Diabetes In Young People Research Articles

Frequency and clinical characteristics of children and young people with type 2 diabetes at diagnosis from five world regions between 2012 and 2021: data from the SWEET Registry.

The diagnosis of type 2 diabetes is increasing in young people worldwide. This study evaluated the frequency and clinical characteristics of young people presenting with type 2 diabetes from the multinational SWEET e.V Registry 2012-2021, including the first years of the COVID-19 pandemic. This is a longitudinal observational study based on the SWEET Registry, which collects demographic and clinical data on children and adolescents with diabetes from centres worldwide, with the diagnosis and classification of diabetes provided locally by each centre according to International Society for Paediatric and Adolescent Diabetes definitions. By July 2022, the SWEET Registry included 96,931 individuals from 130 centres with a total of 1,154,555 visits. Data were analysed by region: Europe (EU), Australia and New Zealand (AU/NZ), South America (SA), North America (NA) and Asia/Middle East and Africa (AS/AF). Trends in proportions for the two-year periods, calculated as cases with type 2 diabetes diagnoses over all cases with diabetes diagnoses, were estimated using logistic regression models adjusted for age at onset and sex. Overall, there were 2819 of 58,170 new cases (4.8%) with type 2 diabetes: 614 in EU, 293 in AU/NZ, 79 in SA, 1211 in NA and 622 in AS/AF. The proportion of type 2 diabetes increased from 3.2% to 6.0% from 2012/2013 to 2020/2021, a relative rate of increase of 9% per two-year period (95% CI 5.9, 12.3; p<0.001). In the two-year period of the COVID-19 pandemic, type 2 diabetes continued to follow the observed trend, with a proportion of 6.0% in 2020-2021 compared with 5.4% in 2018-2019. High variability in the proportion of type 2 diabetes was observed across regions, with the lowest values observed in EU and the highest in NA. A significant increase in the proportion of type 2 diabetes was observed in EU, AU/NZ and NA. The median HbA1c was not uniform and was highest in AS/AF (85 mmol/mol [9.9%]; IQR 55-111 [7.2-12.3%]) and lowest in EU (63 mmol/mol [7.9%]; IQR 48-99 [6.5-11.2%]), and the difference between EU and NA (median value 73 mmol/mol [8.8%]; IQR 50-105 [6.7-11.8%]) was statistically significant (p=0.047). There was also a difference in BMI SD score by region: the lowest median BMI SD score was 2.2 (IQR 1.4-2.7) in AS/AF and the highest was 3.1 (IQR 2.5-3.6) in AU/NZ. The multinational SWEET data from the years 2012 to 2021 inclusive support recent findings of a worldwide increase in type 2 diabetes in young people, albeit with regional differences. This increase highlights the need for ongoing preventive measures and available advanced treatment modalities worldwide.

Effectiveness of Mindfulness-Based Interventions with Respect to Psychological and Biomedical Outcomes in Young People with Type 1 Diabetes: A Systematic Review.

Type 1 diabetes is a chronic disease especially affecting young people. Mindfulness-based psychological interventions might reduce emotional symptoms post-diagnosis, but the evidence is limited. This systematic review aimed to evaluate the effectiveness of mindfulness interventions on psychological well-being and biomedical variables in young people with type 1 diabetes. A systematic review of trials was conducted that involved a bibliographic search in electronic databases (Web of Science, MEDLINE, SciELO, Scopus, PsycINFO, and Cochrane Library) considering studies published between 2013 and 2024. A total of 434 records were identified, of which 252 underwent selection according to title and abstract, leaving 32 that were evaluated for eligibility and 7 included in this review. From Google Scholar, six more studies were identified and evaluated, and two were selected. Finally, nine studies were subjected to full reading and a detailed analysis of the inclusion criteria. A total of 66.6% of the studies were evaluated as having a methodological quality of moderate or optimal, but the samples analysed tended to be small, and only two articles carried out short-term follow-up evaluations. Mindfulness-based interventions, upon reviewing the preliminary results, may be posited as a viable strategy to enhance psychological (anxiety, diabetes distress, perceived stress, depression, self-efficacy, psychological well-being, and quality of life) and biomedical outcomes (glycaemic control, blood glucose levels, and diastolic blood pressure) for type 1 diabetes in young people. Although promising, further research is required to improve the quality, methodology, and design of studies.

Analysis of Determinants of NCD Diabetes Mellitus in Tilango Health Centre

The incidence and prevalence of type 2 diabetes in adolescents varies according to ethnicity and other factors. Populations with a high incidence and prevalence of type 2 diabetes in young people also have a higher risk of developing type 2 diabetes in adults. This research aims to analyze the determinants of PTM Diabetes Mellitus at the Tilango Community Health Center. Analytical survey research method with a cross-sectional study design. The population is all Prolanis patients at the Tilango Community Health Center in 2023 totaling 104 people. Sampling used total sampling, so the total sample was 104 people. Analysis was carried out using the chi-square test and multiple logistic regression test. The research results of the multiple logistic regression test obtained the variables diet (0.016) and hypertension (0.003). The largest OR value was obtained for the diet variable (11.075). This research concludes that there is a relationship between diet, obesity, genetic history, hypertension, physical activity, and the incidence of PTM diabetes mellitus at the Tilango Health Center. Diet is the variable most related to the incidence of PTM Diabetes Mellitus at the Tilango Community Health Center, excessive eating patterns have an 11.075 times greater chance of developing diabetes mellitus.

A practical evidence-based approach to management of type 2 diabetes in children and young people (CYP): UK consensus

BackgroundType 2 diabetes in young people is an aggressive disease with a greater risk of complications leading to increased morbidity and mortality during the most productive years of life. Prevalence in the UK and globally is rising yet experience in managing this condition is limited. There are no consensus guidelines in the UK for the assessment and management of paediatric type 2 diabetes.MethodsMultidisciplinary professionals from The Association of Children’s Diabetes Clinicians (ACDC) and the National Type 2 Diabetes Working Group reviewed the evidence base and made recommendations using the Grading Of Recommendations, Assessment, Development and Evaluation (GRADE) methodology.Results and discussionYoung people with type 2 diabetes should be managed within a paediatric diabetes team with close working with adult diabetes specialists, primary care and other paediatric specialties. Diagnosis of diabetes type can be challenging with many overlapping features. Diabetes antibodies may be needed to aid diagnosis. Co-morbidities and complications are frequently present at diagnosis and should be managed holistically. Lifestyle change and metformin are the mainstay of early treatment, with some needing additional basal insulin. GLP1 agonists should be used as second-line agents once early ketosis and symptoms are controlled. Glycaemic control improves microvascular but not cardiovascular risk. Reduction in excess adiposity, smoking prevention, increased physical activity and reduction of hypertension and dyslipidaemia are essential to reduce major adverse cardiovascular events.ConclusionsThis evidence-based guideline aims to provide a practical approach in managing this condition in the UK.

Psycho-emotional components of young diabetes and the importance of psychological support

In this paper, we proposed to analyze the psychological symptoms present in young adults with diabetes, addressing the comorbidity of diabetes - anxiety - depression, to study how depression and anxiety can affect the quality of life of these groups of people. Thus, the information about the psycho-emotional components of diabetes in young people, considered as probably relevant to the theme of this review, was synthesized. The data obtained were systematized, analyzed and presented in the form of a narrative synthesis.

Multifaceted nature of young-onset diabetes - can genomic medicine improve the precision of diagnosis and management?

Young-onset type 2 diabetes (YOD), defined as diabetes diagnosis before age 40, has an aggressive clinical course with premature mortality, in part due to long disease duration and lack of evidence to guide diagnosis and management. Autoimmune type 1 diabetes, maturity-onset diabetes of the young (MODY), and latent autoimmune diabetes in adults (LADA) are subtypes of diabetes in young people, which, however, cannot fully explain their complex clinical course. Similarly, family members carrying the same rare genetic variant of monogenic diabetes can have different presentations and outcomes. Ancestral heterogeneity, ecological transition, inter-ethnic differences in genomic architecture, and variations in living environment, lifestyles, access to care, and timeliness of diagnosis and treatment can influence the age of diagnosis and exposure to these cardiometabolic-renal risk factors. Despite the wealth of literature on genetic associations with diabetes, the familial cosegregation of rare variants and their relevance to YOD remains uncertain. This perspective was motivated by decades of clinical observations and learnings from an ongoing randomized controlled trial that uses biogenetic markers to classify patients with YOD for improving outcomes. Apart from highlighting the need to use family-based studies to improve the precision of diagnosis, we discussed atypical causes for diabetic ketoacidosis and the importance of lifecourse and psychosocial-behavioral factors in patients with YOD. Apart from detailed clinical evaluation, we propose using plasma C peptide, homeostasis model of assessment (HOMA) indexes, autoantibodies, and polygenic risk scores to stratify risk, classify diabetes subtypes, and personalize treatment in YOD. To achieve these goals, we advocate changing the practice environment and team structure to enable physicians to use the insights they learn from patients and their family members to implement precision medicine and improve the outlook of these high-risk individuals.

Parental Income Level and Risk of Developing Type 2 Diabetes in Youth

In recent years, the global incidence of type 2 diabetes in young people has increased, especially among minoritized, Indigenous, or financially disadvantaged populations. However, few studies have examined whether poverty is associated with increased risk of youth-onset type 2 diabetes. To examine the association of family income level with the risk of youth-onset type 2 diabetes. This nationwide, population-based retrospective cohort study used data from the 2008 National Health Insurance Research Database of Taiwan, with follow-up through December 31, 2019. Participants included children and adolescents aged 0 to 19 years. Data analysis was performed from June 9, 2022, to January 16, 2023. Family income, classified as very low, low, middle, and high. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the risks of youth-onset type 2 diabetes and all-cause mortality for all income groups vs the high-income group. The cohort included a total of 5 182 893 children and adolescents (mean [SD] age, 11.2 [5.2] years; 2 477 807 girls [48.3%]). The mean (SD) follow-up duration was 9.0 (0.3) years. The incidence rates of youth-onset type 2 diabetes were 0.52 cases per 1000 person-years for the very-low-income group, 0.40 cases per 1000 person-years for the low-income group, 0.35 cases per 1000 person-years for the middle-income group, and 0.28 cases per 1000 person-years for the high-income group. Children and adolescents from very-low-income (aHR, 1.55; 95% CI, 1.41-1.71), low-income (aHR, 1.34; 95% CI, 1.27-1.41), and middle-income (aHR, 1.27; 95% CI, 1.20-1.34) families had a significantly higher hazard of youth-onset type 2 diabetes than those from high-income families. Children and adolescents from very-low-income (aHR, 2.18; 95% CI, 1.97-2.41), low-income (aHR, 1.51; 95% CI, 1.42-1.60), and middle-income (aHR, 1.22; 95% CI, 1.14-1.31) families also had a significantly higher hazard of all-cause mortality than those from high-income families. Children and adolescents who were older, female, and obese and had dyslipidemia, gout, or psychiatric disorders had a significantly higher risk of youth-onset type 2 diabetes than children without those characteristics. This population-based cohort study showed that children and adolescents from very-low-income to middle-income families had a higher hazard of youth-onset type 2 diabetes and mortality than those from high-income families. Further research to reveal the factors underlying this association may improve the accuracy of identifying individuals at greatest risk for developing type 2 diabetes in youth.

Developing digital mental health tools for youth with diabetes: an agenda for future research.

Youth living with diabetes face a concurrent challenge: managing a chronic health condition and managing the psychosocial and developmental changes that are characteristic of adolescence and young adulthood. Despite these unique challenges, psychological support is often difficult for youth with diabetes to access due to a lack of trained mental health professionals and other resource constraints. Digital wellbeing tools offer the potential to improve access to psychological support for this population. However, very few digital wellbeing tools exist for youth with diabetes. Of those that do exist, very few are evidence-based therapies, undermining their contribution to the field. Given the increasing global prevalence of diabetes in young people, the support necessitated by the challenges experienced by this population is not always accessible in a face-to-face setting and cannot be effectively scaled to meet demand. To support the health and wellbeing of youth with diabetes, there is a clear need to develop digital interventions that are widely accessible to users, but, more saliently, grounded in empirical evidence that supports their efficacy. Thus, the purpose of this paper is to offer an agenda for future research, including insights into which psychological techniques and behavioral change theories may be a good conceptual fit for digital mental health interventions, and how these tools may be best developed and utilized by the individuals that need them. Scalable, evidence-based wellbeing tools for this population are urgently required to improve psychological outcomes, and potentially, improve the equity of service access.

Efficacy and safety of the SGLT2 inhibitor empagliflozin versus placebo and the DPP-4 inhibitor linagliptin versus placebo in young people with type 2 diabetes (DINAMO): a multicentre, randomised, double-blind, parallel group, phase 3 trial

The incidence of type 2 diabetes in young people is increasing, but treatments remain limited. We aimed to assess the efficacy and safety of an empagliflozin dosing regimen versus placebo and linagliptin versus placebo on glycaemic control in young people with type 2 diabetes. In this double-blind, placebo-controlled trial done in 108 centres in 15 countries, participants with type 2 diabetes (aged 10-17 years; HbA1c 6·5-10·5% [48-91 mmol/mol]) who had been previously treated with metformin or insulin were randomly assigned (1:1:1) to oral empagliflozin 10 mg, oral linagliptin 5 mg, or placebo. Participants in the empagliflozin group who did not have HbA1c below 7·0% (<53 mmol/mol) by week 12 underwent a second double-blinded randomisation (1:1) at week 14, either remaining on 10 mg or increasing to 25 mg. Participants in the placebo group were randomly reassigned (1:1:1) in a double-blinded manner at week 26 to linagliptin 5 mg or one of the empagliflozin doses (10 mg or 25 mg). Investigators were masked throughout the trial and received assignments of blinded medication kits through interactive response technology for all participants at the initial randomisation and for the re-randomisations at weeks 14 and 26. The primary outcome was change from baseline in HbA1c at 26 weeks. For empagliflozin, results were based on a pooled analysis for all participants on empagliflozin. Safety was assessed until week 52. This trial is registered with ClinicalTrials.gov, NCT03429543. Between April 26, 2018, and May 26, 2022, of 262 screened participants, 158 (60%) were randomly assigned to treatment (53 [34%] to placebo, 52 [33%] to empagliflozin 10 mg, and 53 [34%] to linagliptin). For the primary outcome, the adjusted mean HbA1c change from baseline at week 26 was -0·84% [-9·2 mmol/mol] in the empagliflozin pooled group versus placebo (95% CI -1·50 to -0·19 [-16·4 to -2·1]; p=0·012); the corresponding change from baseline for linagliptin versus placebo was -0·34% [-3·8 mmol/mol; 95% CI -0·99 to 0·30 [-10·8 to 3·3]; p=0·29). Adverse events occurred in 34 (64%) participants in the placebo group, 40 (77%) in the empagliflozin pooled group, and 37 (71%) in the linagliptin group, up to week 26. Of these, severe adverse events were reported in two (4%) participants in the placebo group, one (2%) in the empagliflozin pooled group, and one (2%) in the linagliptin group. Hypoglycaemia was the most frequently reported adverse event with higher rates for those on active drug treatment compared with placebo. No severe hypoglycaemia cases were reported. Empagliflozin provided clinically relevant placebo-corrected reductions in HbA1c, whereas linagliptin did not, and might offer a new treatment option for young people with type 2 diabetes. The Boehringer Ingelheim and Eli Lilly and Company Alliance.

Single-centre case–control study investigating the association between acanthosis nigricans, insulin resistance and type 2 diabetes in a young, overweight, UK population

ObjectiveTo determine the extent to which the presence of acanthosis nigricans confers additional risk for insulin resistance, in addition to obesity alone (body mass index, BMI) within a young, overweight,...

Sochetanie saharnogo diabeta I tipa i diabeta, svyazannogo s mutaciej gena GCK

While the incidence of type 1 diabetes mellitus (Dm1) and type 2 diabetes mellitus (Dm2) in children increases due to the influence of various environmental factors, the frequency of new cases of monogenic diabetes, namely MODY (adult type diabetes in young people), increases due to the widespread introduction of modern diagnostic capabilities, including genetic research. As of 2021, 50 cases of neonatal diabetes mellitus (1 in 152.280) have been registered in Russia, for which a molecular genetic study has been conducted, however, the prevalence of GCK in Russia remains largely uncertain due to the lack of nationwide screening for diabetes-associated autoantibodies and limited access to molecular genetic testing.

Children's and young People's diabetes services: What works well and what doesn't?

ObjectivesThe first year of care, post diagnosis, is pivotal for children and young people diagnosed with type 1 diabetes. This study evaluated a paediatric type 1 diabetes intervention, the ‘First Year of Care’, designed to maximise the care that newly diagnosed children and young people received. Study designAn observational mixed methods approach, underpinned by the Influencer Framework. MethodsA purposeful, non-probability sample of children and young people with type 1 diabetes and their families, and healthcare professionals were invited to take part. Data were collected through medical records of thirty-two newly diagnosed children and young people, plus thirty seven semi-structured interviews and exposure to six concurrent sources of influence through a questionnaire. ResultsFor many participants, HbA1c levels were within the optimal range by the time of their first clinic visit post-diagnosis and continued to stay within this range throughout the first year of care. Healthcare professionals prioritised the ‘First Year of Care’ intervention. Positive practices included: a cohesive and collaborative approach; patient-centred care; latest health technology and embedded structured education. Unusually, different multidisciplinary team members were located in one place.Data indicated statistically significant differences in total sources of influence score (t [35] = 2.331, p = 0.026); healthcare professionals’ scores were higher compared to children. This suggests that children and young people have less social capital to self-manage their diabetes effectively. Greater encouragement and assistance from healthcare professionals and social networks may be needed. ConclusionsThis paper identifies contemporary issues in practice and highlights the strengths and challenges for a paediatric diabetes intervention. The findings confirm the potential of layered approaches to behaviour change in managing type 1 diabetes across multiple domains of influence. Our study strongly suggests enhancing social motivation among children, young people and families to support successful long-term engagement in a paediatric diabetes intervention. Findings demonstrate healthcare professionals are key in delivering the intervention, along with opportunities to improve patient care, experience and outcomes.

Dapagliflozin in young people with type 2 diabetes

The trial data presented by William V Tamborlane and colleagues, evaluating the effects of a novel adjunctive type 2 diabetes medication in young people (aged 18–24), provide an important therapeutic insight into this burgeoning, high-risk, and understudied population.1 Nearly 14 million people younger than 19 years in the USA have obesity and are at increased risk of type 2 diabetes.2 Rising rates of obesity and other metabolic conditions are projected to increase the incidence of type 2 diabetes in young people by 600% between 2017 and 2060.

Type 2 diabetes in young people About 30 cases preliminary results

Type 2 diabetes in young people About 30 cases preliminary results

Сахарный диабет 2-го типа в молодом возрасте. Клинический случай из практики эндокринолога

In recent decades, type 2 diabetes is increasingly recorded in young people, adolescents and children. The most significant risk factors for type 2 diabetes in young patients are family history of the disease, overweight and obesity, and the presence of insulin resistance. The main diagnostic criteria for type 2 diabetes mellitus in young patients, in addition to the traditional ones (hyperglycemia and glycosylated hemoglobin), are a high level of C-peptide and insulin resistance in the absence of antibodies to ICA, insulin, GAD. In connection with the projected increase in the incidence of type 2 diabetes at a young age, it is necessary to pay attention to the implementation of preventive measures and timely clinical examination among groups of children and adolescents with the presence of abdominal obesity, burdened with a family history of obesity and type 2 diabetes, in order to prevent or delay the early development of disorders carbohydrate metabolism among this group at an earlier age. Given the predominance of insulin resistance in the pathogenesis of type 2 diabetes in young people, it is necessary to give priority to drugs from the metformin group when prescribing treatment. Thus, the global growth of type 2 diabetes, the tendency to "rejuvenate" diabetes, insufficient information on the prevalence, risk factors and clinical manifestations of the disease at a young age emphasize the urgency of studying this problem.

Comparison of clinical features, complication profile, and achievement of guideline targets in early- and late-onset type 2 diabetes patients from North India

The prevalence of diabetes in young people is rising in India. The risk factors are high body mass index, lack of physical activity, and a positive family history. Young patients with type 2 diabetes mellitus are at a higher risk of longer disease duration and enhanced risk for chronic complications. We have studied the difference between early- and late-onset type 2 diabetes mellitus with respect to various glycemic and non-glycemic parameters. This is an observational cross-sectional study conducted from November 2018 to October 2019. A total of 5142 patients were included in the study. The demographic, anthropometric, clinical, and biochemical information was obtained from the record of the patients. The number of patients diagnosed before 40 years of age was 1574 and 3568 patients after 40 years of age. There was female preponderance, 75.7% of the study subjects were from the urban area, and 60% had an income of < 2 lakh rupees per annum. Two-third (77%) of the patients were either overweight or obese. Significantly higher proportion of patients achieved glycemic and blood pressure targets in the early-onset type 2 diabetes mellitus group. The younger group had higher weight and body mass index, strong family history of diabetes, and more severe dyslipidemia. The comorbid conditions were significantly higher in the older age group. Our study has revealed that about one-third of type 2 diabetes mellitus patients are diagnosed before 40 years of age. The younger patients are more obese. Two-third (73%) of these patients have uncontrolled diabetes.

High prevalence of diabetes in young people in Bangalore, India

Background and aims: The burden of diabetes in India is increasing, especially in cities. We conducted a cross- sectional survey of the prevalence of diabetes and a measure of prediabetes in an urban population in Bangalore, India.Methods: Screening was conducted free of charge and without need for a prior appointment in 32 screening sites throughout Bangalore. Diabetes was defined either on the basis of a self-reported prior diagnosis or as undiagnosed diabetes on the basis of a random blood glucose measurement of &gt;11.1 mmol/L (200 mg/dL). A second index of dysglycaemia, termed prediabetes, was defined as a random blood glucose measurement of &gt;7.8 mmol/L (140 mg/dL) but less than 11.1 mmol/L.Results: The study population comprised 3,691 subjects, screened over a period of 15 months. Previously diagnosed diabetes was present in 818 patients (22.2%), previously undiagnosed diabetes in 67 patients (1.8%) and the additional measure of prediabetes in 221 patients (6%). Accordingly, almost one-third of subjects (30%) had diabetes or prediabetes by our criteria. Diabetes (diagnosed or undiagnosed) and prediabetes were more common in older subjects than younger subjects, as would be expected.Conclusions: We observed high rates of dysglycaemia in a large urban population in Bangalore. Our data add to previous reports of a substantial burden of abnormal glucose regulation in this setting. Additional public health initiatives are required to protect the citizens of Bangalore from diabetes and its future complications.

Possibilities of using continuous glycemic monitoring to assess the effectiveness of therapy in patients with MODY-diabetes

Verification of the type of diabetes mellitus in young people is of high clinical significance in the clinical practice since the purpose of treatment depends on this: from the correction of carbohydrate metabolism by a rational diet to the administration of oral hypoglycemic drugs and insulin therapy. The chosen therapy has a significant impact on the quality of life of the patient. With the most common types of diabetes in young people the appointment of therapy is not in doubt, since with type 1 diabetes mellitus there is an absolute need for the maintenance of exogenous insulin, and with type 2 the administration of metformin is pathogenetically substantiated. In more rare forms of diabetes which MODY belongs to sulfonylurea preparations are recommended in most cases and there are few conflicting data on the effects of newer classes (DPP4, SGLT2 inhibitors, GLP1 agonists) with monogenic forms. Using the method of continuous monitoring of glucose (CGMS) and glycemic variability indicators it is possible to determine the effectiveness of various classes of sugar-lowering drugs for rare types of diabetes mellitus which will help practitioners in choosing therapy. In the literature single studies using CGMS have been described in this group of patients. In Turkey CGMS was performed for 8 patients with GCK-MODY; it was shown that in 50% of patients the glucose values during the day exceeded the normal ranges. Italian scientists conducted a study in which they diagnosed glycemic variability, in particular episodes of hypoglycemia, in patients with HNF4AMODY diabetes (MODY1) using CGMS. The clinical consequence of episodes of asymptomatic hypoglycemia in the MODY cohort remains unknown. Diagnosing the predominance of fasting or postprandial hyperglycemia, the determination of hypoglycemia can help in the appointment of pathogenetic therapy and improve the quality of life of people diagnosed with MODY-diabetes.

HEALTH CARE PROVISION FOR CHILDREN WITH DIABETES IN UKRAINE

Diabetes mellitus is one of the most common human diseases that lead to disability and death. According to the reports of Ministry of Health, in Ukraine at the end of 2018 there were about 1,300,000 diabetic patients and 9,000 of them were children under 18 years of age. The sooner a child is diagnosed with diabetes, the more likely he/she is to save from the complications that cause disability and premature death. Solving issues on diabetes is one of the top priorities of national health systems. Purpose. The paper is aimed at the study of current health care provision for children with diabetes. Methods and Material. The steps in organization of health care provision for children with diabetes in Ukraine have been studied. The following methods have been used: bibliosemantic: for the analysis of scientific literature; content-analysis: to study the regulatory framework; system analysis: to analyze the organizational provision of health care for children with diabetes. Results. Type 1 diabetes is characterized by the destruction of beta cells, which leads to absolute insulin deficiency. About 75% of all type 1 diabetes cases are diagnosed in people under 18 years of age. Children and adolescents are assigned to a special category of patients who need more attention from physicians. Children find it difficult to understand what negative manifestations and the development of specific complications, leading to early disability, can be caused by a persistent and long-term decompensation of the disease. Based on the Adapted Clinical Guidelines for Type 1 Diabetes, the Working Group has developed Unified Clinical Protocols for Type 1 Diabetes in Young People and Adults and Type 1 Diabetes in Children, using evidence-based provisions for the effectiveness of medical interventions, which also served as the basis for identifying quality indicators for the health care provision for patients with type 1 diabetes. The main directions of the developed therapeutic and rehabilitation approach to medical assistance for patients with type 1 diabetes are the provision of medical, psychological and social assistance by multidisciplinary teams, involving an endocrinologist, specialists (therapist, neurologist, ophthalmologist, nephrologist, pediatrician), a social worker, a guidance counselor at the Diabetes School, a nurse. First of all, it is necessary to raise the awareness of physicians, especially at the primary level. The improvement of outpatient and in-patient care for children with diabetes, involving children themselves and their parents is also relevant. It is important to organize and provide an effective school for diabetes awareness and self-control. It is indisputably necessary to constantly and continuously monitor the state of clinical and metabolic compensation of diabetes. Attention should be paid to the need for more active use of the advanced technologies, such as pump insulin therapy. The main components of treatment are diet and insulin therapy, which the child must keep to throughout the whole life to compensate his/her health state. The role of the international diabetes movement in overcoming the diabetes epidemic in Ukraine and worldwide is noteworthy, since it called on all nations to adopt National Diabetes Prevention and Treatment Programs. Consequently, the Ministry of Health of Ukraine, together with international and national experts, has developed a number of fundamental legal acts that initiate structural changes in the health care system. Conclusion. Ukraine is one of the countries with the highest incidence of diabetes. Currently, there is a very significant increase in the incidence of diabetes among children of preschool and school age. Therefore, solving issues on diabetes is one of the top priorities of national health systems. Consequently, the life of a sick child depends on the level of organization of medical and social assistance. It is crucial that awareness and support for diabetes self-management, drug therapy and psychosocial assistance be provided from the time of diagnosis and regularly thereafter. Living a long life with diabetes is possible in proper disease control and prevention. In recent years, diabetes treatment has improved, though it has not solved all the problems. The novel modes of treatment are being actively implemented, namely, insulin analogues and insulin pumps.

Improving the patient journey in the children and young people diabetes clinics of the Cardiff and Vale Health Board

Improving the patient journey in the children and young people diabetes clinics of the Cardiff and Vale Health Board