative aspects that have helped it stay afloat in a resource limited setting (e.g., home-based care, mobile phones for monitoring glucose levels, peer-based diabetes education, etc.). If you are interested in learning more, I would be happy to put you in contact with the pharmacist who helped to set it up. Best, Atieno Jalang'o Repli Continue reading >>

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