Liz Davis

Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

The significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers, and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals.

Protein Ingestion in Reducing the Risk of Late-Onset Post-Exercise Hypoglycemia: A Pilot Study in Adolescents and Youth with Type 1 Diabetes

Dietary protein causes dose-dependent hyperglycemia in individuals with type 1 diabetes. This study investigated the effect of consuming 50 g of protein on overnight blood glucose levels following late-afternoon moderate-intensity exercise.

Diabetic Ketoacidosis at Onset of Type 1 Diabetes and Long-term HbA1c in 7,961 Children and Young Adults in the Australasian Diabetes Data Network

The relationship between diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes and long-term glycemic control varies between studies. We aimed, firstly, to characterize the association of DKA and its severity with long-term HbA1c in a large contemporary cohort, and secondly, to identify other independent determinants of long-term HbA1c.

ISPAD Clinical Practice Consensus Guidelines 2022: Exercise in children and adolescents with diabetes

Mapping care provision for type 1 diabetes throughout Australia: a protocol for a mixed-method study

Type 1 diabetes (T1D) is a chronic and incurable autoimmune disease, diagnosed in early childhood and managed initially in paediatric healthcare services. In many countries, including Australia, national audit data suggest that management and care of T1D, and consequently glycaemic control, are consistently poor.

Decreased occurrence of ketoacidosis and preservation of beta cell function in relatives screened and monitored for type 1 diabetes in Australia and New Zealand

Islet autoantibody screening of infants and young children in the Northern Hemisphere, together with semi-annual metabolic monitoring, is associated with a lower risk of ketoacidosis (DKA) and improved glucose control after diagnosis of clinical (stage 3) type 1 diabetes (T1D). We aimed to determine if similar benefits applied to older Australians and New Zealanders monitored less rigorously.

Longitudinal audit of assessment and pharmaceutical intervention for cardiovascular risk in the Australasian Diabetes Data Network

Universal Subsidized Continuous Glucose Monitoring Funding for Young People With Type 1 Diabetes: Uptake and Outcomes Over 2 Years, a Population-Based Study

Continuous glucose monitoring (CGM) is increasingly used in type 1 diabetes management; however, funding models vary. This study determined the uptake rate and glycemic outcomes following a change in national health policy to introduce universal subsidized CGM funding for people with type 1 diabetes aged <21 years.

Moderate and severe diabetic ketoacidosis at type 1 diabetes onset in children over two decades: A population-based study of prevalence and long-term glycemic outcomes

To investigate in a population-based pediatric cohort: prevalence of moderate-severe diabetic ketoacidosis at type 1 diabetes diagnosis over two decades and its association with long-term glycemic control.

Mental Health During Late Pregnancy and Postpartum in Mothers With and Without Type 1 Diabetes: The ENDIA Study

Pregnancy and type 1 diabetes are each associated with increased anxiety and depression, but the combined impact on well-being is unresolved. We compared the mental health of women with and without type 1 diabetes during pregnancy and postpartum and examined the relationship between mental health and glycemic control.

A Long-Term Evaluation of Facebook for Recruitment and Retention in the ENDIA Type 1 Diabetes Pregnancy-Birth Cohort Study

The Environmental Determinants of Islet Autoimmunity (ENDIA) study is an Australia-wide pregnancy-birth cohort study following children who have a first-degree relative with type 1 diabetes (ACTRN1261300794707). A dedicated ENDIA Facebook page was established in 2013 with the aim of enhancing recruitment and supporting participant retention through dissemination of study information.

Effects of Dietary Fat and Protein on Glucoregulatory Hormones in Adolescents and Young Adults With Type 1 Diabetes

Dietary fat and protein impact postprandial hyperglycemia in people with type 1 diabetes, but the underlying mechanisms are poorly understood. Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect.

Youth-onset type 2 diabetes among First Nations young people in northern Australia: a retrospective, cross-sectional study

Women with type 1 diabetes exhibit a progressive increase in gut Saccharomyces cerevisiae in pregnancy associated with evidence of gut inflammation

Studies of the gut microbiome have focused on its bacterial composition. We aimed to characterize the gut fungal microbiome (mycobiome) across pregnancy in women with and without type 1 diabetes.

Nationally Subsidized Continuous Glucose Monitoring: A Cost-effectiveness Analysis

The Continuous Glucose Monitoring (CGM) Initiative recently introduced universal subsidized CGM funding for people with type 1 diabetes under 21 years of age in Australia. We thus aimed to evaluate the cost-effectiveness of this CGM Initiative based on national implementation data and project the economic impact of extending the subsidy to all age-groups.

Reproducibility of plasma glucose responses to moderate-intensity exercise in individuals with type 1 diabetes

To examine the within-person variability in plasma glucose responses to moderate-intensity morning exercise in young individuals with type 1 diabetes after overnight fasting and under basal insulin conditions.

The COVID-19 Pandemic Affects Seasonality, With Increasing Cases of New-Onset Type 1 Diabetes in Children, From the Worldwide SWEET Registry

To analyze whether the coronavirus disease 2019 (COVID-19) pandemic increased the number of cases or impacted seasonality of new-onset type 1 diabetes (T1D) in large pediatric diabetes centers globally.

The Cost of Control: Cost-effectiveness Analysis of Hybrid Closed-Loop Therapy in Youth

Hybrid closed-loop (HCL) therapy is an efficacious management strategy for young people with type 1 diabetes. However, high costs prevent equitable access. We thus sought to evaluate the cost-effectiveness of HCL therapy compared with current care among young people with type 1 diabetes in Australia.

Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry

Competing challenges in adolescence and young adulthood can distract from optimal type 1 diabetes (T1D) self-management, and increase risks of premature morbidity and mortality. There are limited data mapping the glycemic control of people with T1D in this age group, across Australasia.

Hybrid closed-loop therapy with a first-generation system increases confidence and independence in diabetes management in youth with type 1 diabetes

Hybrid closed-loop (HCL) therapy improves glycaemic control in adolescents with type 1 diabetes; however, little is known about their lived experience using these systems. The aim of this study was to explore the lived experiences of youth with type 1 diabetes using HCL therapy, and their parents, to provide insight into their lived experiences.

Urinary albumin/creatinine ratio tertiles predict risk of diabetic retinopathy progression: a natural history study from the Adolescent Cardio-Renal Intervention Trial (AdDIT) observational cohort

We hypothesised that adolescents with type 1 diabetes with a urinary albumin/creatinine ratio (ACR) in the upper tertile of the normal range (high ACR) are at greater risk of three-step diabetic retinopathy progression (3DR) independent of glycaemic control.

International comparison of glycaemic control in people with type 1 diabetes: an update and extension

o update and extend a previous cross-sectional international comparison of glycaemic control in people with type 1 diabetes. Methods: Data were obtained for 520,392 children and adults with type 1 diabetes from 17 population and five clinic-based data sources in countries or regions between 2016 and 2020.

Driving with Type 1 Diabetes: Real-World Evidence to Support Starting Glucose Level and Frequency of Monitoring During Journeys

There is limited evidence supporting the recommendation that drivers with insulin-treated diabetes need to start journeys with glucose >90 mg/dL. Glucose levels of drivers with type 1 diabetes were monitored for 3 weeks using masked continuous glucose monitoring (CGM).

Management of type 2 diabetes in young adults aged 18–30 years: ADS/ADEA/APEG consensus statement

Type 2 diabetes in young adults (nominally, 18–30 years of age) is a more aggressive condition than that seen in older age, with a greater risk of major morbidity and early mortality. This first Australian consensus statement on the management of type 2 diabetes in young adults considers areas where existing type 2 diabetes guidance, directed mainly towards older adults, may not be appropriate or relevant for the young adult population.

Effects of simulated high altitude on blood glucose levels during exercise in individuals with Type 1 Diabetes

Current exercise guidelines for individuals with type 1 diabetes (T1D) do not consider the impact that high altitude may have on blood glucose levels (BGL) during exercise.

Use of linked administrative and laboratory data to confirm that serum 25(OH)D levels in pregnant women can be predicted from satellite estimates of ultraviolet radiation

Serum 25 hydroxyvitamin D [25(OH)D] levels of pregnant women have been linked to various health outcomes in their offspring. Satellite-derived ultraviolet radiation (UVR) data have been used as a proxy for 25(OH)D levels, as individual-level cohort studies are time-consuming, costly and only feasible for common outcomes.

Variation in nutrition education practices in SWEET pediatric diabetes centers-an international comparison

Nutrition education is central to pediatric type 1 diabetes management. Dietary management guidelines for type 1 diabetes are evidence based, but implementation may be challenging and inconsistent.

Two decades of increasing incidence of childhood-onset type 2 diabetes in Western Australia (2000–2019)

This retrospective population‐based study aimed to determine the incidence of type 2 diabetes from 2012 to 2019 in Western Australian youth aged under 16 years, and to examine temporal trends between 2000 and 2019, using data from the Western Australian Children’s Diabetes Database (WACDD). The data extracted for eligible patients diagnosed with type 2 diabetes, according to standard criteria, included diagnosis year, age, sex and self‐reported Aboriginal or Torres Strait Islander status.

Determinants of Cardiovascular Risk in 7000 Youth With Type 1 Diabetes in the Australasian Diabetes Data Network

Cardiovascular disease occurs prematurely in type 1 diabetes. The additional risk of overweight is not well characterized. The primary aim was to measure the impact of body mass index (BMI) in youth with type 1 diabetes on cardiovascular risk factors. The secondary aim was to identify other determinants of cardiovascular risk.

Effect of Exercise Intensity on Exogenous Glucose Requirements to Maintain Stable Glycemia At High Insulin Levels in Type 1 Diabetes

Under basal insulin levels, there is an inverted U relationship between exercise intensity and exogenous glucose requirements to maintain stable blood glucose levels in type 1 diabetes (T1D), with no glucose required for intense exercise (80% V̇O2 peak), implying that high-intensity exercise is not conducive to hypoglycemia.

Substantial intra‐individual variability in post‐prandial time to peak in controlled and free‐living conditions in children with Type 1 diabetes

The optimal time to bolus insulin for meals is challenging for children and adolescents with type 1 diabetes (T1D). Current guidelines to control glucose excursions do not account for individual differences in glycaemic responses to meals.

Evaluation of protocol amendments to the Environmental Determinants of Islet Autoimmunity (ENDIA) study during the COVID-19 pandemic

Effect of a Hybrid Closed-Loop System on Glycemic and Psychosocial Outcomes in Children and Adolescents with Type 1 Diabetes: A Randomized Clinical Trial

Hybrid closed-loop (HCL) therapy has improved glycemic control in children and adolescents with type 1 diabetes; however, the efficacy of HCL on glycemic and psychosocial outcomes has not yet been established in a long-term randomized clinical trial.

A novel mobile health app to educate and empower young people with type 1 diabetes to exercise safely: Prospective single-arm mixed methods pilot study

Empowering young people with type 1 diabetes (T1D) to manage their blood glucose levels during exercise is a complex challenge faced by health care professionals due to the unpredictable nature of exercise and its effect on blood glucose levels. Mobile health (mHealth) apps would be useful as a decision-support aid to effectively contextualize a blood glucose result and take appropriate action to optimize glucose levels during and after exercise.

Evaluation of real-life clinical outcomes in Australian youth with type 1 diabetes on hybrid closed-loop therapy: A retrospective study

To determine the clinical outcomes and evaluate the perspectives of children with Type 1 diabetes (T1D) and their parents managing their child on hybrid closed-loop (HCL) therapy.

Demographic and clinical characteristics of a population-based pediatric cohort of type 1 and type 2 diabetes in Western Australia (1999-2019)

To determine demographic and clinical characteristics of youth diagnosed with Type 1 (T1D) or Type 2 (T2D) diabetes aged </=15 years from 1999 to 2019 in Western Australia, and examine time to first diagnosis of diabetes complications. A retrospective cohort study was conducted of patients identified from the population-based, prospective Western Australian Children's Diabetes Database and longitudinal data extracted for available demographic and clinical variables.

The utility of continuous glucose monitoring systems in the management of children with persistent hypoglycaemia

Glucose monitoring is vital in children with persistent hypoglycaemia to reduce the risk of adverse neuro-behavioural outcomes; especially in children with hyperinsulinism. The role of continuous glucose monitoring (CGM) systems in monitoring glucose levels in this cohort is limited.

Higher ultraviolet radiation during early life is associated with lower risk of childhood type 1 diabetes among boys

Population-level ecological studies show type 1 diabetes incidence is inversely correlated with ambient ultraviolet radiation (UVR) levels. We conducted a nested case–control study using administrative datasets to test this association at the individual level.

Continuous Glucose Monitoring Improves Glycemic Outcomes in Children With Type 1 Diabetes: Real-World Data From a Population-Based Clinic

Although recent clinical trials of continuous glucose monitoring (CGM) use have shown positive glycemic benefit, outcomes outside the research setting may differ and real-world studies over a long time period are limited. In April 2017, CGM was fully subsidized in Australia for people living with type 1 diabetes (T1D) <21 years. Perth Children’s Hospital is the sole pediatric diabetes center in Western Australia and is where almost all patients <18 years of age are seen.

Effects of dietary fat and protein on glucoregulatory hormones in adolescents and young adults with type 1 diabetes

Dietary fat and protein impact postprandial hyperglycaemia in people with type 1 diabetes, but the underlying mechanisms are poorly understood. Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect.

Continuous subcutaneous insulin infusion alters microRNA expression and glycaemic variability in children with type 1 diabetes

To determine whether continuous subcutaneous insulin infusion (CSII) vs. multiple daily injections (MDI) therapy from near-diagnosis of type 1 diabetes is associated with reduced glycaemic variability (GV) and altered microRNA (miRNAs) expression.

The relationship between meal carbohydrate quantity and the insulin to carbohydrate ratio required to maintain glycaemia is non-linear in young people with type 1 diabetes: A randomized crossover trial

To determine if the relationship between meal carbohydrate quantity and the insulin to carbohydrate ratio (ICR) required to maintain glycaemia is linear in people with type 1 diabetes.

Additional Insulin Is Required in Both the Early and Late Postprandial Periods for Meals High in Protein and Fat: A Randomized Trial

The pattern and quantity of insulin required for high-protein high-fat (HPHF) meals is not well understood. This study aimed to determine the amount and delivery pattern of insulin required to maintain euglycemia for 5 hours after consuming a HPHF meal compared with a low-protein low-fat (LPLF) meal.

Type 1 diabetes in pregnancy is associated with distinct changes in the composition and function of the gut microbiome

The gut microbiome changes in response to a range of environmental conditions, life events and disease states. Pregnancy is a natural life event that involves major physiological adaptation yet studies of the microbiome in pregnancy are limited and their findings inconsistent. Pregnancy with type 1 diabetes (T1D) is associated with increased maternal and fetal risks but the gut microbiome in this context has not been characterized. By whole metagenome sequencing, we defined the taxonomic composition and function of the gut bacterial microbiome across 70 pregnancies, 36 in women with T1D.

Selective attention to threat, anxiety and glycaemic management in adolescents with type 1 diabetes

Previous research has established that adolescents with type 1 diabetes (T1D) experience more anxiety symptoms than their healthy peers and are also more likely to develop an anxiety disorder. Research in cognitive psychology has found that selective attention favouring the processing of threatening information causally contributes to elevated levels of anxiety; however, this process has not been investigated in the context of T1D.

Impact of Hybrid Closed Loop Therapy on Hypoglycemia Awareness in Individuals with Type 1 Diabetes and Impaired Hypoglycemia Awareness

This study evaluated the efficacy of using a hybrid closed loop system in restoring hypoglycemia awareness in individuals with impaired awareness of hypoglycemia. Participants with IAH (Gold score ≥4) were recruited into a randomized crossover pilot study.

The Challenges of Being Physically Active: A Qualitative Study of Young People With Type 1 Diabetes and Their Parents

Benefits of physical activity are well recognized for youth with type 1 diabetes mellitus (T1DM), but being active is challenging. In this study, we aimed to investigate the challenges experienced by adolescents, their parents and young adults with T1DM when they are physically active.

Antidiuretic hormone and the activation of glucose production during high intensity aerobic exercise

This study aimed to investigate the role that antidiuretic hormone (ADH) may play in the activation of glucose production during high intensity aerobic exercise.

Advances in Exercise and Nutrition as Therapy in Diabetes

We surveyed 2200 potentially eligible titles on PubMed and other common search engines for manuscripts on “exercise, nutrition, and diabetes” published between July 1, 2019, and June 30, 2020. This year's articles tended to focus on testing new applications for exercise management, including new insulin treatment approaches, wearables, and new smartphone applications.

Less Nocturnal Hypoglycemia but Equivalent Time in Range among Adults with Type 1 Diabetes Using Insulin Pumps Versus Multiple Daily Injections

This prerandomization analysis from the Australian HCL-Adult trial (registration number: ACTRN12617000520336) compared masked continuous glucose monitoring (CGM) metrics among adults using insulin pumps versus multiple daily injections (MDIs), who were all self-monitoring blood glucose (SMBG).

Glycaemic outcomes in Australasian children and adults with Type 1 Diabetes: failure to meet targets across the age spectrum

The goal of therapy in Type 1 diabetes is to achieve optimal glycaemic targets and reduce complications. Robust data representing glycaemic outcomes across the lifespan are lacking in Australasia.

Additional Insulin is Required in Both the Early and Late Postprandial Periods for Meals High in Protein and Fat: A Randomised Trial

The pattern and quantity of insulin required for high protein high fat (HPHF) meals is not well understood. This study aimed to determine the amount and delivery pattern of insulin required to maintain euglycaemia for five hours after consuming a HPHF meal compared to a low protein low fat (LPLF) meal.

Acute hyperglycaemia does not have a consistent adverse effect on exercise performance in recreationally active young people with type 1 diabetes: a randomised crossover in-clinic study

In individuals with type 1 diabetes, chronic hyperglycaemia impairs aerobic fitness. However, the effect of acute marked hyperglycaemia on aerobic fitness is unclear, and the impact of insulin level has not been examined. In this study, we explored if acute hyperglycaemia with higher or low insulin levels affects [Formula: see text] and other exercise performance indicators in individuals with type 1 diabetes.

Lower HbA1c targets are associated with better metabolic control

Previous studies have suggested that clear HbA1c target setting by the diabetes team is associated with HbA1c outcomes in adolescents. The aim of this study was to evaluate whether this finding is consistent in a larger cohort of children from centers participating in the SWEET international diabetes registry. A questionnaire was sent out to 76 SWEET centers, of which responses from 53 pediatric centers were included (70%). Descriptive outcomes were presented as median with lower and upper quartile.

Six Months of Hybrid Closed-Loop Versus Manual Insulin Delivery With Fingerprick Blood Glucose Monitoring in Adults With Type 1 Diabetes: A Randomized, Controlled Trial

To investigate glycemic and psychosocial outcomes with hybrid closed-loop (HCL) versus user-determined insulin dosing with multiple daily injections (MDI) or insulin pump (i.e., standard therapy for most adults with type 1 diabetes). Adults with type 1 diabetes using MDI or insulin pump without continuous glucose monitoring (CGM) were randomized to 26 weeks of HCL (Medtronic 670G) or continuation of current therapy.

Copeptin Kinetics and Its Relationship to Osmolality During Rehydration for Diabetic Ketoacidosis in Children

Copeptin is a surrogate marker for arginine vasopressin (AVP) release in response to hyperosmolal stimuli such as diabetic ketoacidosis (DKA). The objective of this work is to characterize kinetics of copeptin and osmolality, and their dynamic relationship during rehydration and insulin therapy in children with type 1 diabetes (T1D) and DKA.

Variation in nutrition education practices in SWEET pediatric diabetes centers-an international comparison

Nutrition education is central to pediatric type 1 diabetes management. Dietary management guidelines for type 1 diabetes are evidence based, but implementation may be challenging and inconsistent. We describe variation in the practice of nutrition education across pediatric diabetes centers globally and explore associations with A1c and BMI.

Lessons from schools with high levels of support for students with type 1 diabetes: A qualitative study

This project aimed to investigate how schools provide support for the psychosocial wellbeing and disease management of students with type 1 diabetes

Higher frequency of vertebrate-infecting viruses in the gut of infants born to mothers with type 1 diabetes

We demonstrate a distinct gut virome profile in infants of mothers with type 1 diabetes, which may influence health outcomes later in life

The Impact of Externally Worn Diabetes Technology on Sexual Behavior and Activity, Body Image, and Anxiety in Type 1 Diabetes

Wearable technologies impact upon sexual activity and this influences the decision to adopt the technology

Clinical characteristics of Western Australian children diagnosed with type 2 diabetes before 10 years of age

We aimed to describe the characteristics of Western Australian children aged less than 10 years diagnosed with type 2 diabetes between June 2000 and June 2017

Advances in Exercise, Physical Activity, and Diabetes

We screened more than 750 potentially eligible titles on PubMed and other common search engines for manuscripts on “exercise and diabetes”

Effect of frequency of sensor use on glycaemic control in individuals on sensor-augmented pump therapy with and without Predictive Low Glucose Management System

Improved frequency of sensor use improves glycaemic control

Comprehensive genetic screening: The prevalence of maturity-onset diabetes of the young gene variants in a population-based childhood diabetes cohort

This is the first comprehensive study of maturity-onset diabetes of the young variants in an unselected population-based pediatric diabetes cohort

Emerging diabetes and metabolic conditions among Aboriginal and Torres Strait Islander young people

Collaboration between clinicians and researchers is required to establish the prevalence and disease burden of type 2 diabetes among Indigenous young people

Characteristics of Automated Insulin Suspension and Glucose Responses with the Predictive Low-Glucose Management System

Longer suspends and fewer glycemic excursions occur at night compared with day

Use of Continuous Glucose Monitoring Trends to Facilitate Exercise in Children with Type 1 Diabetes

This study investigated the use of a carbohydrate intake algorithm based on continuous glucose monitoring trends during physical activity

Cost-effectiveness analysis of routine screening using massively parallel sequencing for maturity-onset diabetes of the young in a pediatric diabetes cohort

Routine MPS screening for Maturity-onset diabetes of the young in the pediatric population with diabetes could reduce health system costs and improve patient QoL

Distinct gut virome profile of pregnant women with type 1 diabetes in the ENDIA study

These findings provide novel insight into the composition of the gut virome during pregnancy and demonstrate a distinct profile of viruses in women with T1D

Distinct Gut Virome Profile of Pregnant Women With Type 1 Diabetes in the ENDIA Study

Findings provide novel insight into the composition of the gut virome during pregnancy and demonstrate a distinct profile of viruses in women with type 1 diabetes

Improvement in Psychosocial Outcomes in Children with Type 1 Diabetes and Their Parents Following Subsidy for Continuous Glucose Monitoring

Introduction of subsidized CGM showed early improvement in psychosocial and glycemic outcomes in patients and their families in Western Australia

Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus

Our results indicate that pump therapy is associated with a better lipid profile

Decreasing Trends in Mean HbA1c Are Not Associated With Increasing Rates of Severe Hypoglycemia in Children

There have been concurrent improvements in HbA1c and decreasing severe hypoglycemia rates in two pediatric cohorts of type 1 diabetes

Role of HLA-DQ typing and anti-tissue transglutaminase antibody titers in diagnosing celiac disease without duodenal biopsy in type 1 diabetes

HLA-DQ typing is not cost effective as a first-line screening test for CD in T1D patients because of over-representation of CD permissive HLA alleles in this group

Exercise Management for Young People With Type 1 Diabetes: A Structured Approach to the Exercise Consultation

This review provides a structured approach to assist in formulating person-specific exercise management plans for young people with T1D

Effect of combining pre-exercise carbohydrate intake and repeated short sprints on the blood glucose response to exercise in young individuals with Type 1 diabetes

When carbohydrates are ingested prior to moderate-intensity exercise, adding repeated sprints is not significantly detrimental to glycaemic management

Dietary protein affects both the dose and pattern of insulin delivery required to achieve postprandial euglycaemia in Type 1 diabetes: a randomized trial

A high-protein meal requires ~50% more insulin to maintain euglycaemia than a low-protein meal that contains the same quantity of carbohydrate

Real-world outcomes of insulin pump compared to injection therapy in a population-based sample of children with type 1 diabetes

Patients using insulin pump therapy had a better long-term glycemic control relative to the matched injection therapy cohort

The use of continuous glucose monitoring with remote monitoring improves psychosocial measures in parents of children with type 1 diabetes: A randomized crossover trial

CGM with remote monitoring was found to improve multiple measures of quality of life, reduce family stress, and improve parental sleep

The time lag prior to the rise in glucose requirements to maintain stable glycaemia during moderate exercise in a fasted insulinaemic state is of short duration

There is a 20-min low exogenous glucose demand period during which the glucose requirements to maintain stable glycaemia do not increase during moderate exercise

ISPAD Clinical Practice Consensus Guidelines 2018: Exercise in children and adolescents with diabetes

Promotion of regular physical activity is an integral part of diabetes care delivery and health care providers should promote this message at every available opportunity

Performance of medtronic hybrid closed-loop iterations: Results from a randomized trial in adolescents with type 1 diabetes

This study investigates the performance of an iteration of the Medtronic hybrid closed-loop algorithm

A randomized comparison of three prandial insulin dosing algorithms for children and adolescents with Type 1 diabetes

The Pankowska Equation resulted in reduced postprandial hyperglycaemia at the expense of an increase in hypoglycaemia

Insulin Pump Therapy in Adolescents With Very Poor Glycemic Control During a 12-Month Cohort Trial

We conclude that insulin pump therapy can be an effective tool to improve glycemic control in adolescents with long-standing treatment resistance

The school experiences of children and adolescents with type 1 diabetes in Western Australia

Elevated levels of emotional difficulties among school students with T1D and variable levels of support from school staff to assist these students to manage their diabetes at school

Effect of 6 months hybrid closed-loop insulin delivery in young people with type 1 diabetes: a randomised controlled trial protocol

This is a randomised controlled home trial to test the MiniMed Medtronic 670G system in people with type 1 diabetes aged 12-25 years

Arylsulphatase A Pseudodeficiency (ARSA-PD), hypertension and chronic renal disease in Aboriginal Australians

Traits associated with CVD, CRD and T2D in Aboriginal Australians provide novel insight into function of Arylsulphatase A Pseudodeficiency variants

Incidence of childhood onset type 1 diabetes in Western Australia from 1985 to 2016: Evidence for a plateau

This study provides evidence for a possible plateauing in the incidence of childhood T1D in Western Australia, following a peak in 2003

Effect of 6 months of hybrid closed-loop insulin delivery in adults with type 1 diabetes: A randomised controlled trial protocol

Determine the effectiveness of 6 months' closed-loop compared with manually determined insulin dosing on time-in-target glucose range in adults with type 1 diabetes

The glycaemic benefits of a very-low-carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia

This study provides the first evidence that, ketogenic diets in adults with Type 1 diabetes are associated with excellent HbA1c levels and little glycaemic variability

The Importance of the Hawthorne Effect on Psychological Outcomes Unveiled in a Randomized Controlled Trial of Diabetes Technology

The objective of this communication is to highlight the Hawthorne effect on psychobehavioral measures and the importance of a control group in clinical research, particularly for diabetes technologies

Unexpected Management Behaviors in Adolescents With Type 1 Diabetes Using Sensor-Augmented Pump Therapy

Constant exposure to real-time data can lead to unsafe management responses in adolescents with the behavior influenced by trust or mistrust in the system

Comparable glycemic outcomes for pediatric type 1 diabetes patients in metropolitan and non-metropolitan regions of Western Australia: A population-based study

This study reports similar glycemic outcomes for patients attending diabetes clinics in metropolitan and non-metropolitan areas of WA

The Adolescent Cardio-Renal Intervention Trial (AdDIT): retinal vascular geometry and renal function in adolescents with type 1 diabetes

We examined the hypothesis that elevation in urinary (ACR) in adolescents with type 1 diabetes is associated with RVG phenotypes.

Influence of fecal collection conditions and 16S rRNA gene sequencing at two centers on human gut microbiota analysis

To optimise fecal sampling for reproducible analysis of the gut microbiome, we compared different methods of sample collection and sequencing of 165 rRNA genes.

Endocrine and metabolic consequences due to restrictive carbohydrate diets in children with type 1 diabetes: An illustrative case series

The promotion of a low carbohydrate diet in media is in contrast to published pediatric diabetes guidelines that endorse a balanced diet from a variety of foods

Exploration of the Performance of a Hybrid Closed Loop Insulin Delivery Algorithm That Includes Insulin Delivery Limits Designed to Protect Against Hypoglycemia

The algorithm that was tested against moderate exercise and an overreading glucose sensor performed well in terms of hypoglycemia avoidance

Reduced prevalence of impaired awareness of hypoglycemia in a population-based clinic sample of youth with type 1 diabetes

The aim of this study was to determine the change in prevalence of Impaired awareness of hypoglycemia in adolescents with Type 1 diabetes

Qualitative Analysis of Parental Observations on Quality of Life in Australian Children with Down Syndrome

We investigated parental observations to identify QOL domains in children with Down Syndrome and determined whether domains differed between children and teens.

Are low sun exposure and/or Vitamin D risk factors for type 1 diabetes

Evidence supports that higher sun exposure and/or vitamin D sufficiency in pregnancy, or supplementation in early life, decreases type 1 diabetes risk

Endocrine and metabolic consequences due to restrictive carbohydrate diets in children with type 1 diabetes: An illustrative case series

We describe a series of 6 cases where adoption of a low carbohydrate diet in children impacted growth and cardiovascular risk factors with potential long-term sequelae.

Incidence of and risk factors for hospitalisations due to vascular complications: A population-based type 1 diabetes cohort (n=1316) followed into early adulthood

Determining the incidence of hospitalisations and risk factors for vascular complications experienced during early adulthood in patients with childhood T1D

Comparable glycemic outcomes for pediatric type 1 diabetes patients in metropolitan and non-metropolitan regions of Western Australia

This study reports similar glycemic outcomes for patients attending diabetes clinics in metropolitan and non-metropolitan areas of WA, suggesting that a model of care provided as outreach from a specialized diabetes service is effective in achieving equitable glycemic outcomes.

The psychosocial burden of childhood overweight and obesity: evidence for persisting difficulties in boys and girls

Overweight and obese children reported greater psychosocial distress than healthy weight children, and these differences were more pronounced for girls than boys.

Reproducibility of the plasma glucose response to moderate-intensity exercise in adolescents with Type 1 diabetes

The plasma glucose response to moderate-intensity exercise can be reproducible in adolescents with Type 1 diabetes

A 10-second sprint does not blunt hormonal counter-regulation to subsequent hypoglycaemia

A 10-second sprint is unlikely to blunt the subsequent hormonal counter-regulation to hypoglycaemia in individuals with Type 1 diabetes

Home-based vs inpatient education for children newly diagnosed with type 1 diabetes

With adequate support, children newly diagnosed with Type 1 Diabetes can be safely managed at home following practical skills training

Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up

To determine the incidence of and risk factors for psychiatric disorders in early adulthood in patients with childhood onset type 1 diabetes (T1D)

Severe hypoglycemia rates are not associated with HbA1c: A cross-sectional analysis of 3 contemporary pediatric diabetes registry databases

To examine the association between glycated hemoglobin (HbA1c) and severe hypoglycemia rates in patients with type 1 diabetes receiving usual care.

Glycemia, Treatment Satisfaction, Cognition, and Sleep Quality in Adults and Adolescents with Type 1 Diabetes When Using a Closed-Loop System

Android-HCLS in both adults and adolescents reduced nocturnal hypoglycemia and, in adults, improved overnight time in target range and treatment satisfaction

Childhood Overweight and Obesity: Maternal and Family Factors

The need to target prevention and intervention efforts for childhood overweight and obesity towards families with overweight parents

Effectiveness of a Predictive Algorithm in the Prevention of Exercise-Induced Hypoglycemia in Type 1 Diabetes

The aim of this study was to determine the efficacy of this algorithm in the prevention of exercise-induced hypoglycemia under in-clinic conditions

Continuous Glucose Monitoring Adherence: Lessons from a Clinical Trial to Predict Outpatient Behavior

Continuous glucose monitoring adherence and patterns of use are individualized

Increasing incidence of type 2 diabetes in Indigenous and non-Indigenous children in Western Australia, 1990-2012

In this study, we aimed to determine the incidence and incidence rate trends of childhood T2D in Indigenous and non-Indigenous children in WA.

Safety and efficacy of the predictive low glucose management system in the prevention of hypoglycaemia

The predictive low glucose management system was evaluated in in-clinic studies, and has informed a larger home trial to study its efficacy and safety

School performance in children with type 1 diabetes: A contemporary population-based study

Type 1 diabetes is not associated with a significant decrement in school performance, as assessed by NAPLAN

Effect of exercise intensity on glucose requirements to maintain euglycemia during exercise in type 1 diabetes

Inverted-U relationship between exercise intensity and glucose requirement

Exercise training improves vascular function in adolescents with type 2 diabetes

Exercise training can improve both endothelial function and health, independent of changes in insulin sensitivity in adolescents with type 2 diabetes

Prevention of Insulin-Induced Hypoglycemia in Type 1 Diabetes with Predictive Low Glucose Management System

The aim of this study was to determine whether predictive low glucose management (PLGM) system is effective in preventing insulin-induced hypoglycemia

Regular peaks and troughs in the Australian incidence of childhood type 1 diabetes mellitus (2000–2011).

This study aimed to determine the incidence and incidence rate trends of type 1 diabetes mellitus in children aged 0–14 years...

Genome-wide methylation analysis identifies differentially methylated CpG loci associated with severe obesity in childhood.

This study identifies widespread DNA methylation changes in whole blood associated with childhood obesity.

Feasibility of Outpatient 24-Hour Closed-Loop Insulin Delivery

This study used a prototype algorithm to look at the feasibility of home use insulin pump hardware (MiniMed 670G) for improved insulin delivery.

Efficacy and safety of sirolimus in a neonate with persistent hypoglycaemia following near-total pancreatectomy for hyperinsulinaemic hypoglycaemia

This study looks at hyperinsulinaemic hypoglycaemia, as characterised by inappropriate insulin secretion, as it is the most common cause for persistent...

Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: An international comparison

Improving glycaemic control in people with Type 1 diabetes is known to reduce complications.

Assessment of cardiometabolic risk in children in population studies: underpinning developmental origins of health and disease mother–offspring cohort studies

Pregnancy and birth cohorts have been utilised extensively to investigate the developmental origins of health and disease, particularly in relation to...

Cardiac autonomic dysfunction is associated with high-risk albumin-to-creatinine ratio in young adolescents with type 1 diabetes in AdDIT

This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes.

First genome-wide association study in an Australian Aboriginal population provides insights into genetic risk factors for body mass index and type 2 diabetes

A body mass index (BMI) >22kg/m2 is a risk factor for type 2 diabetes (T2D) in Aboriginal Australians.

Acute hyperglycaemia does not alter nitric oxide-mediated microvascular function in the skin of adolescents with type 1 diabetes

Impact of an acute bout of hyperglycaemia on nitric oxide (NO)-mediated microvascular function in the skin of adolescents with type 1 diabetes

School performance in children with type 1 diabetes: a contemporary population-based study

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...

Early atherosclerosis relates to urinary albumin excretion and cardiovascular risk factors in adolescents with type 1 diabetes

Higher urinary albumin excretion, even within the normal range, is associated with early atherosclerosis

Clinical and demographic risk factors associated with mortality during early adulthood in a population-based cohort of childhood-onset Type 1 diabetes

This paper reports calculated standardized mortality ratios in patients with Type 1 diabetes, and assesses the association between poor management of...

Spatial and temporal variation in type 1 diabetes incidence in Western Australia from 1991 to 2010: Increased risk at higher latitudes and over time

This study analysed spatial and historical variation in childhood incidence of type 1 diabetes mellitus (T1DM) among Western Australia's 36 Health Districts...

Maternal and family factors and child eating pathology: Risk and protective relationships

This study aimed to identify maternal and family factors that may predict increases or decreases in child eating disorder symptoms over time, accounting for...

Antecedent hypoglycaemia does not diminish the glycaemia-increasing effect and glucoregulatory responses of a 10 s sprint in people with type 1 diabetes

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...

Maternal smoking during pregnancy and the risk of childhood type 1 diabetes in Western Australia

The aim of this study was to investigate the association between maternal smoking during pregnancy and type 1 diabetes in the offspring, using complete...

Exercise to prevent late-onset hypoglycemia in individuals with type1 diabetes

A 10-s sprint performed after 30 min of moderate-intensity exercise does not affect the amount of carbohydrate required to maintain euglycemia postexercise...

Both Dietary Protein and Fat Increase Postprandial Glucose Excursions in Children With Type 1 Diabetes

Our objective was to determine the separate and combined effects of high-protein (HP) and high-fat (HF) meals, with the same carbohydrate content, on...

Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia

Sensor-augmented insulin pump with automated low-glucose insulin suspension has the potential to reduce the incidence of major hypoglycemic events.

Hypoglycaemia, fear of hypoglycaemia and quality of life in children with Type 1 diabetes and their parents

To evaluate the association between fear of hypoglycaemia, episodes of hypoglycaemia and quality of life in children with Type 1 diabetes and their parents.

Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case-control study

We determined the impact of insulin pump therapy on long-term glycaemic control, BMI, rate of severe hypoglycaemia and diabetic ketoacidosis (DKA) in children.

A population-based study of risk factors for severe hypoglycaemia in a contemporary cohort of childhood-onset type 1 diabetes

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...

The effect of midday moderate-intensity exercise on postexercise hypoglycemia risk in individuals with type 1 diabetes

Recently we reported a biphasic increase in glucose requirements to maintain euglycemia after late-afternoon exercise, suggesting a unique pattern of delayed...

Short report: Care for children and adolescents with diabetes in Australia and New Zealand: Have we achieved the defined goals?

In 2010, the Australasian Paediatric Endocrinology Group formed a national Children's Diabetes Network that represented clinical teams managing over 95% of...

Standardised mortality is increased three-fold in a population-based sample of children and adolescents with type 1 diabetes

Fatalities in children and adolescents (1-17 yr) with T1DM were identified from the Western Australia Children's Diabetes Database between 1987-2011.

How training affects Australian paediatricians' management of obesity

Secondary care could be the optimal sector for managing child and adolescent obesity, given low primary care uptake and limited tertiary services.

Acute hyperglycaemia does not alter nitric oxide-mediated microvascular function in the skin of adolescents with type 1 diabetes

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...

The effect of a short sprint on postexercise whole-body glucose production and utilization rates in individuals with type 1 diabetes mellitus

A sprint as short as 10 sec can increase plasma glucose levels in nondiabetic and T1DM individuals, with this rise resulting from a transient decline in...

Ethnic and gender differences in rates of congenital adrenal hyperplasia in Western Australia over a 21 year period

The aim was to evaluate the incidence, sex distribution, ethnicity, age at diagnosis, clinical presentation and morbidity of all childhood-onset congenital...

The use of an automated, portable glucose control system for overnight glucose control in adolescents and young adults with type 1 diabetes

A key milestone in progress towards providing an efficacious and safe closed-loop artificial pancreas system for outpatient use is the development of fully...

Cyclical variation in the incidence of childhood type 1 diabetes in Western Australia (1985-2010)

The objective was to examine the incidence of childhood type 1 diabetes in Western Australia from 1985-2010.

Early loss of the glucagon response to hypoglycemia in adolescents with type 1 diabetes

The objective was to assess the glucagon response to hypoglycemia and identify influencing factors in patients with type 1 diabetes compared with nondiabetic...

Analysis of glucose responses to automated insulin suspension with sensor-augmented pump therapy

The advent of sensor-augmented pump therapy with a low-glucose suspend (LGS) function.

Hypoglycemia does not change the threshold for arousal from sleep in adolescents with type 1 diabetes

In adolescents with type 1 diabetes, hypoglycemia does not impair arousal from slow-wave sleep induced by an external auditory stimulus.

Reducing Rates of Severe Hypoglycemia in a Population-Based Cohort of Children and Adolescents With Type 1 Diabetes Over the Decade 2000–2009

The objective of this study was to examine rates of severe hypoglycemia (SH) in a large population-based cohort of children with type 1 diabetes and...

Neurocognitive Outcomes in Young Adults With Early-Onset Type 1 Diabetes

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...

Lower cardiorespiratory fitness in children with Type 1 diabetes

The present study aimed to compare cardiorespiratory fitness levels in children with and without Type 1 diabetes.

High incidence of obesity co-morbidities in young children: A cross-sectional study

The prevalence of overweight and obesity in children is a public health problem because of future morbidity.

Improving epinephrine responses in hypoglycemia unawareness with real-time continuous glucose

The objective of this study was to determine whether real-time continuous glucose monitoring (CGM) with preset alarms at specific glucose levels would prove...

Fatness, fitness, and increased cardiovascular risk in young children

To investigate the relationships between cardiorespiratory fitness and adiposity among young children, and their influence on a comprehensive cardiovascular ris

Birthweight and the risk of childhood-onset type 1 diabetes

We investigated whether children who are heavier at birth have an increased risk of type 1 diabetes

Clustering of psychosocial symptoms in overweight children

The aims of the present study were to (i) examine the relationship between children's degree of adiposity and psychosocial functioning; and (ii) compare patterns of clustering of psychosocial measures between healthy weight and overweight/obese children.

Exercise alone reduces insulin resistance in obese children independently of changes in body composition

The number of obese children with insulin resistance and type 2 diabetes is increasing, but the best management strategy is not clear.

The role of family and maternal factors in childhood obesity

The aim of this study was to investigate the relationship between a child's weight and a broad range of family and maternal factors.

Perinatal risk factors for childhood Type 1 diabetes in Western Australia - a population-based study (1980-2002)

To investigate perinatal risk factors for childhood Type 1 diabetes in Western Australia, using a complete population-based cohort.

Independent effects of socioeconomic status and place of residence on the incidence of type 1 diabetes in Western Australia

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.