scholarly journals Epidemiology of visual impairment, sight-threatening or treatment-requiring diabetic eye disease in children and young people in the UK: findings from DECS

2020 ◽  
pp. bjophthalmol-2020-315886
Author(s):  
Maria Carolina Ibanez-Bruron ◽  
Ameenat Lola Solebo ◽  
Phillippa Cumberland ◽  
Jugnoo S Rahi
Keyword(s):  
Young People ◽  
Self Management ◽  
Eye Disease ◽  
Visual Disability ◽  
Children And Young People ◽  
Eye Screening ◽  
Diabetic Eye Disease ◽  
The Uk ◽  
Prevention Of Diabetes

BackgroundWe investigated the incidence and causes of sight-threatening diabetes-related eye disease in children living with diabetes in the UK, to inform the national eye screening programme and enable monitoring of trends.MethodsWe undertook a prospective active national surveillance via the British Ophthalmic Surveillance Unit. Eligible cases were children aged 18 years or younger, with type 1 or 2 diabetes, newly diagnosed between January 2015 and February 2017 with sight-threatening diabetic eye disease.ResultsEight children were reported. The annual incidence of all sight-threatening diabetes-related eye disease requiring referral to an ophthalmologist among children living with diabetes (n=8) in the UK was 1.21 per 10 000 person-years (95% CI 0.52 to 2.39) and was largely attributable to cataract (n=5) 0.76 per 10 000 person-years (95% CI 0.25 to 1.77). The incidence of sight-threatening diabetic retinopathy (n=3) among those eligible for screening (12 to 18 year-olds living with diabetes) was 1.18 per 10 000 person-years (95% CI 0.24 to 3.46). No subjects eligible for certification as visually impaired or blind were reported.ConclusionsSecondary prevention of visual disability due to retinopathy is currently the sole purpose of national eye screening programmes globally. However, the rarity of treatment-requiring retinopathy in children/young people living with diabetes, alongside growing concerns about suboptimal screening uptake, merit new consideration of the utility of screening for primary prevention of diabetes-related morbidity by using the screening event and findings as a catalyst for better diabetes self-management.

scholarly journals Children and young people’s experiences and perceptions of self-management of type 1 diabetes: A qualitative meta-synthesis

2019 ◽  
Vol 6 (2) ◽  
pp. 205510291987710 ◽  
Author(s):  
Ella Tuohy ◽  
Caroline Rawdon ◽  
Pamela Gallagher ◽  
Michele Glacken ◽  
Nuala Murphy ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Contextual Factors ◽  
Self Management ◽  
Inclusion Criteria ◽  
Children And Young People ◽  
Thematic Synthesis ◽  
Synthesis Approach

The aim of this review was to conduct a meta-synthesis of the experiences and perceptions of self-management of type 1 diabetes of children and young people living with type 1 diabetes (CYPDs). Six databases were systematically searched for studies with qualitative findings relevant to CYPDs’ (aged 8–18 years) experiences of self-management. A thematic synthesis approach was used to combine articles and identify analytical themes. Forty articles met the inclusion criteria. Two analytical themes important to CYPDs’ experiences and perceptions of self-management were identified: (1) negotiating independence and (2) feeling in control. The synthesis contributes to knowledge on contextual factors underpinning self-management and what facilitates or impedes transition towards autonomous self-management for CYPDs.

scholarly journals Psycho-educational interventions for children and young people with Type 1 Diabetes in the UK: How effective are they? A systematic review and meta-analysis

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0179685 ◽  
Author(s):  
Dimitrios Charalampopoulos ◽  
Kathryn R. Hesketh ◽  
Rakesh Amin ◽  
Veena Mazarello Paes ◽  
Russell M. Viner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 1 Diabetes ◽  
Young People ◽  
Meta Analysis ◽  
Educational Interventions ◽  
Children And Young People ◽  
The Uk

scholarly journals Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19: a national UK survey

2020 ◽  
Vol 4 (1) ◽  
pp. e000884
Author(s):  
Sze May Ng ◽  
Katherine Woodger ◽  
Fiona Regan ◽  
Astha Soni ◽  
Neil Wright ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Diabetes Education ◽  
Healthcare Providers ◽  
Delayed Presentation ◽  
Medical Provider ◽  
Children And Young People ◽  
The Uk ◽  
New Onset

In the UK, there have been reports of significant reductions in paediatric emergency attendances and visits to the general practitioners due to COVID-19. A national survey undertaken by the UK Association of Children’s Diabetes Clinicians found that the proportion of new-onset type 1 diabetes (T1D) presenting with diabetes ketoacidosis (DKA) during this COVID-19 pandemic was higher than previously reported, and there has been an increase in presentation of severe DKA at diagnosis in children and young people under the age of 18 years. Delayed presentations of T1D have been documented in up 20% of units with reasons for delayed presentation ranging from fear of contracting COVID-19 to an inability to contact or access a medical provider for timely evaluation. Public health awareness and diabetes education should be disseminated to healthcare providers on the timeliness of referrals of children with T1D.

Diabetes control is worse in children and young people with type 1 diabetes requiring interpreter support

2018 ◽  
Author(s):  
Jan Idkowiak ◽  
Sabba Elhag ◽  
Vrinda Saraff ◽  
Renuka Dias ◽  
Timothy Barrett ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Diabetes Control ◽  
Children And Young People

scholarly journals Collateral impact of COVID-19: why should children continue to suffer?

2021 ◽  
Author(s):  
Prasad Nagakumar ◽  
Ceri-Louise Chadwick ◽  
Andrew Bush ◽  
Atul Gupta
Keyword(s):  
Young People ◽  
Large Scale ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Children And Young People ◽  
Collateral Effects ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Set Up ◽  
The Uk

AbstractThe COVID-19 pandemic caused by SARS-COV-2 virus fortunately resulted in few children suffering from severe disease. However, the collateral effects on the COVID-19 pandemic appear to have had significant detrimental effects on children affected and young people. There are also some positive impacts in the form of reduced prevalence of viral bronchiolitis. The new strain of SARS-COV-2 identified recently in the UK appears to have increased transmissibility to children. However, there are no large vaccine trials set up in children to evaluate safety and efficacy. In this short communication, we review the collateral effects of COVID-19 pandemic in children and young people. We highlight the need for urgent strategies to mitigate the risks to children due to the COVID-19 pandemic. What is Known:• Children and young people account for <2% of all COVID-19 hospital admissions• The collateral impact of COVID-19 pandemic on children and young people is devastating• Significant reduction in influenza and respiratory syncytial virus (RSV) infection in the southern hemisphere What is New:• The public health measures to reduce COVID-19 infection may have also resulted in near elimination of influenza and RSV infections across the globe• A COVID-19 vaccine has been licensed for adults. However, large scale vaccine studies are yet to be initiated although there is emerging evidence of the new SARS-COV-2 strain spreading more rapidly though young people.• Children and young people continue to bear the collateral effects of COVID-19 pandemic

scholarly journals O31 Trajectories of anxiety in children young people and adults with rheumatic diseases in the wake of COVID-19: results from the COVID-19 European patient registry

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Stephanie J W Shoop-Worrall ◽  
Suzanne M M Verstappen ◽  
Wendy Costello ◽  
Saskya P Angevare ◽  
Yosef Uziel ◽  
...  
Keyword(s):  
Young People ◽  
Rheumatic Diseases ◽  
Model Fit ◽  
Patient Registry ◽  
Linear Quadratic ◽  
High Anxiety ◽  
Children And Young People ◽  
Chi Squared ◽  
The Uk ◽  
Cubic Polynomials

Abstract Background/Aims  Younger and older people with rheumatic diseases may experience increased anxiety during the COVID-19 pandemic, due to the uncertainty regarding their likelihood of contracting the virus, its complications alongside their existing condition and whether their immunosuppressive treatments pose additional risks. This study explored trajectories of anxiety in parents of children and young people (CYP) with rheumatic diseases and adults with rheumatic diseases in the six months following March 2020 during the COVID-19 pandemic. Methods  CYP and adults recruited to the international COVID-19 European Patient Registry, a parent-led, online, self-referred prospective cohort recruiting participants globally, were selected if enrolled within 20th March to 17th April 2020. Anxiety scores (0-10, 10=Highest anxiety) were collected weekly for up to 28 weeks and denoted parent anxiety in the CYP cohort and self-reported anxiety in the adult cohort. Group-based trajectory models explored anxiety clusters using censored-normal models in the CYP and adult populations, separately. Linear, quadratic and cubic polynomials were tested within 1 to 10 clusters and optimal models selected based on a combination of model fit (BIC), parsimony and clinical plausibility. Demographic (country, age, gender) and clinical (diagnosis, disease control, respiratory comorbidity, immunosuppressive therapy) information and COVID-19 mitigation behaviours (isolation, distancing, none) were collected at initial enrolment and compared between clusters using Chi-squared, Fisher’s exact and Kruskal-Wallis tests. Results  Among 498 CYP and 2640 adults, most were female (65%, 89%) and from the UK (50%, 84%), respectively. The most common diagnoses were polyarticular JIA (37%) and oligoarticular JIA (29%) among CYP and RA among the adults (63%). Respiratory comorbidities were uncommon in the CYP (10%) and adult (17%) cohorts, and most were taking any immunosuppressive therapies (85%, 87%), respectively. As of March 2020, 88% and 79% were self-isolating, respectively. In both the parents of CYP and adult cohorts, four trajectory clusters were identified with similar patterns: Persistent extremely high anxiety (32%, 17%), persistent high anxiety (43%, 41%), high anxiety that marginally improved (25%, 32%) and moderate anxiety that improved (11%, 10%). Among CYP, few characteristics distinguished the clusters. However, in the adult cohort, clusters with greater and more persistent anxiety were associated with higher levels of respiratory comorbidities, higher use of immunosuppressive therapies, higher initial levels of self-isolation and slightly older age than those with lower or improving anxiety over time. Conclusion  This study reports four trajectories of anxiety during the COVID-19 pandemic that are consistent across parents of CYP with rheumatic diseases and among adults with these conditions. Despite relatively lower risks for CYP, parental anxiety regarding COVID-19 was high and not associated with characteristics of their child or of their child's disease. Among adults with rheumatic diseases, greater anxiety was associated with risk factors potentially associated with COVID-19 morbidity and mortality. Disclosure  S.J.W. Shoop-Worrall: None. S.M.M. Verstappen: None. W. Costello: None. S.P. Angevare: None. Y. Uziel: None. C. Wouters: None. N. Wulffraat: Honoraria; Sobi. Grants/research support; Abbvie. R. Beesley: None.

Prevention and early help for eating disorders in young people with type 1 diabetes

2021 ◽  
pp. 135910452199417
Author(s):  
Rosie Oldham-Cooper ◽  
Claire Semple
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Early Intervention ◽  
Young People ◽  
Current Evidence ◽  
Future Directions ◽  
Team Collaboration ◽  
Children And Young People ◽  
Specialist Services

There is building evidence that early intervention is key to improving outcomes in eating disorders, whereas a ‘watch and wait’ approach that has been commonplace among GPs and other healthcare professionals is now strongly discouraged. Eating disorders occur at approximately twice the rate in individuals with type 1 diabetes compared to the general population. In this group, standard eating disorder treatments have poorer outcomes, and eating disorders result in a particularly high burden of morbidity. Therefore, our first priority must be prevention, with early intervention where disordered eating has already developed. Clinicians working in both eating disorders and diabetes specialist services have highlighted the need for multidisciplinary team collaboration and specific training, as well as improved treatments. We review the current evidence and future directions for prevention, identification and early intervention for eating disorders in children and young people with type 1 diabetes.

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