Other articles by Timothy W. Jones on PubMed

• Exercise Training and Glycemic Control in Adolescents with Poorly Controlled Type 1 Diabetes Mellitus Journal of Pediatric Endocrinology & Metabolism : JPEM. May, 2002  |   Pubmed ID: 12014521 This study sought to establish whether the glycemic control achieved in exercise-trained adolescents with type 1 diabetes mellitus (DM) is dependent on the quality of glycemic control prior to the initiation of exercise training. Adolescents with type 1 DM were randomly assigned to groups with either lower or higher than 9% glycosylated hemoglobin (HbA1c), and submitted to 12 weeks of supervised training followed by 12 weeks of unsupervised training (n = 12 per group). Supervised training caused a 17% rise in the patients' aerobic capacity which during the ensuing period of unsupervised training decreased to pre-training levels, thus suggesting a poor compliance with unsupervised training. The average levels of HbA1c in poorly and well controlled diabetic patients were not affected by training, a finding indicating that irrespective of the quality of glycemia prior to exercise training, glycemic control in adolescents with type 1 DM does not improve in response to exercise training alone.
• Hypoglycemia in Children with Type 1 Diabetes: Current Issues and Controversies Pediatric Diabetes. Sep, 2003  |   Pubmed ID: 14655273 Hypoglycemia is a common complication of insulin therapy, particularly in the young. For children and adolescents with diabetes, the risk of hypoglycemia may not only prevent optimal glycemic control but can also add significantly to the psychosocial burden of the disease. Recently, surveys employing prospective monitoring techniques have allowed more precise information to be gained about rates of hypoglycemia, its clinical associations, and the impact of new therapies and technologies. A number of reports have estimated rates of hypoglycemic comas and convulsions to be approximately 20 events per 100 patient years in children on current conventional therapy. There is evidence that the introduction of new analog short- and longer-acting insulins and the more widespread use of continuous subcutaneous infusion therapies may allow improvements in glycemic control to occur without the usual increased rate of severe hypoglycemic episodes. The use of glucose sensor technology has brought into focus the widespread occurrence of asymptomatic hypoglycemia. Asymptomatic hypoglycemia has long been recognized, particularly at night, when the combination of excessive insulin action and suppressed counter-regulatory hormone responses put children at special risk of hypoglycemia. Hypoglycemia unawareness is common in the young and is associated with an increased risk of severe hypoglycemia. Whether episodes of severe hypoglycemia have long-term consequences is controversial. Early studies suggesting that the developing brain is sensitive to permanent neurological damage as a result of hypoglycemia have not been confirmed in more recent reports. Many studies have not found convincing evidence of neurological sequelae of the hypoglycemic events that are an inevitable complication of insulin therapy. The question, however, remains under active investigation. Continued prospective monitoring of hypoglycemia rates and consequences has become an essential component of diabetes management.
• Lack of Effect of Oral Glucose Loading on Conduit Vessel Endothelial Function in Healthy Subjects Clinical Science (London, England : 1979). Aug, 2004  |   Pubmed ID: 15068394 The aim of the present study was to investigate the impact of an oral glucose load on circulating insulin and glucose levels and arterial function in healthy non-diabetic subjects. Thirty-nine non-obese, healthy subjects (24 female, 15 male), aged 21.0+/-1.8 years of age, were randomly assigned to undergo either an OGTT (oral glucose tolerance test; 75 g of glucose) or administration of a placebo. Analyses of lipids, liver function and HbA(1c) (glycated haemoglobin) at baseline revealed results which were within the standard reference range. Insulin and glucose levels as well as vascular function [FMD (flow-mediated dilation)] were measured at 0, 60 and 120 min. Compared with baseline, the control subjects did not exhibit any significant changes in glucose or insulin levels, whereas, in the OGTT group, blood glucose levels at both 60 (5.4+/-1.7 mmol/l) and 120 (5.0+/-1.1 mmol/l) min increased significantly relative to baseline (4.1+/-0.4 mmol/l; both P
• Increase in Type 2 Diabetes in Children and Adolescents in Western Australia The Medical Journal of Australia. May, 2004  |   Pubmed ID: 15115424 To document diagnosis rates of type 2 diabetes mellitus in children and adolescents in Western Australia over the past 12 years, the clinical characteristics of these patients and any comorbidities.
• Effects of Exercise Training on Vascular Function in Obese Children The Journal of Pediatrics. May, 2004  |   Pubmed ID: 15126996 Atherosclerosis is a disease that begins in childhood; endothelial dysfunction is its earliest detectable manifestation, and primary prevention strategies are likely to be most effective if instituted early. The aim of this study was to characterize the impact of obesity on vascular function in young children and to determine whether an exercise program improves abnormalities in vascular function.
• Exercise Training Normalizes Vascular Dysfunction and Improves Central Adiposity in Obese Adolescents Journal of the American College of Cardiology. May, 2004  |   Pubmed ID: 15145107 We sought to characterize the impact of obesity on vascular function in adolescents and to determine whether an exercise program reverses abnormalities in endothelial function.
• The Impact of a Decade of Changing Treatment on Rates of Severe Hypoglycemia in a Population-based Cohort of Children with Type 1 Diabetes Diabetes Care. Oct, 2004  |   Pubmed ID: 15451890 To determine the impact of changes to treatment on the incidence of severe hypoglycemia and its risk factors in a large population-based cohort of children with type 1 diabetes.
• Intermittent High-intensity Exercise Does Not Increase the Risk of Early Postexercise Hypoglycemia in Individuals with Type 1 Diabetes Diabetes Care. Feb, 2005  |   Pubmed ID: 15677802
• Exercise Training in Obese Children and Adolescents: Current Concepts Sports Medicine (Auckland, N.Z.). 2005  |   Pubmed ID: 15896088 Childhood obesity has reached epidemic proportions worldwide and is associated with increased cardiovascular mortality and morbidity in adult life. The increase in fat mass in children and adolescents has occurred concomitantly with a decline in reported time for exercise. Evidence suggests that non-physically active children are more likely to become non-physically active adults and that encouraging the development of physical activity habits in children helps establish patterns that continue into adulthood. Dietary treatment of obesity is relatively ineffective in adults and it has been suggested that prevention of obesity in childhood and adolescence should emphasise increased physical activity rather than diet because of fears relating to the adverse effects of inappropriate eating patterns. Despite this, there are very few randomised controlled studies investigating the efficacy of exercise training in obese children or adolescents and many of the extant studies have been poorly controlled and have not specifically stratified the independent effect of exercise versus dietary modification. This review focuses on the well designed controlled trials that have evaluated the effect of exercise training in obese children and adolescents on body composition, haemodynamic and metabolic variables, cardiovascular fitness, muscular strength and vascular function. These studies indicate that, although exercise training does not consistently decrease bodyweight or body mass index, it is associated with beneficial changes in fat and lean body mass, emphasising the importance of comprehensive assessment of body composition in future exercise-training studies. Exercise training improves cardiovascular fitness and muscular strength; however, it seems to have little effect on blood lipid profile or blood pressure in obese young people. Importantly, recent studies have demonstrated that exercise training improves vascular endothelial function, an important surrogate measure that may predict future atherosclerotic risk in obese children and adolescents. Given that improvement in vascular function in these training studies occurred in the absence of changes in lipid fractions, haemodynamic variables or glucose metabolism, exercise appears to have a direct beneficial effect on the vasculature, in addition to its putative benefits through risk-factor modification.
• Point-of-care Testing of HbA1c and Blood Glucose in a Remote Aboriginal Australian Community The Medical Journal of Australia. May, 2005  |   Pubmed ID: 15896181 To assess the accuracy of point-of-care (POC) measurements of capillary blood glucose and glycosylated haemoglobin (HbA(1c)) levels in a remote Aboriginal community with high diabetes prevalence.
• The Decline in Blood Glucose Levels is Less with Intermittent High-intensity Compared with Moderate Exercise in Individuals with Type 1 Diabetes Diabetes Care. Jun, 2005  |   Pubmed ID: 15920041 To compare the response of blood glucose levels to intermittent high-intensity exercise (IHE) and moderate-intensity exercise (MOD) in individuals with type 1 diabetes.
• Cognitive Functioning in Children with Early Onset Type 1 Diabetes and Severe Hypoglycemia The Journal of Pediatrics. Nov, 2005  |   Pubmed ID: 16291363 To investigate whether severe hypoglycemia in young children with early-onset type 1 diabetes (T1DM) is associated with subsequent abnormalities in cognitive status.
• The 10-s Maximal Sprint: a Novel Approach to Counter an Exercise-mediated Fall in Glycemia in Individuals with Type 1 Diabetes Diabetes Care. Mar, 2006  |   Pubmed ID: 16505513 To investigate whether a short maximal sprint can provide another means to counter the rapid fall in glycemia associated with moderate-intensity exercise in individuals with type 1 diabetes and therefore decrease the risk of early postexercise hypoglycemia.
• Do Skinfolds Accurately Assess Changes in Body Fat in Obese Children and Adolescents? Medicine and Science in Sports and Exercise. Mar, 2006  |   Pubmed ID: 16540830 Obesity is epidemic in Western societies, with rapid rates of increase in the young. Various methods exist for the assessment of body composition, but these have not been compared in obese children and adolescents. This study compared methods of body composition assessment in obese young people to determine whether changes in various measures of body composition as a result of exercise training were correlated.
• Independent Effects of Socioeconomic Status and Place of Residence on the Incidence of Childhood Type 1 Diabetes in Western Australia Pediatric Diabetes. Apr, 2006  |   Pubmed ID: 16629715 To analyze the incidence of type 1 diabetes in 0- to 14-year olds in Western Australia, from 1985 to 2002, by region and socioeconomic status.
• Type 2 Diabetes in Youth from the Western Pacific Region: Glycaemic Control, Diabetes Care and Complications Current Medical Research and Opinion. May, 2006  |   Pubmed ID: 16709323 To describe the glycaemic control, diabetes care and prevalence of complications in youth with type 2 diabetes from the Western Pacific Region.
• Effects of Hypoglycemia on Human Brain Activation Measured with FMRI Magnetic Resonance Imaging. Jul, 2006  |   Pubmed ID: 16824963 Functional magnetic resonance imaging (fMRI) was used to measure the effects of acute hypoglycemia caused by passive sensory stimulation on brain activation. Visual stimulation was used to generate blood-oxygen-level-dependent (BOLD) contrast, which was monitored during hyperinsulinemic hypoglycemic and euglycemic clamp studies. Hypoglycemia (50 +/- 1 mg glucose/dl) decreased the fMRI signal relative to euglycemia in 10 healthy human subjects: the fractional signal change was reduced by 28 +/- 12% (P < .05). These changes were reversed when euglycemia was restored. These data provide a basis of comparison for studies that quantify hypoglycemia-related changes in fMRI activity during cognitive tasks based on visual stimuli and demonstrate that variations in blood glucose levels may modulate BOLD signals in the healthy brain.
• Effect of Exercise-mediated Acidosis on Determination of Glycemia Using CGMS Diabetes Technology & Therapeutics. Aug, 2006  |   Pubmed ID: 16939377
• Acute Effects of Hyperglycaemia in Children with Type 1 Diabetes Mellitus: the Patient's Perspective Journal of Pediatric Endocrinology & Metabolism : JPEM. Jul, 2006  |   Pubmed ID: 16995573 This study presents the results of a systematic examination of how parents and patients perceive the effects of acute hyperglycaemia on mood and on intellectual and fine-motor performance.
• Neural-network Detection of Hypoglycemic Episodes in Children with Type 1 Diabetes Using Physiological Parameters Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2006  |   Pubmed ID: 17945929 The most common and highly feared adverse effect of intensive insulin therapy in patients with diabetes is the increased risk of hypoglycemia. Symptoms of hypoglycemia arise from the activation of the autonomous central nervous systems and from reduced cerebral glucose consumption. HypoMon is a non-invasive monitor that measures some physiological parameters continuously to provide detection of hypoglycemic episodes in Type 1 diabetes mellitus patients (T1DM). Based on heart rate, corrected QT interval of the ECG signal and skin impedance, a neural network detection algorithm has been developed to recognize the presence of hypoglycemic episodes. From a clinical study of 21 children with T1DM, associated with hypoglycemic episodes, their heart rates increased (1.16 +/- 0.16 vs. 1.03 +/- 0.11, P
• Increasing Body Mass Index Z-score is Continuously Associated with Complications of Overweight in Children, Even in the Healthy Weight Range The Journal of Clinical Endocrinology and Metabolism. Feb, 2007  |   Pubmed ID: 17105842 Overweight/obesity in children is increasing. Incidence data for medical complications use arbitrary cutoff values for categories of overweight and obesity. Continuous relationships are seldom reported.
• Glucose Requirements to Maintain Euglycemia After Moderate-intensity Afternoon Exercise in Adolescents with Type 1 Diabetes Are Increased in a Biphasic Manner The Journal of Clinical Endocrinology and Metabolism. Mar, 2007  |   Pubmed ID: 17118993 Exercise increases the risk of hypoglycemia in type 1 diabetes.
• Exercise Alone Reduces Insulin Resistance in Obese Children Independently of Changes in Body Composition The Journal of Clinical Endocrinology and Metabolism. Nov, 2007  |   Pubmed ID: 17698905 The number of obese children with insulin resistance and type 2 diabetes is increasing, but the best management strategy is not clear.
• Diabetes Care, Glycemic Control, and Complications in Children with Type 1 Diabetes from Asia and the Western Pacific Region Journal of Diabetes and Its Complications. Sep-Oct, 2007  |   Pubmed ID: 17825751 The incidence of type 1 diabetes is increasing in many parts of Asia, where resources may not enable targets for glycemic control to be achieved. The aims of this study were to describe glycemic control, diabetes care, and complications in youth with type 1 diabetes from the Western Pacific Region and to identify factors associated with glycemic control and hypoglycemia.
• New Insights into Managing the Risk of Hypoglycaemia Associated with Intermittent High-intensity Exercise in Individuals with Type 1 Diabetes Mellitus: Implications for Existing Guidelines Sports Medicine (Auckland, N.Z.). 2007  |   Pubmed ID: 17953465 Exercise is generally recommended for individuals with type 1 diabetes mellitus since it is associated with numerous physiological and psychological benefits. However, participation in exercise can also increase the risk of experiencing severe hypoglycaemia, a potentially life-threatening condition, both during exercise and for up to 31 hours of recovery. Fortunately, this risk of exercise-induced hypoglycaemia can be managed by adjusting the dosage of self-administered exogenous insulin and nutritional intake to maintain blood glucose levels within the normal physiological range. In order to provide evidence-based guidelines to allow individuals with type 1 diabetes to safely participate in a range of physical activities, much previous research has focused on understanding the metabolic and hormonal responses to exercise. Consequently, it is well established that moderate- and high-intensity exercise have a contrasting effect on blood glucose levels and require different management strategies to maintain euglycaemia. On the other hand, the response of blood glucose levels to a combination of moderate- and high-intensity exercise, a pattern of physical activity referred to as intermittent high-intensity exercise (IHE) has received little research attention. This is despite the fact that this type of exercise characterises the activity patterns of most team and field sports as well as spontaneous play in children. The lack of previous research into the glucoregulatory responses to IHE is reflected in existing guidelines, which either do not address IHE, or suggest similar management strategies for blood glucose levels during and after IHE as for moderate- or high-intensity exercise alone. It is important, however, to appreciate that there are fundamental differences in the metabolic responses to intermittent exercise compared with other types of exercise. Recently, a series of investigations into the glucoregulatory responses to IHE that replicates the work-to-recovery ratios observed in team and field sports have been conducted. The findings of these studies do not support the existing recommendations for managing blood glucose levels during IHE. Hence, the purpose of this article is to discuss the results of these recent studies, which provide new insight into the management of blood glucose levels during and after IHE and have implications for current guidelines aimed at minimising the risk of hypoglycaemia. These findings, along with future investigations, should provide valuable information for health professionals and individuals with type 1 diabetes on the management of blood glucose levels during and after exercise to allow for safe participation in intermittent activities along with their peers.
• Detection of Hypoglycemic Episodes in Children with Type 1 Diabetes Using an Optimal Bayesian Neural Network Algorithm Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2007  |   Pubmed ID: 18002661 Hypoglycemia or low blood glucose is a common and serious side effect of insulin therapy in patients with diabetes. HypoMon is a non-invasive monitor that measures some physiological parameters continuously to provide detection of hypoglycemic episodes in Type 1 diabetes mellitus patients (T1DM). Based on heart rate, corrected QT interval of the ECG signal and skin impedance, a Bayesian neural network detection algorithm has been developed to recognize the presence of hypoglycemic episodes. From a clinical study of 25 children with T1DM, associated with hypoglycemic episodes, their heart rates increased (1.152+/-0.157 vs. 1.035+/-0.108, P
• New Insights into Managing the Risk of Hypoglycaemia Associated with Intermittent High-Intensity Exercise in Individuals with Type 1 Diabetes Mellitus : Implications for Existing Guidelines Sports Medicine (Auckland, N.Z.). Nov, 2007  |   Pubmed ID: 28224407 Exercise is generally recommended for individuals with type 1 diabetes mellitus since it is associated with numerous physiological and psychological benefits. However, participation in exercise can also increase the risk of experiencing severe hypoglycaemia, a potentially life-threatening condition, both during exercise and for up to 31 hours of recovery. Fortunately, this risk of exerciseinduced hypoglycaemia can be managed by adjusting the dosage of self-administered exogenous insulin and nutritional intake to maintain blood glucose levels within the normal physiological range. In order to provide evidence-based guidelines to allow individuals with type 1 diabetes to safely participate in a range of physical activities, much previous research has focused on understanding the metabolic and hormonal responses to exercise. Consequently, it is well established that moderate-and high-intensity exercise have a contrasting effect on blood glucose levels and require different management strategies to maintain euglycaemia. On the other hand, the response of blood glucose levels to a combination of moderate-and high-intensity exercise, a pattern of physical activity referred to as intermittent high-intensity exercise (IHE) has received little research attention. This is despite the fact that this type of exercise characterises the activity patterns of most team and field sports as well as spontaneous play in children.The lack of previous research into the glucoregulatory responses to IHE is reflected in existing guidelines, which either do not address IHE, or suggest similar management strategies for blood glucose levels during and after IHE as for moderate- or high-intensity exercise alone. It is important, however, to appreciate that there are fundamental differences in the metabolic responses to intermittent exercise compared with other types of exercise.Recently, a series of investigations into the glucoregulatory responses to IHE that replicates the work-to-recovery ratios observed in team and field sports have been conducted. The findings of these studies do not support the existing recommendations for managing blood glucose levels during IHE. Hence, the purpose of this article is to discuss the results of these recent studies, which provide new insight into the management of blood glucose levels during and after IHE and have implications for current guidelines aimed at minimising the risk of hypoglycaemia. These findings, along with future investigations, should provide valuable information for health professionals and individuals with type 1 diabetes on the management of blood glucose levels during and after exercise to allow for safe participation in intermittent activities along with their peers.
• Angiotensinogen Gene T235 Variant: a Marker for the Development of Persistent Microalbuminuria in Children and Adolescents with Type 1 Diabetes Mellitus Journal of Diabetes and Its Complications. May-Jun, 2008  |   Pubmed ID: 18413222 We examined genetic polymorphisms in the renin-angiotensin system (RAS) coding for angiotensin I-converting enzyme (ACE) insertion/deletion (I/D) for angiotensinogen (AGT) M235T and angiotensin II receptor type 1 (AGTR1) A1166C as predictors for the development of microalbuminuria (MA) in children with type 1 diabetes mellitus (T1DM).
• Prevalence of Structural Central Nervous System Abnormalities in Early-onset Type 1 Diabetes Mellitus The Journal of Pediatrics. Sep, 2008  |   Pubmed ID: 18534238 To characterize the effects of severe hypoglycemia on the developing brain in children with early-onset type 1 diabetes mellitus (T1DM).
• Waist Circumference Predicts Cardiovascular Risk in Young Australian Children Journal of Paediatrics and Child Health. Dec, 2008  |   Pubmed ID: 19077071 It has been shown that compared with healthyweight children, overweight and obese primary school-aged children have a higher incidence of hyperinsulinism, dyslipidaemia and hypertension. It is therefore important to investigate clinically relevant markers of cardiovascular risk in children. Waist circumference is a simple, non-invasive anthropometric measure, but its association with cardiovascular risk profile in young Australian children is not clear.
• Detection of Nocturnal Hypoglycemic Episodes (natural Occurrence) in Children with Type 1 Diabetes Using an Optimal Bayesian Neural Network Algorithm Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2008  |   Pubmed ID: 19162908 Hypoglycemia or low blood glucose is dangerous and can result in unconsciousness, seizures and even death. It is a common and serious side effect of insulin therapy in patients with diabetes. HypoMon is a non-invasive monitor that measures some physiological parameters continuously to provide detection of hypoglycemic episodes in Type 1 diabetes mellitus patients (T1DM). Based on heart rate and corrected QT interval of the ECG signal, we have continued to develop Bayesian neural network detection algorithms to recognize the presence of hypoglycemic episodes. From a clinical study of 16 children with T1DM, natural occurrence of nocturnal hypoglycemic episodes are associated with increased heart rates (1.033+/-0.242 vs. 1.082+/-0.298, P0.06) and increased corrected QT intervals (1.031+/-0.086 vs. 1.060+/-0.084, P0.001). The overall data were organized into a training set (8 patients) and a test set (another 8 patients) randomly selected. Using the optimal Bayesian neural network with 10 hidden nodes which was derived from the training set with the highest log evidence, the sensitivity (true positive) value for detection of hypoglycemia in the test set is 89.2%.
• Impaired Awareness of Hypoglycemia in a Population-based Sample of Children and Adolescents with Type 1 Diabetes Diabetes Care. Oct, 2009  |   Pubmed ID: 19587370 To determine the prevalence and clinical associations of impaired awareness of hypoglycemia in a population-based sample of children and adolescents with type 1 diabetes.
• Real-time Detection of Nocturnal Hypoglycemic Episodes Using a Novel Non-invasive Hypoglycemia Monitor Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2009  |   Pubmed ID: 19965241 Hypoglycemia or low blood glucose is a common and serious side effect of insulin therapy in patients with diabetes. Hypoglycemia is unpleasant and can result in unconsciousness, seizures and even death. HypoMon is a realtime non-invasive monitor that measures relevant physiological parameters continuously to provide detection of hypoglycemic episodes in Type 1 diabetes mellitus patients (T1DM). Based on heart rate and corrected QT interval of the ECG signal, we have continued to develop effective algorithms for early detection of nocturnal hypoglycemia. From a clinical study of 24 children with T1DM, associated with natural occurrence of hypoglycemic episodes at night, their heart rates increased (1.021+/-0.264 vs. 1.068+/-0.314, P
• Hypoglycemia Alarm Enhancement Using Data Fusion Journal of Diabetes Science and Technology. Jan, 2010  |   Pubmed ID: 20167165 The acceptance of closed-loop blood glucose (BG) control using continuous glucose monitoring systems (CGMS) is likely to improve with enhanced performance of their integral hypoglycemia alarms. This article presents an in silico analysis (based on clinical data) of a modeled CGMS alarm system with trained thresholds on type 1 diabetes mellitus (T1DM) patients that is augmented by sensor fusion from a prototype hypoglycemia alarm system (HypoMon). This prototype alarm system is based on largely independent autonomic nervous system (ANS) response features.
• Clinical Evaluation of a Noninvasive Alarm System for Nocturnal Hypoglycemia Journal of Diabetes Science and Technology. Jan, 2010  |   Pubmed ID: 20167169 The aim of this study was to evaluate the performance of a prototype noninvasive alarm system (HypoMon) for the detection of nocturnal hypoglycemia. A prospective cohort study evaluated an alarm system that included a sensor belt, a radio frequency transmitter for chest belt signals, and a receiver. The receiver incorporated integrated "real-time" algorithms designed to recognize hypoglycemia "signatures" in the physiological parameters monitored by the sensor belt.
• Fatness, Fitness, and Increased Cardiovascular Risk in Young Children The Journal of Pediatrics. Oct, 2010  |   Pubmed ID: 20542285 To investigate the relationships between cardiorespiratory fitness and adiposity among young children, and their influence on a comprehensive cardiovascular risk profile.
• Detection of Nocturnal Hypoglycemic Episodes Using EEG Signals Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2010  |   Pubmed ID: 21096665 Hypoglycemia (low blood glucose) or the fear of hypoglycemia constitutes a significant barrier to the achievement of good glycemic control in the insulin treated diabetic patients. By measuring physiological responses derived from EEG and analyzing these, we establish that hypoglycemia can be detected non-invasively. From a clinical study of six children with type 1 diabetes (T1D), associated with hypoglycemic episodes at night, their centroid (centre of gravity) alpha frequency reduced significantly (P〈0.001) and their centroid theta frequency increased significantly (P〈0.02). The overall data were organized into a training set (3 patients) and a test set (another 3 patients) randomly selected. Using the optimal Bayesian neural network which was derived from the training set with the highest log evidence, the estimated blood glucose profiles produced a significant correlation (P〈0.005) against measured values in the test set.
• Contribution of an Intrinsic Lag of Continuous Glucose Monitoring Systems to Differences in Measured and Actual Glucose Concentrations Changing at Variable Rates in Vitro Journal of Diabetes Science and Technology. Nov, 2010  |   Pubmed ID: 21129335 Current continuous glucose monitoring (CGM) systems measure glucose levels in the interstitial fluid to estimate blood glucose concentration. A lag time has been observed between CGM system glucose readings and blood glucose levels when glucose levels are changing. Although this lag has been attributed to the time it takes glucose to equilibrate between blood and interstitial fluid compartments, it is unclear to what extent these inaccuracies reflect an intrinsic delay of the device itself.
• Effect of Short-term Use of a Continuous Glucose Monitoring System with a Real-time Glucose Display and a Low Glucose Alarm on Incidence and Duration of Hypoglycemia in a Home Setting in Type 1 Diabetes Mellitus Journal of Diabetes Science and Technology. Nov, 2010  |   Pubmed ID: 21129341 The objective of this study was to examine whether setting the low glucose alarm of a Guardian® REAL-Time continuous glucose monitoring system (CGMS) to 80 mg/dl for 3 days and providing instructions to users reduce the risk of hypoglycemia under free-living conditions in individuals with type 1 diabetes mellitus (T1DM).
• Improving Epinephrine Responses in Hypoglycemia Unawareness with Real-time Continuous Glucose Monitoring in Adolescents with Type 1 Diabetes Diabetes Care. Jan, 2011  |   Pubmed ID: 20929999 To determine whether real-time continuous glucose monitoring (CGM) with preset alarms at specific glucose levels would prove a useful tool to achieve avoidance of hypoglycemia and improve the counterregulatory response to hypoglycemia in adolescents with type 1 diabetes with hypoglycemia unawareness.
• Endothelial Function and Carotid Intima-medial Thickness in Adolescents with Type 2 Diabetes Mellitus The Journal of Pediatrics. Dec, 2011  |   Pubmed ID: 21722916 We assessed the effect of type 2 diabetes mellitus and obesity on flow-mediated dilation (FMD) and endothelial-dependent vasodilation and carotid intima-medial thickness (cIMT) in young people.
• Neurocognitive Outcomes in Young Adults with Early-onset Type 1 Diabetes: a Prospective Follow-up Study Diabetes Care. Oct, 2011  |   Pubmed ID: 21844288 The aim of this study was to reexamine the neurocognitive function of a cohort of young adults with early-onset type 1 diabetes and compare their cognitive function to a matched control group. We also examined whether cognitive function was related to prospectively obtained severe hypoglycemia history, long-term glycemic control, or severe diabetic ketoacidosis.
• High Incidence of Obesity Co-morbidities in Young Children: a Cross-sectional Study Journal of Paediatrics and Child Health. Dec, 2011  |   Pubmed ID: 21902753 The prevalence of overweight and obesity in children is a public health problem because of future morbidity. However, the prevalence of medical complications in overweight and obese primary school children in Australia is not well documented. As part of the larger, prospective cohort Growth and Development Study, this report aimed to identify the medical complications of obesity in a population-based community sample of primary school-aged children.
• Reducing Rates of Severe Hypoglycemia in a Population-based Cohort of Children and Adolescents with Type 1 Diabetes over the Decade 2000-2009 Diabetes Care. Nov, 2011  |   Pubmed ID: 21926291 To examine rates of severe hypoglycemia (SH) in a large population-based cohort of children with type 1 diabetes and relationships to HbA(1c).
• Structural Chromosome Disruption of the NR3C2 Gene Causing Pseudohypoaldosteronism Type 1 Presenting in Infancy Journal of Pediatric Endocrinology & Metabolism : JPEM. 2011  |   Pubmed ID: 21932599 Type I pseudohypoaldosteronism (PHA1) is a rare form of mineralocorticoid resistance presenting in infancy with renal salt wasting and failure to thrive. Here, we present the case of a 6-week-old baby girl who presented with mild hyponatraemia and dehydration with a background of severe failure to thrive. At presentation, urinary sodium was not measurably increased, but plasma aldosterone and renin were increased, and continued to rise during the subsequent week. Despite high calorie feeds the infant weight gain and hyponatraemia did not improve until salt supplements were commenced. Subsequently, the karyotype was reported as 46,XX,inv (4)(q31.2q35). A search of the OMIM database for related genes at or near the inversion breakpoints, showed that the mineralocorticoid receptor gene (NR3C2) at 4q31.23 was a likely candidate. Further FISH analysis showed findings consistent with disruption of the NR3C2 gene by the proximal breakpoint (4q31.23) of the inversion. There was no evidence of deletion or duplication at or near the breakpoint. This is the first report of a structural chromosome disruption of the NR3C2 gene giving rise to the classical clinical manifestations of pseudohypoaldosteronism type 1 in an infant.
• Identification of Hypoglycemic States for Patients with T1DM Using Various Parameters Derived from EEG Signals Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2011  |   Pubmed ID: 22254913 For patients with Type 1 Diabetes Mellitus (T1DM), hypoglycemia is a very common but dangerous complication which can lead to unconsciousness, coma and even death. The variety of hypoglycemia symptoms is originated from the inadequate supply of glucose to the brain. In this study, we explore the connection between hypoglycemic episodes and the electrical activity of neurons within the brain or electroencephalogram (EEG) signals. By analyzing EEG signals from a clinical study of five children with T1DM, associated with hypoglycemia at night, we find that some EEG parameters change significantly under hypoglycemia condition. Based on these parameters, a method of detecting hypoglycemic episodes using EEG signals with a feed-forward multi-layer neural network is proposed. In our application, the classification results are 72% sensitivity and 55% specificity when the EEG signals are acquired from 2 electrodes C3 and O2. Furthermore, signals from different channels are also analyzed to observe the contributions of each channel to the performance of hypoglycemia classification.
• Hypoglycemia Does Not Change the Threshold for Arousal from Sleep in Adolescents with Type 1 Diabetes Diabetes Technology & Therapeutics. Feb, 2012  |   Pubmed ID: 21988312 Nocturnal hypoglycemia is a significant problem for children and adolescents with type 1 diabetes. The counterregulatory hormone response to hypoglycemia is blunted in both patients with type 1 diabetes and healthy subjects during sleep. It is not known whether the threshold for arousal from sleep is also modified by hypoglycemia. To address this question we compared the acoustic arousal threshold from sleep during hypoglycemia and euglycemia in adolescents with type 1 diabetes.
• The Effect of Short-term Use of the Guardian RT Continuous Glucose Monitoring System on Fear of Hypoglycaemia in Patients with Type 1 Diabetes Mellitus Primary Care Diabetes. Apr, 2012  |   Pubmed ID: 22047939 This study examines whether the short-term use of a continuous glucose monitor (CGM) can reduce the fear of hypoglycaemia in individuals with type 1 diabetes mellitus (T1DM).
• Anaphylaxis Triggered by Benzyl Benzoate in a Preparation of Depot Testosterone Undecanoate Case Reports in Medicine. 2012  |   Pubmed ID: 22272209 We report the first case of an anaphylactic reaction to Reandron 1000 (depot testosterone undecanoate with a castor oil and benzyl benzoate vehicle). While considered to have a favourable safety profile, serious complications such as oil embolism and anaphylaxis can occur. In our patient, skin testing identified benzyl benzoate to be the trigger, with no reaction to castor oil or testosterone undecanoate components. As benzyl benzoate exists in multiple pharmaceuticals, foods, and cosmetics, individual components of pharmaceuticals should be tested when investigating drug allergies. Doctors should be alert to the potential for serious reactions to any of the components of Reandron 1000.
• Analysis of Glucose Responses to Automated Insulin Suspension with Sensor-augmented Pump Therapy Diabetes Care. Jul, 2012  |   Pubmed ID: 22584133 The advent of sensor-augmented pump therapy with a low-glucose suspend (LGS) function (Medtronic Paradigm Veo System), allowing insulin to be automatically suspended for up to 2 h when sensor glucose falls below a preset threshold, has the potential to reduce the duration of hypoglycemia. In this article, we analyzed blood glucose profiles following a full 2-h insulin suspension activated by the LGS function, as well as examined different patterns of use among patients.
• Early Loss of the Glucagon Response to Hypoglycemia in Adolescents with Type 1 Diabetes Diabetes Care. Aug, 2012  |   Pubmed ID: 22699295 To assess the glucagon response to hypoglycemia and identify influencing factors in patients with type 1 diabetes compared with nondiabetic control subjects.
• Cyclical Variation in the Incidence of Childhood Type 1 Diabetes in Western Australia (1985-2010) Diabetes Care. Nov, 2012  |   Pubmed ID: 22837374 To examine the incidence of childhood type 1 diabetes in Western Australia from 1985-2010.
• The Use of an Automated, Portable Glucose Control System for Overnight Glucose Control in Adolescents and Young Adults with Type 1 Diabetes Diabetes Care. Nov, 2012  |   Pubmed ID: 22875230 A key milestone in progress towards providing an efficacious and safe closed-loop artificial pancreas system for outpatient use is the development of fully automated, portable devices with fault detection capabilities to ensure patient safety. The ability to remotely monitor the operation of the closed-loop system would facilitate future physician-supervised home studies.
• Ethnic and Gender Differences in Rates of Congenital Adrenal Hyperplasia in Western Australia over a 21 Year Period Journal of Paediatrics and Child Health. Nov, 2012  |   Pubmed ID: 23039988 To evaluate the incidence, sex distribution, ethnicity, age at diagnosis, clinical presentation and morbidity of all childhood-onset congenital adrenal hyperplasia (CAH) cases in Western Australia (WA) between 1990 and 2010, a state where newborn screening for CAH is not in place.
• The Effect of Midday Moderate-intensity Exercise on Postexercise Hypoglycemia Risk in Individuals with Type 1 Diabetes The Journal of Clinical Endocrinology and Metabolism. Jul, 2013  |   Pubmed ID: 23780373 Exercise increases the risk of hypoglycemia in type 1 diabetes.
• A Population-based Study of Risk Factors for Severe Hypoglycaemia in a Contemporary Cohort of Childhood-onset Type 1 Diabetes Diabetologia. Oct, 2013  |   Pubmed ID: 23832082 Severe hypoglycaemia is a major barrier to optimising glycaemic control. Recent changes in therapy, however, may have altered the epidemiology of severe hypoglycaemia and its associated risk factors. The aim of this study was to examine the incidence rates and risk factors associated with severe hypoglycaemia in a contemporary cohort of children and adolescents with type 1 diabetes.
• Environmental Determinants of Islet Autoimmunity (ENDIA): a Pregnancy to Early Life Cohort Study in Children At-risk of Type 1 Diabetes BMC Pediatrics. Aug, 2013  |   Pubmed ID: 23941366 The incidence of type 1 diabetes has increased worldwide, particularly in younger children and those with lower genetic susceptibility. These observations suggest factors in the modern environment promote pancreatic islet autoimmunity and destruction of insulin-producing beta cells. The Environmental Determinants of Islet Autoimmunity (ENDIA) Study is investigating candidate environmental exposures and gene-environment interactions that may contribute to the development of islet autoimmunity and type 1 diabetes.
• Long-term Outcome of Insulin Pump Therapy in Children with Type 1 Diabetes Assessed in a Large Population-based Case-control Study Diabetologia. Nov, 2013  |   Pubmed ID: 23963323 We determined the impact of insulin pump therapy on long-term glycaemic control, BMI, rate of severe hypoglycaemia and diabetic ketoacidosis (DKA) in children.
• Overexpression of Aromatase Associated with Loss of Heterozygosity of the STK11 Gene Accounts for Prepubertal Gynecomastia in Boys with Peutz-Jeghers Syndrome The Journal of Clinical Endocrinology and Metabolism. Dec, 2013  |   Pubmed ID: 24037887 Peutz-Jeghers syndrome (PJS) is an autosomal-dominant disorder that arises as a consequence of mutations in the STK11 gene that encodes LKB1. PJS males often have estrogen excess manifesting as gynecomastia and advanced bone age. We and others have previously described an increase in testicular aromatase expression in PJS patients. However, the underlying mechanism has not yet been explored.
• Effect of Sensor-augmented Insulin Pump Therapy and Automated Insulin Suspension Vs Standard Insulin Pump Therapy on Hypoglycemia in Patients with Type 1 Diabetes: a Randomized Clinical Trial JAMA. Sep, 2013  |   Pubmed ID: 24065010 Hypoglycemia is a critical obstacle to the care of patients with type 1 diabetes. Sensor-augmented insulin pump with automated low-glucose insulin suspension has the potential to reduce the incidence of major hypoglycemic events.
• A 10-s Sprint Performed After Moderate-intensity Exercise Neither Increases nor Decreases the Glucose Requirement to Prevent Late-onset Hypoglycemia in Individuals with Type 1 Diabetes Diabetes Care. Dec, 2013  |   Pubmed ID: 24130362 To determine whether performing a 10-s sprint after moderate-intensity exercise increases the amount of carbohydrate required to maintain euglycemia and prevent late-onset postexercise hypoglycemia relative to moderate-intensity exercise alone.
• Both Dietary Protein and Fat Increase Postprandial Glucose Excursions in Children with Type 1 Diabetes, and the Effect is Additive Diabetes Care. Dec, 2013  |   Pubmed ID: 24170749 To determine the separate and combined effects of high-protein (HP) and high-fat (HF) meals, with the same carbohydrate content, on postprandial glycemia in children using intensive insulin therapy (IIT).
• Maternal Smoking During Pregnancy and the Risk of Childhood Type 1 Diabetes in Western Australia Diabetologia. Mar, 2014  |   Pubmed ID: 24297601 The aim of this study was to investigate the association between maternal smoking during pregnancy and type 1 diabetes in the offspring, using complete population data sources available in Western Australia.
• Acute Hyperglycaemia Does Not Alter Nitric Oxide-mediated Microvascular Function in the Skin of Adolescents with Type 1 Diabetes European Journal of Applied Physiology. Feb, 2014  |   Pubmed ID: 24337670 We assessed the impact of an acute bout of hyperglycaemia on nitric oxide (NO)-mediated microvascular function in the skin of adolescents with type 1 diabetes (T1DM).
• Antecedent Hypoglycaemia Does Not Diminish the Glycaemia-increasing Effect and Glucoregulatory Responses of a 10 S Sprint in People with Type 1 Diabetes Diabetologia. Jun, 2014  |   Pubmed ID: 24632737 A 10 s sprint has been reported to provide a means to prevent acute post-exercise hypoglycaemia in young adults with type 1 diabetes because of its glycaemia-raising effect, but it is unclear whether this effect is impaired by antecedent hypoglycaemia. The purpose of this study was to investigate whether antecedent hypoglycaemia impairs the glycaemia-raising effect of a 10 s sprint in individuals with type 1 diabetes.
• Building Tasks from Verbal Instructions: an EEG Study on Practice Trial Exposure and Task Structure Complexity During Novel Sequences of Behavior Cognitive, Affective & Behavioral Neuroscience. Dec, 2014  |   Pubmed ID: 24796598 Configuring the mind to perform a novel task is an effortful process and one that is related to differences in general intelligence. Previous research has suggested that when participants are given instructions for a future task, representations of the rules contained in the instructions can influence subsequent behavior, even when the rules are not necessary to perform the upcoming task. One hypothesis for the continued activation of rule representations suggests that the practice trials participants perform before the experimental trials may instantiate the unnecessary task rules into participants' mental model of the task (i.e., the task space). To test this hypothesis, EEGs were recorded as participants (N = 66) completed a multirule task designed to contrast the effects of increasing task structure complexity and practice trial exposure. The results showed that, as was predicted, performance is significantly poorer when more task rules are specified in the task instructions. Practice trials with the extra rule did not affect task performance, indicating that an unacted verbal instruction is sufficient to incorporate the rule into participants' mental model of the task. The EEG results showed that instruction complexity was linked to a phasic increase in frontal theta synchronization but reduced posterior alpha and beta desynchronization. These changes in synchronization occurred during a time period of low intertrial phase coherence and suggest that participants were "checking the task rules" amidst a trial. This transient neural activity may reflect compensatory mechanisms for dealing with increased mind-wandering that is more likely to occur in complex tasks.
• ISPAD Clinical Practice Consensus Guidelines 2014. Assessment and Management of Hypoglycemia in Children and Adolescents with Diabetes Pediatric Diabetes. Sep, 2014  |   Pubmed ID: 25040141
• Early Atherosclerosis Relates to Urinary Albumin Excretion and Cardiovascular Risk Factors in Adolescents with Type 1 Diabetes: Adolescent Type 1 Diabetes Cardio-renal Intervention Trial (AdDIT) Diabetes Care. Nov, 2014  |   Pubmed ID: 25071076 The origins of cardiovascular and renal disease in type 1 diabetes begin during childhood. We aimed to evaluate carotid (cIMT) and aortic intima-media thickness (aIMT) and their relationship with cardiovascular risk factors and urinary albumin excretion in adolescents with type 1 diabetes in the Adolescent Type 1 Diabetes cardio-renal Intervention Trial (AdDIT).
• A Cost-effectiveness Analysis of Sensor-augmented Insulin Pump Therapy and Automated Insulin Suspension Versus Standard Pump Therapy for Hypoglycemic Unaware Patients with Type 1 Diabetes Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research. Jul, 2014  |   Pubmed ID: 25128049 To assess the cost-effectiveness of sensor-augmented insulin pump therapy with "Low Glucose Suspend" (LGS) functionality versus standard pump therapy with self-monitoring of blood glucose in patients with type 1 diabetes who have impaired awareness of hypoglycemia.
• Cardiac Autonomic Dysfunction is Associated with High-risk Albumin-to-creatinine Ratio in Young Adolescents with Type 1 Diabetes in AdDIT (adolescent Type 1 Diabetes Cardio-renal Interventional Trial) Diabetes Care. Apr, 2015  |   Pubmed ID: 25573882 This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes.
• Effect of Antecedent Moderate-intensity Exercise on the Glycemia-increasing Effect of a 30-sec Maximal Sprint: a Sex Comparison Physiological Reports. May, 2015  |   Pubmed ID: 26019290 This study investigated whether a prior bout of moderate-intensity exercise attenuates the glycemia-increasing effect of a maximal 30-sec sprint. A secondary aim was to determine whether the effect of antecedent exercise on the glucoregulatory response to sprinting is affected by sex. Participants (men n = 8; women n = 7) were tested on two occasions during which they either rested (CON) or cycled for 60-min at a moderate intensity of ~65% V ˙ O 2 peak (EX) before performing a 30-sec maximal cycling effort 195 min later. In response to the sprint, blood glucose increased to a similar extent between EX and CON trials, peaking at 10 min of recovery, with no difference between sexes (P > 0.05). Blood glucose then declined at a faster rate in EX, and this was associated with a glucose rate of disappearance (R d) that exceeded the glucose rate of appearance (R a) earlier in EX compared with CON, although the overall glucose R a and R d profile was higher in men compared with women (P 
• Efficacy and Safety of Sirolimus in a Neonate with Persistent Hypoglycaemia Following Near-total Pancreatectomy for Hyperinsulinaemic Hypoglycaemia Journal of Pediatric Endocrinology & Metabolism : JPEM. Nov, 2015  |   Pubmed ID: 26226122 Hyperinsulinaemic hypoglycaemia (HH) is characterised by inappropriate insulin secretion and is the most common cause for persistent neonatal hypoglycaemia. The only treatment available for medically unresponsive hypoglycaemia is a near-total pancreatectomy. A neonate with severe HH, due to a homozygous ABCC8 mutation, was not responsive to treatment with maximal doses of diazoxide and subcutaneous daily octreotide, and underwent a near-total pancreatectomy; however, hypoglycaemia persisted. Introduction of sirolimus, an mTOR (mammalian target of rapamycin) inhibitor, obviated the requirement for glucose infusion. Euglycaemia was achieved with no significant adverse events from the drug. Sirolimus therapy was ceased at 13 months of age. No episodes of persistent hypoglycaemia were observed after cessation of sirolimus. This report demonstrates the successful use of sirolimus for persistent hypoglycaemia in the critically ill infant post pancreatectomy. Sirolimus could be considered in patients with severe HH not responsive to conventional medical and surgical therapy. However, the long-term efficacy and safety with this immunosuppressive drug in very young patients are not assured.
• Regular Peaks and Troughs in the Australian Incidence of Childhood Type 1 Diabetes Mellitus (2000-2011) Diabetologia. Nov, 2015  |   Pubmed ID: 26228717 The aim of this study was to determine the incidence and incidence rate trends for type 1 diabetes mellitus in children aged 0-14 years, Australia-wide, from 2000 to 2011.
• Feasibility of Outpatient 24-Hour Closed-Loop Insulin Delivery Diabetes Care. Nov, 2015  |   Pubmed ID: 26316630
• School Performance in Children with Type 1 Diabetes: a Contemporary Population-based Study Pediatric Diabetes. Mar, 2016  |   Pubmed ID: 25423904 Our aim was to examine the school performance of children with type 1 diabetes in comparison to their peers, exploring changes over time, and the impact of clinical factors on school performance.
• Effect of Exercise Intensity on Glucose Requirements to Maintain Euglycemia During Exercise in Type 1 Diabetes The Journal of Clinical Endocrinology and Metabolism. Mar, 2016  |   Pubmed ID: 26765581 No recommendations exist to inform the carbohydrate amount required to prevent hypoglycemia associated with exercise of different intensities in individuals with type 1 diabetes (T1D).
• Exercise Training Improves Vascular Function in Adolescents with Type 2 Diabetes Physiological Reports. Feb, 2016  |   Pubmed ID: 26887327 The impact of exercise training on vascular health in adolescents with type 2 diabetes has not been previously studied. We hypothesized that exercise training would improve micro- and macrovascular health in adolescents with type 2 diabetes. Thirteen adolescents (13-21 years, 10F) with type 2 diabetes were recruited from Princess Margaret Hospital. Participants were randomized to receive either an exercise program along with standard clinical care (n = 8) or standard care alone (n = 5). Those in the intervention group received 12 weeks of gym-based, personalized, and supervised exercise training. Those in the control group were instructed to maintain usual activity levels. Assessments were conducted at baseline and following week 12. The exercise group was also studied 12 weeks following the conclusion of their program. Assessments consisted of conduit artery endothelial function (flow-mediated dilation, FMD) and microvascular function (cutaneous laser Doppler). Secondary outcomes included body composition (dual-energy X-ray absorptiometry, DXA), glycemic control (whole body insulin sensitivity, M) assessed using the euglycemic-hyperinsulinemic clamp protocol, cardiorespiratory fitness (V˙O2peak), and muscular strength (1RM). Exercise training increased FMD (P 
• Prevention of Insulin-Induced Hypoglycemia in Type 1 Diabetes with Predictive Low Glucose Management System Diabetes Technology & Therapeutics. Jul, 2016  |   Pubmed ID: 27148807 Sensor-augmented pump therapy (SAPT) with algorithms to predict impending low blood glucose and suspend insulin delivery has the potential to reduce hypoglycemia exposure. The aim of this study was to determine whether predictive low glucose management (PLGM) system is effective in preventing insulin-induced hypoglycemia in controlled experiments.
• Outcome Measures for Artificial Pancreas Clinical Trials: A Consensus Report Diabetes Care. Jul, 2016  |   Pubmed ID: 27330126 Research on and commercial development of the artificial pancreas (AP) continue to progress rapidly, and the AP promises to become a part of clinical care. In this report, members of the JDRF Artificial Pancreas Project Consortium in collaboration with the wider AP community 1) advocate for the use of continuous glucose monitoring glucose metrics as outcome measures in AP trials, in addition to HbA1c, and 2) identify a short set of basic, easily interpreted outcome measures to be reported in AP studies whenever feasible. Consensus on a broader range of measures remains challenging; therefore, reporting of additional metrics is encouraged as appropriate for individual AP studies or study groups. Greater consistency in reporting of basic outcome measures may facilitate the interpretation of study results by investigators, regulatory bodies, health care providers, payers, and patients themselves, thereby accelerating the widespread adoption of AP technology to improve the lives of people with type 1 diabetes.
• Effectiveness of a Predictive Algorithm in the Prevention of Exercise-Induced Hypoglycemia in Type 1 Diabetes Diabetes Technology & Therapeutics. Sep, 2016  |   Pubmed ID: 27505305 Sensor-augmented pump therapy (SAPT) with a predictive algorithm to suspend insulin delivery has the potential to reduce hypoglycemia, a known obstacle in improving physical activity in patients with type 1 diabetes. The predictive low glucose management (PLGM) system employs a predictive algorithm that suspends basal insulin when hypoglycemia is predicted. The aim of this study was to determine the efficacy of this algorithm in the prevention of exercise-induced hypoglycemia under in-clinic conditions.
• Glycemia, Treatment Satisfaction, Cognition, and Sleep Quality in Adults and Adolescents with Type 1 Diabetes When Using a Closed-Loop System Overnight Versus Sensor-Augmented Pump with Low-Glucose Suspend Function: A Randomized Crossover Study Diabetes Technology & Therapeutics. Dec, 2016  |   Pubmed ID: 27835037 We compared glycemia, treatment satisfaction, sleep quality, and cognition using a nighttime Android-based hybrid closed-loop system (Android-HCLS) with sensor-augmented pump with low-glucose suspend function (SAP-LGS) in people with type 1 diabetes.
• Reduced Prevalence of Impaired Awareness of Hypoglycemia in a Population-based Clinic Sample of Youth with Type 1 Diabetes Pediatric Diabetes. Nov, 2016  |   Pubmed ID: 27862736 Impaired awareness of hypoglycemia (IAH) is associated with an increased risk for severe hypoglycemia (SH). However, reduced rates of SH raise the question as to whether there has been a reduction in IAH. The aim of this study was to determine the change in prevalence of IAH in a population-based cohort of adolescents with Type 1 diabetes (T1D).
• Severe Hypoglycemia Rates Are Not Associated with HbA1c: a Cross-sectional Analysis of 3 Contemporary Pediatric Diabetes Registry Databases Pediatric Diabetes. Nov, 2016  |   Pubmed ID: 27878914 To examine the association between glycated hemoglobin (HbA1c) and severe hypoglycemia rates in patients with type 1 diabetes receiving usual care, by analysing data from the US Type 1 Diabetes Exchange (T1DX), German/Austrian Diabetes Patienten Verlaufsdokumenation (DPV), and Western Australian Children Diabetes Database (WACDD) diabetes registries.
• Exercise Management in Type 1 Diabetes: a Consensus Statement The Lancet. Diabetes & Endocrinology. Jan, 2017  |   Pubmed ID: 28126459 Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.
• The Australasian Diabetes Data Network: First National Audit of Children and Adolescents with Type 1 Diabetes The Medical Journal of Australia. Feb, 2017  |   Pubmed ID: 28208043 To assess glycaemic control, anthropometry and insulin regimens in a national sample of Australian children and adolescents with type 1 diabetes.
• Incidence of and Risk Factors for Hospitalisations Due to Vascular Complications: A Population-based Type 1 Diabetes Cohort (n=1316) Followed into Early Adulthood Journal of Diabetes and Its Complications. Jan, 2017  |   Pubmed ID: 28242271 To determine the incidence of hospitalisations and risk factors for vascular complications experienced during early adulthood in patients with childhood onset type 1 diabetes.