Dataset Information

Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension.

ABSTRACT: To compare the frequency of elevated morning blood ketone levels according to age in 4-14 year olds with type 1 diabetes following overnight use of an automated low glucose insulin suspension system, or following control nights when the system was not used.For 28 children ages 4-9 years and 54 youth ages 10-14 years, elevation of morning blood ketone levels was assessed using the Precision Xtra Ketone meter following 1155 and 2345 nights, respectively. Repeated measures logistic regression models were used to compare age groups for blood ketone level elevation following control nights (system not activated) and following intervention nights with and without insulin suspension.Elevated morning blood ketones (?0.6 mmol/L) were present following 10% of 580 control nights in the 4-9 year olds compared with 2% of 1162 control nights in 10-14 year olds (P < 0.001). Likewise, the frequency was greater following intervention nights in the younger age group (13% of 575 nights vs 2% of 1183 nights, P < 0.001). A longer duration of pump suspension resulted in a higher percentage of mornings with elevated blood ketones in the younger age group (P = 0.002), but not in the older age group (P = 0.63). The presence of elevated morning ketone levels did not progress to ketoacidosis in any subject.Elevated morning blood ketones are more common in younger children with type 1 diabetes with or without nocturnal insulin suspension. Care providers need to be aware of the differences in ketogenesis in younger age children relative to various clinical situations.

SUBMITTER: Wadwa RP

PROVIDER: S-EPMC5233607 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension.

Wadwa R Paul RP Chase H Peter HP Raghinaru Dan D Buckingham Bruce A BA Hramiak Irene I Maahs David M DM Messer Laurel L Ly Trang T Aye Tandy T Clinton Paula P Kollman Craig C Beck Roy W RW Lum John J

Pediatric diabetes 20160712 6

<h4>Objective</h4>To compare the frequency of elevated morning blood ketone levels according to age in 4-14 year olds with type 1 diabetes following overnight use of an automated low glucose insulin suspension system, or following control nights when the system was not used.<h4>Research design and methods</h4>For 28 children ages 4-9 years and 54 youth ages 10-14 years, elevation of morning blood ketone levels was assessed using the Precision Xtra Ketone meter following 1155 and 2345 nights, res ...[more]

PMID: 27402452

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Project description:ImportancePhysical activity may promote healthy brain development in children, but previous research was predominantly cross-sectional and included small samples, providing limited knowledge.ObjectiveTo investigate the longitudinal associations of physical activity with brain morphology changes.Design, setting, and participantsA 4-year longitudinal population-based cohort study in Rotterdam, the Netherlands, embedded in Generation R, a cohort from fetal life onward. From the women enrolled during pregnancy, children who had repeated measures of brain structure at ages 10 (range 8 to 12) years and 14 (range 13 to 15) years were included. Data were collected from March 2013 to November 2015 (baseline) and from October 2016 to January 2020 (follow-up). Data were analyzed from April to December 2022.ExposureAt age 10 years, both the child and their primary caregiver reported the child's levels of physical activity with regard to sport participation, outdoor play, and total physical activity. Primary analyses were based on an average multi-informant report.Main outcomes and measuresBrain morphology was quantified by magnetic resonance imaging. Hypothesized regions of interest were the bilateral amygdala and hippocampal volumes. Global brain measures were studied to test the specificity of the hypothesis.ResultsData were available for 1088 children (566 girls [52%]; 693 [64%] Dutch). Their mean (SD) age at baseline was 10.1 (0.6) years. For amygdala volume change, positive associations with multi-informant reports of total physical activity (β = 2.6; 95% CI, 0.3-4.9) were found. Total physical activity was associated with hippocampal volume increases only when reported by the child (β = 3.1; 95% CI, 0.4-5.8). No robust associations with global brain measures were found.Conclusions and relevanceIn this cohort study of 1088 children, more physical activity at 10 years was consistently associated with an increase in amygdala volume in children aged 10 to 14 years. Physical activity and increases in hippocampal volume were found using child reports of physical activity only. These findings suggest physical activity in late childhood was prospectively associated with volumetric changes in specific subcortical structures, but not to global brain development, from late childhood to early adolescence. These findings may inform the design of future public health interventions to best facilitate neurodevelopment with physical activity.

Project description:ObjectivesDescribe (1) time-segment specific changes in physical activity (PA) into adolescence, (2) differences in change in PA between specific time-segments (weekdays-weekends, in-school-out-of-school, out-of-school-weekends, lesson-time-lunch-time), and (3) associations of change in time-segment specific with overall PA.DesignLongitudinal observational study (4-year follow-up).MethodsChildren from the SPEEDY study (n=769, 42% boys) had PA measured by accelerometer for at least three days at ages 10.2±0.3, 11.2±0.3 and 14.3±0.3years. Changes in moderate-to-vigorous PA (ΔMVPA, minutes ≥2000counts/minute [cpm]) and total PA (ΔTPA, average cpm) during weekdays, weekends, in-school, out-of-school, lesson-times and lunch-times, were tested using three level (age, individual, school) mixed-effects linear regression. Differences in ΔMVPA/ΔTPA between time-segments were tested using time-segment×age interaction terms. Associations of four-year time-segment specific ΔMVPA/ΔTPA with four-year overall ΔMVPA/ΔTPA were tested using two level (time-segment specific ΔMVPA/ΔTPA, school) mixed-effects linear regression.ResultsMVPA and TPA declined in all time-segments, except lesson-time MVPA. Annual ΔMVPA and, for boys only, ΔTPA was greater on weekends than weekdays (beta±SE for interaction term: boys, -3.53±0.83min, -29.64±7.64cpm; girls, -2.20±0.64min) and out-of-school (boys, -4.36±0.79min, -19.36±8.46cpm; girls, -2.44±0.63min). ΔMVPA and ΔTPA during lunch-time was greater than during lesson-time (boys, -0.96±0.20min, -36.43±6.55cpm; girls, -0.90±0.13min, -38.72±4.40cpm). ΔTPA was greater out-of-school than in-school (boys, -19.89±6.71cpm; girls, -18.46±6.51cpm). For all time-segments, four-year ΔMVPA/ΔTPA was positively associated with four-year overall ΔMVPA/ΔTPA (all p<0.042), except for girl's in-school and lunch-time TPA.ConclusionsInterventions focused on PA maintenance could target all time-segments, but weekends and out-of-school may be particularly advantageous due to the relatively large declines observed.

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Dataset Information

Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension.

Publications

Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension.

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