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Children
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Glycemic Control in Children and Adolescents with Type 1 Diabetes
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Glycemic Control in Children and Adolescents with Type 1 Diabetes

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Endocrinology & Diabetes".

Deadline for manuscript submissions: closed (15 January 2025) | Viewed by 12538

Special Issue Editors

Dr. Stefano Passanisi

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Guest Editor
Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Messina, Italy
Interests: pediatrics; diabetes; allergy
Special Issues, Collections and Topics in MDPI journals
Dr. Claudia Piona

E-Mail Website
Guest Editor
Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University of Verona, Verona, Italy
Interests: pediatrics; diabetes; cystic fibrosis
Dr. Agata Chobot

E-Mail Website
Guest Editor
Department of Pediatrics, Institute of Medical Sciences, University of Opole, Opole, Poland
Interests: pediatric diabetes; pediatrics; pediatric gastroenterology

Special Issue Information

Dear Colleagues,

We are delighted to invite all researchers, clinicians, and experts in the field of pediatric diabetes to contribute to our upcoming Special Issue, titled "Glycemic Control in Children and Adolescents with Type 1 Diabetes." This Special Issue aims to provide a comprehensive platform for the exchange of knowledge and insights in this critical area of healthcare.

Type 1 diabetes presents unique challenges in pediatric populations, and effective glycemic control is paramount for the health and wellbeing of young people. We invite original research, clinical studies, reviews, and perspectives that address several aspects of glucose control among children and adolescents with type 1 diabetes, including innovative treatments, technological advancements, data on acute and chronic complications, psychosocial support, and patient education.

Dr. Stefano Passanisi
Dr. Claudia Piona
Dr. Agata Chobot
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • automated insulin delivery system
  • continuous glucose monitoring system
  • diabetic ketoacidosis
  • glycemic variability
  • technological devices

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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9 pages, 613 KiB  
Article
Comparison of Metabolic Control in Children and Adolescents Treated with Insulin Pumps
by Agnieszka Lejk, Karolina Myśliwiec, Arkadiusz Michalak, Barbara Pernak, Wojciech Fendler and Małgorzata Myśliwiec
Children 2024, 11(7), 839; https://doi.org/10.3390/children11070839 - 10 Jul 2024
Cited by 1 | Viewed by 1518
Abstract
Background: While insulin pumps remain the most common form of therapy for youths with type 1 diabetes (T1DM), they differ in the extent to which they utilize data from continuous glucose monitoring (CGM) and automate insulin delivery. Methods: The aim of the study [...] Read more.
Background: While insulin pumps remain the most common form of therapy for youths with type 1 diabetes (T1DM), they differ in the extent to which they utilize data from continuous glucose monitoring (CGM) and automate insulin delivery. Methods: The aim of the study was to compare metabolic control in patients using different models of insulin pumps. This retrospective single-center study randomly sampled 30 patients for each of the following treatments: Medtronic 720G without PLGS (predictive low glucose suspend), Medtronic 640G or 740G with PLGS and Medtronic 780G. In the whole study group, we used CGM systems to assess patients’ metabolic control, and we collected lipid profiles. In three groups of patients, we utilized CGM sensors (Guardian 3, Guardian 4, Libre 2 and Dexcom G6) to measure the following glycemic variability proxy values: time in range (TIR), time below 70 mg/dL (TBR), time above 180 mg/dL (TAR), coefficient of variation (CV) and mean sensor glucose. Results: Medtronic 640G or 740G and 780G users were more likely to achieve a target time in the target range 70–180 mg/dL (≥80%) [Medtronic 720G = 4 users (13.3%) vs. Medtronic 640G/740G = 10 users (33.3%) vs. Medtronic 780G = 13 users (43.3%); p = 0.0357)] or low glucose variability [Medtronic 720G = 9 users (30%) vs. Medtronic 640G/740G = 18 users (60%) vs. Medtronic 780G = 19 users (63.3%); p = 0.0175)]. Conclusions: Any integration between the insulin pump and CGM was associated with better glycemic control. More advanced technologies and artificial intelligence in diabetes help patients maintain better glycemia by eliminating various factors affecting postprandial glycemia. Full article
(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)
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9 pages, 234 KiB  
Article
The Impact of Dietary Habits on Sleep Deprivation and Glucose Control in School-Aged Children with Type 1 Diabetes: A Cross-Sectional Study
by Merve Askin Ceran, Muteber Gizem Keser, Murat Bektas, Nurhan Unusan and Beray Selver Eklioglu
Children 2024, 11(7), 779; https://doi.org/10.3390/children11070779 - 27 Jun 2024
Cited by 1 | Viewed by 1301
Abstract
Diet plays a crucial role in managing type 1 diabetes (T1DM). Background/Objectives:This study aimed to determine the impact of nutritional habits on sleep deprivation and glucose control in school-aged children with T1DM. Methods: In this cross-sectional study, nutritional habits and sleep deprivation [...] Read more.
Diet plays a crucial role in managing type 1 diabetes (T1DM). Background/Objectives:This study aimed to determine the impact of nutritional habits on sleep deprivation and glucose control in school-aged children with T1DM. Methods: In this cross-sectional study, nutritional habits and sleep deprivation were assessed in 100 school-aged children with T1DM, aged 7–13 years. The Dietary Habits Index and the Sleep Deprivation Scale for Children and Adolescents were used to evaluate nutritional habits and the level of sleep deprivation. Patients’ sociodemographic and nutritional variables were collected through researcher-composed questionnaires. HbA1c levels over the past 6 months were obtained from the patient data system. Results: The study found a moderately strong positive correlation between the Dietary Habits Index score and HbA1c (p < 0.001), with 28% of the variation in HbA1c explained by changes in the Dietary Habits Index score. However, no correlation was found between the Dietary Habits Index score and the level of sleep deprivation. Conclusions: The nutritional habits of school-aged children with T1DM may affect glucose control and sleep deprivation. Therefore, it is important to educate children with T1DM on making healthy food choices to manage their condition effectively. Full article
(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)
9 pages, 223 KiB  
Article
Skin Reactions in Children with Type 1 Diabetes Associated with the Use of New Diabetes Technologies—An Observational Study from a Regional Polish Pediatric Diabetes Center
by Ewa Ledwoń, Paula Zemła-Szten, Thekla von dem Berge, Krzysztof Nalewajko, Stefano Passanisi, Claudia Piona, Tiago Jeronimo dos Santos, Jannet Svensson, Anna Korsgaard Berg and Agata Chobot
Children 2024, 11(6), 740; https://doi.org/10.3390/children11060740 - 17 Jun 2024
Cited by 4 | Viewed by 1725
Abstract
The study aimed to estimate the prevalence of skin problems in children and adolescents with type 1 diabetes (T1D) using insulin pumps (IPs) and/or continuous glucose monitoring (CGM) in our center and analyze their association with various factors. As part of the international [...] Read more.
The study aimed to estimate the prevalence of skin problems in children and adolescents with type 1 diabetes (T1D) using insulin pumps (IPs) and/or continuous glucose monitoring (CGM) in our center and analyze their association with various factors. As part of the international ISPAD JENIOUS-initiated SKIN-PEDIC project, we interviewed and examined patients who visited the regional pediatric diabetes center in Opole (Poland) for four weeks regarding the use of IP and/or CGM and the presence of skin problems. Body mass index (BMI) and glycemic parameters were obtained retrospectively from medical records. Among 115 individuals (45.2% girls, 83.5% IP users, 96.5% CGM users), old scars were the most common skin problem (IP users 53.1%; CGM users 66.4%), while ≥2 types of skin problems co-occurred (IP users 40.6%; CGM users 27.3%). Longer IP use was associated with a higher prevalence of skin problems (50% for IP < 1 year, 98.1%-IP 1–3 years, 100% for IP > 3 years; p < 0.001), pointing out extra attention with IP use > 1 year. No significant associations were found between skin problems and gender, age, BMI centile and glycemic parameters. Dermatological complications were common among children using IP and CGM in our center, highlighting the need for vigilant monitoring and early intervention to manage these skin-related issues effectively. Full article
(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)
11 pages, 260 KiB  
Article
Discordance between Glucose Management Indicator and Glycated Hemoglobin in a Pediatric Cohort with Type 1 Diabetes: A Real-World Study
by Simone Foti Randazzese, Bruno Bombaci, Serena Costantino, Ylenia Giorgianni, Fortunato Lombardo and Giuseppina Salzano
Children 2024, 11(2), 210; https://doi.org/10.3390/children11020210 - 6 Feb 2024
Cited by 3 | Viewed by 2019
Abstract
The introduction of continuous glucose monitoring (CGM) systems in clinical practice has allowed a more detailed picture of the intra- and interdaily glycemic fluctuations of individuals with type 1 diabetes (T1D). However, CGM-measured glucose control indicators may be occasionally inaccurate. This study aims [...] Read more.
The introduction of continuous glucose monitoring (CGM) systems in clinical practice has allowed a more detailed picture of the intra- and interdaily glycemic fluctuations of individuals with type 1 diabetes (T1D). However, CGM-measured glucose control indicators may be occasionally inaccurate. This study aims to assess the discrepancy between the glucose management indicator (GMI) and glycated hemoglobin (HbA1c) (ΔGMI-HbA1c) within a cohort of children and adolescents with T1D, exploring its correlation with other CGM metrics and blood count parameters. In this single-center, cross-sectional study, we gathered demographic and clinical data, including blood count parameters, HbA1c values, and CGM metrics, from 128 pediatric subjects with T1D (43% female; mean age, 13.4 ± 3.6 years). Our findings revealed higher levels of the coefficient of variation (CV) (p < 0.001) and time above range > 250 mg/dL (p = 0.033) among subjects with ΔGMI-HbA1c > 0.3%. No association was observed between blood count parameters and ΔGMI-HbA1c. In conclusion, despite the advancements and the widespread adoption of CGM systems, HbA1c remains an essential parameter for the assessment of glycemic control, especially in individuals with suboptimal metabolic control and extreme glycemic variability. Full article
(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)
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Review

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11 pages, 575 KiB  
Review
Psychological and Clinical Challenges in the Management of Type 1 Diabetes during Adolescence: A Narrative Review
by Bruno Bombaci, Arianna Torre, Alessandro Longo, Maria Pecoraro, Mattia Papa, Lacrima Sorrenti, Mariarosaria La Rocca, Fortunato Lombardo and Giuseppina Salzano
Children 2024, 11(9), 1085; https://doi.org/10.3390/children11091085 - 4 Sep 2024
Cited by 9 | Viewed by 5043
Abstract
Adolescence, a critical period of physical and psychological development, presents unique challenges in type 1 diabetes (T1D) management due to endocrinological changes, reduced therapeutic adherence, and elevated susceptibility to psychological issues such as depression, anxiety, and eating disorders. This narrative review explores the [...] Read more.
Adolescence, a critical period of physical and psychological development, presents unique challenges in type 1 diabetes (T1D) management due to endocrinological changes, reduced therapeutic adherence, and elevated susceptibility to psychological issues such as depression, anxiety, and eating disorders. This narrative review explores the impact of psychological and behavioral factors on glycemic control in adolescents with T1D. We examine the prevalence and influence of mental health disorders, lifestyle factors, harmful behaviors, and social dynamics on diabetes management and glycemic outcomes. Strategies for improving metabolic control are also reviewed, including cognitive behavioral therapy, technological devices, and educational interventions. The importance of tailored psychological support, family involvement, and targeted interventions to improve adherence to treatment and glycemic control in adolescents with T1D should be emphasized. Full article
(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)
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