Hypoglycemia-Associated EEG Changes in Prepubertal Children With Type 1 Diabetes

Previous literature has demonstrated that hypoglycemic events in patients with type 1 diabetes (T1D) are associated with measurable scalp electroencephalography (EEG) changes in power spectral density. In the present study, we used a dataset of 19-channel scalp EEG recordings in 34 patients with T1D who underwent a hyperinsulinemic–hypoglycemic clamp study. We found that hypoglycemic events are also characterized by EEG complexity changes that are quantifiable at the single-channel level through empirical conditional and permutation entropy and fractal dimension indices, i.e., the Higuchi index, residuals, and tortuosity. Moreover, we demonstrated that the EEG complexity indices computed in parallel in more than one channel can be used as the input for a neural network aimed at identifying hypoglycemia and euglycemia. The accuracy was about 90%, suggesting that nonlinear indices applied to EEG signals might be useful in revealing hypoglycemic events from EEG recordings in patients with T1D.

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Normal physical working capacity in prepubertal children with type 1 diabetes compared with healthy controls

Acta Paediatrica ◽

10.1111/j.1651-2227.2005.tb01809.x ◽

2007 ◽

Vol 94 (10) ◽

pp. 1389-1394 ◽

Cited By ~ 1

Author(s):

Elsa Heyman ◽

David Briard ◽

Arlette Gratas-Delamarche ◽

Paul Delamarche ◽

Marc Kerdanet

Keyword(s):

Type 1 Diabetes ◽

Healthy Controls ◽

Physical Working Capacity ◽

Working Capacity ◽

Prepubertal Children

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Altered Cortisol Metabolism Increases Nocturnal Cortisol Bioavailability in Prepubertal Children With Type 1 Diabetes Mellitus

Frontiers in Endocrinology ◽

10.3389/fendo.2021.742669 ◽

2021 ◽

Vol 12 ◽

Author(s):

Julie Brossaud ◽

Jean-Benoît Corcuff ◽

Vanessa Vautier ◽

Aude Bergeron ◽

Aurelie Valade ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Hpa Axis ◽

Trait Anxiety ◽

Hydroxysteroid Dehydrogenase ◽

Prepubertal Children ◽

Cortisol Metabolism ◽

Hypothalamus Pituitary Adrenal Axis ◽

Pituitary Adrenal Axis

ObjectiveDisturbances in the activity of the hypothalamus-pituitary-adrenal axis could lead to functional alterations in the brain of diabetes patients. In a later perspective of investigating the link between the activity of the hypothalamus-pituitary-adrenal axis and the developing brain in children with diabetes, we assessed here nocturnal cortisol metabolism in prepubertal children with type 1 diabetes mellitus (T1DM).MethodsPrepubertal patients (aged 6–12 years) diagnosed with T1DM at least 1 year previously were recruited, along with matched controls. Nocturnal urine samples were collected, with saliva samples taken at awakening and 30 minutes after awakening. All samples were collected at home over 5 consecutive days with no detectable nocturnal hypoglycaemia. The State-Trait Anxiety Inventory (trait scale only) and Child Depression Inventory were also completed. Glucocorticoid metabolites in the urine, salivary cortisol (sF) and cortisone (sE) were measured by liquid chromatography–tandem mass spectrometry. Metabolic data were analysed by logistic regression, adjusting for sex, age, BMI and trait anxiety score.ResultsUrine glucocorticoid metabolites were significantly lower in T1DM patients compared to controls. 11β-hydroxysteroid dehydrogenase type 1 activity was significantly higher, while 11β-hydroxysteroid dehydrogenase type 2, 5(α+β)-reductase and 5α-reductase levels were all lower, in T1DM patients compared to controls. There was a significant group difference in delta sE level but not in delta sF level between the time of awakening and 30 minutes thereafter.ConclusionsOur findings suggest that altered nocturnal cortisol metabolism and morning HPA axis hyperactivity in children with T1DM leads to greater cortisol bioavailability and lower cortisol production as a compensatory effect. This altered nocturnal glucocorticoid metabolism when cortisol production is physiologically reduced and this HPA axis hyperactivity question their impact on brain functioning.

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Evaluation of the effect of glycemic control on the Growth and its relation to Insulin like growth factor binding protein type 3 in a sample of prepubertal Egyptian children with type 1 Diabetes Mellitus

QJM ◽

10.1093/qjmed/hcab100.131 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohamed R Halawa ◽

Aliaa A. Abdo El-Sherbeeny ◽

Salah H Elhalawany ◽

Mohammed D Alesi

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Prepubertal Children ◽

Female Patients ◽

Egyptian Children ◽

Male Patients ◽

Disease Free ◽

Igfbp 3

Abstract Background PrePubertal children with type 1 diabetes mellitus are shorter than their non- diabetic peers. we aimed to evaluate the role of HbA1c and IGFBP-3 in this phenomenon. Aim of the work: The aim of the study was to evaluate the effect of glycemic control on the growth and IGFBP-3, represented by height, weight, height and weight percentiles for age in a sample of prepubertal Egyptian children with T1DM. Patients and Methods This study was a cross sectional study conducted on 80 pre-pubertal Egyptian children, divided into 25 Males and 25 Females with T1DM and 30 age matched controls (15 Males and 15 Females), the participants were recruited from the Outpatient Clinic of the Pediatric Department of Ain Shams University Hospitals and the National Institute of Diabetes and Endocrinology in Cairo, Egypt during the period from July 2018 to August 2019. Anthropometric measures including height and weight were obtained and used to calculate the height and weight percentiles using the CDC calculators. HbA1c as well as IGFBP-3 levels were tested. Results The mean age (years) of the participants was (9.671±2.24) for male patients, (9.22 ± 2.19) for female patients and (8.39 ± 2.034) for controls. The height found to be lower in the children with T1DM when compared to the disease-free controls with median values of (129.287 ± 13.410) in male patients, (127.727 ±10.155) in female patients and (136.760 ± 13.431) in the controls. the height and weight percentiles (%) were found to be lower in the children with T1DM when compared to the disease-free controls, the height percentile with median values of 14.54 (IQR 27.95) in male patients, 17.93 (IQR 29.20) in female patients and 87.07 (IQR 20.48) in the controls. the weight percentile with median values of 40.68 (IQR 40.83) in male patients, 30.64(IQR 35.59) in female patients and 85.18 (IQR 20.17) in the controls. A negative correlation between HbA1c (%) and serum IGFBP-3 (ng/ml), height and height percentile were found with (0.014, 0.049 and 0.012) as well as a positive correlation between serum IGFBP-3 and height, height and weight percentiles (%), were found with (,0.004, 0.009 and 0.005 respectively). Serum IGFBP-3 levels were also found to be significantly lower in patients (P < 0.001) with a mean value of (198.6 ± 45.335) in male patients and (168.4 ± 44.317) in female patients and (285.333 ± 61.936) in the disease-free controls. Conclusion Serum IGFBP-3 levels (ng/ml) as well as growth are negatively affected in prepubertal children with T1DM in relation to the glycemic control.

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Does type 1 diabetes mellitus affect bone quality in prepubertal children?

Journal of Taibah University Medical Sciences ◽

10.1016/j.jtumed.2015.03.004 ◽

2015 ◽

Vol 10 (3) ◽

pp. 300-305 ◽

Cited By ~ 1

Author(s):

Khalid I. Khoshhal ◽

Salah A. Sheweita ◽

Mohammad S. Al-Maghamsi ◽

Abdelhadi M. Habeb

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Bone Quality ◽

Prepubertal Children

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Post-prandial insulin lispro vs. human regular insulin in prepubertal children with Type 1 diabetes mellitus

Diabetic Medicine ◽

10.1046/j.1464-5491.2001.00564.x ◽

2001 ◽

Vol 18 (8) ◽

pp. 654-658 ◽

Cited By ~ 27

Author(s):

S. Tupola ◽

J. Komulainen ◽

J. Jääskeläinen ◽

I. Sipilä

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Insulin Lispro ◽

Regular Insulin ◽

Prepubertal Children ◽

Prandial Insulin

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Insulin glargine is effective in prepubertal children with type 1 diabetes

Nature Clinical Practice Endocrinology &#38 Metabolism ◽

10.1038/ncpendmet0764 ◽

2008 ◽

Vol 4 (4) ◽

pp. 184-185

Keyword(s):

Type 1 Diabetes ◽

Insulin Glargine ◽

Prepubertal Children

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Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus

Diabetes Technology & Therapeutics ◽

10.1089/dia.2016.0331 ◽

2017 ◽

Vol 19 (2) ◽

pp. 85-90 ◽

Cited By ~ 8

Author(s):

Anne-Sophie Sejling ◽

Troels W. Kjaer ◽

Ulrik Pedersen-Bjergaard ◽

Line S. Remvig ◽

Christian S. Frandsen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Eeg Changes

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Residual β-Cell Function and the Insulin-Like Growth Factor System in Danish Children and Adolescents With Type 1 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-3521 ◽

2015 ◽

Vol 100 (3) ◽

pp. 1053-1061 ◽

Cited By ~ 14

Author(s):

Jesper S. Sorensen ◽

Niels H. Birkebaek ◽

Mette Bjerre ◽

Flemming Pociot ◽

Kurt Kristensen ◽

...

Keyword(s):

Type 1 Diabetes ◽

Cell Function ◽

Β Cell ◽

Cross Sectional ◽

Prepubertal Children ◽

C Peptide ◽

Pubertal Status ◽

Igf System ◽

Β Cell Function

Context: C-peptide-positive adults with type 1 diabetes (T1D) have higher circulating total and free IGF-1 and lower IGF binding protein 1 (IGFBP-1) than C-peptide-negative patients. Whether this is also the case in children remains unknown. Objective: The objective of the study was to examine the IGF system in children/adolescents with and without residual β-cell function (RBF). Design and Patients: This was a cross-sectional study containing 136 prepubertal (hereof 15 RBF positive) and 206 pubertal (hereof 42 RBF positive) children/adolescents with T1D for 3–6 years as well as 40 prepubertal and 30 pubertal healthy controls. RBF was evaluated by meal-stimulated C-peptide. Main Outcome Measures: Fasting serum levels of bioactive IGF (ie, the ability of serum to activate the IGF-1 receptor in vitro), total IGF-1, total IGF-2, and IGFBP-1 and -3. Results: Irrespective of pubertal status, patients with T1D showed lower bioactive IGF and total IGF-1, but higher IGFBP-1 as compared with controls (P < .05). When stratified according to RBF status, a positive RBF was associated with normalization of all IGF-related peptides but IGFBP-1 in prepubertal children (P < .05), whereas none of the IGF components were normalized in prepubertal, RBF-negative children. In pubertal children, total IGF-1 and bioactive IGF remained subnormal and IGFBP-1 supranormal, irrespective of RBF status (P < .05). Conclusion: Independent of pubertal status, T1D was associated with an abnormal IGF system. However, a positive RBF status appeared important but only in prepubertal children, in whom all IGF components but IGFBP-1 were normalized. We speculate that the pubertal GH surge induces insulin resistance, which overrides the stimulatory effect that an RBF may exert on the liver-derived IGF system.

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