Tim Jones

An Assessment of Clinical Continuous Glucose Monitoring Targets for Older and High-Risk People Living with Type 1 Diabetes

To assess relationships between continuous glucose monitoring (CGM) time in range (TIR), 70-180 mg/dL, time below range (TBR), <70 mg/dL, time above range (TAR), >180 mg/dL, and glucose coefficient of variation (CV) in relation to currently recommended clinical CGM targets for older people, which recommend reduced TIR and TBR targets relative to the general type 1 diabetes population. 

Coexisiting type 1 diabetes and celiac disease is associated with lower Hba1c when compared to type 1 diabetes alone: data from the Australasian Diabetes Data Network (ADDN) registry

To compare HbA1c and clinical outcomes in adolescents and young adults with type 1 diabetes, with or without celiac disease. 

Blood pressure in adolescents and young adults with type 1 diabetes: data from the Australasian Diabetes Data Network registry

Hypertension increases complication risk in type 1 diabetes (T1D). We examined blood pressure (BP) in adolescents and young adults with T1D from the Australasian Diabetes Data Network, a prospective clinical diabetes registry in Australia and New Zealand. 

Improved Glycemic Outcomes With Diabetes Technology Use Independent of Socioeconomic Status in Youth With Type 1 Diabetes

Technology use in type 1 diabetes (T1D) is impacted by socioeconomic status (SES). This analysis explored relationships between SES, glycemic outcomes, and technology use.

Clinical Outcomes with MiniMedTM 780G Advanced Hybrid Closed-Loop Therapy in 2- to 6-Year-Old Children with Type 1 Diabetes

Advanced hybrid closed-loop (AHCL) therapy with the Medtronic MiniMed™ 780G system improves glycemia; however, the clinical outcomes in younger children remain less established. This pilot study aimed to explore the continuous glucose monitoring (CGM) metrics in very young children on AHCL. Children between 2 and 7 years of age and on insulin pump therapy were recruited.

Advances in Automated Insulin Delivery with the Medtronic 780G: The Australian Experience

To assess the real-world performance of MiniMed™ 780G for Australians with type 1 diabetes (T1D) following advanced hybrid closed loop (AHCL) activation and to evaluate the effect of changing from MiniMed 670/770G to 780G.

Hybrid Closed-Loop Versus Manual Insulin Delivery in Adults With Type 1 Diabetes: A Post Hoc Analysis Using the Glycemia Risk Index

Glycemia risk index (GRI) is a novel composite metric assessing overall glycemic risk, accounting for both hypoglycemia and hyperglycemia and weighted toward extremes. Data assessing GRI as an outcome measure in closed-loop studies and its relation with conventional key continuous glucose monitoring (CGM) metrics are limited.

Socioeconomic representativeness of Australian, Canadian and British cohorts from the paediatric diabetes AdDIT study: comparisons to regional and national data

Given limited data regarding the involvement of disadvantaged groups in paediatric diabetes clinical trials, this study aimed to evaluate the socioeconomic representativeness of participants recruited into a multinational clinical trial in relation to regional and national type 1 diabetes reference populations. 

Effect of Neck-Deep Immersion in Cool or Thermoneutral Water on Blood Glucose Levels in Individuals With Type 1 Diabetes

It is unclear whether immersion in cool water, typical of many beaches, increases the concentration of blood glucose in individuals with type 1 diabetes mellitus (T1DM).

Socioeconomic status and diabetes technology use in youth with type 1 diabetes: a comparison of two funding models

Technology use, including continuous glucose monitoring (CGM) and insulin pump therapy, is associated with improved outcomes in youth with type 1 diabetes (T1D). In 2017 CGM was universally funded for youth with T1D in Australia. In contrast, pump access is primarily accessed through private health insurance, self-funding or philanthropy.

The diabetes management experiences questionnaire: Psychometric validation among adults with type 1 diabetes

To examine the psychometric properties of the Diabetes Management Experiences Questionnaire (DME-Q). Adapted from the validated Glucose Monitoring Experiences Questionnaire, the DME-Q captures satisfaction with diabetes management irrespective of treatment modalities.

Impact of Body Composition on the Accuracy of a Medtronic Guardian Continuous Glucose Monitoring System

Continuous glucose monitoring systems are used in therapeutic decisions for diabetes management, however, the impact of body composition on CGM accuracy is not known. Body composition variables were collected in an observational study designed to determine the accuracy of an investigational Medtronic Guardian™ sensor 3.

Transition models of care for type 1 diabetes: a systematic review

Managing the care regimen for Type 1 Diabetes is challenging for emerging adults, as they take on greater responsibility for self-management. A diverse range of models of care have been implemented to improve safety and quality of care during transition between paediatric and adult services. However, evidence about acceptability and effectiveness of these is limited.

Digenic Congenital Hypogonadotropic Hypogonadism Due to Heterozygous GNRH1 p.R31C and AMHR2 p.G445_L453del Variants

A 28-year-old man with congenital hypogonadotropic hypogonadism (CHH) was found to be heterozygous for the GNRH1 p.R31C mutation, reported in the literature as pathogenic and dominant. The same mutation was found in his son at birth, but the testing of the infant at 64 days confirmed the hormonal changes associated with minipuberty.

Outcomes and experiences of families with children with type 1 diabetes on insulin pumps through subsidised pump access programs in Western Australia

In Australia, access to insulin pump therapy for children with type 1 diabetes is predominantly restricted to families with private health insurance. In an attempt to improve equity, additional subsidised pathways exist which provide pumps to families with reduced financial resources. We aimed to describe the outcomes and experiences of families with children commenced on pumps through these subsidised pathways in Western Australia.

Impact of Missing Data on the Accuracy of Glucose Metrics from Continuous Glucose Monitoring Assessed Over a 2-Week Period

To explore the impact of missing data on the accuracy of continuous glucose monitoring (CGM) metrics collected for a 2-week period in a clinical trial.

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.

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.

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.

ISPAD Clinical Practice Consensus Guidelines 2022: Assessment and management of hypoglycemia 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.

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.

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.

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.

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).

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.

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.

Long-term cost-effectiveness of Dexcom G6 real-time continuous glucose monitoring system in people with type 1 diabetes in Australia

Real-time continuous glucose monitoring allows patients with diabetes to adjust insulin dosing, potentially improving glucose control. This study aimed to compare the long-term cost-effectiveness of the Dexcom G6 rt-CGM device versus self-monitoring of blood glucose and flash glucose monitoring in Australia in people with type 1 diabetes.

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.

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.

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.

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.

The Effect of Hypoglycemia on Spectral Moments in EEG Epochs of Different Durations in Type 1 Diabetes Patients

The potential of using an electroencephalogram (EEG) to detect hypoglycemia in patients with type 1 diabetes has been investigated in both time and frequency domains. Under hyperinsulinemic hypoglycemic clamp conditions, we have shown that the brain's response to hypoglycemic episodes could be described by the centroid frequency and spectral gyration radius evaluated from spectral moments of EEG signals.

Type 2 diabetes in children and adolescents across Australia and New Zealand: A 6‐year audit from The Australasian Diabetes Data Network (ADDN)

To assess the clinical and demographic characteristics of children and adolescents across Australia and New Zealand (NZ) with type 2 diabetes.

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.

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.

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.

Advanced glycation end products as predictors of renal function in youth with type 1 diabetes

To examine if skin autofluorescence differed in early adulthood between individuals with type 1 diabetes and age-matched controls and to ascertain if sAF aligned with risk for kidney disease.

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.

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.

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.

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

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.

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.

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.

T-Cell Expression and Release of Kidney Injury Molecule-1 in Response to Glucose Variations Initiates Kidney Injury in Early Diabetes

Half of the mortality in diabetes is seen in individuals <50 years of age and commonly predicted by the early onset of diabetic kidney disease (DKD). In type 1 diabetes, increased urinary albumin-to-creatinine ratio (uACR) during adolescence defines this risk, but the pathological factors responsible remain unknown.

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.

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.

Meal-time glycaemia in adults with type 1 diabetes using multiple daily injections vs insulin pump therapy following carbohydrate-counting education and bolus calculator provision

To compare meal-time glycaemia in adults with type 1 diabetes mellitus managed with multiple daily injections vs. insulin pump therapy, using self-monitoring blood glucose, following diabetes education.

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.

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.

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).

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.

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.

Vascular Effects of ACE (Angiotensin-Converting Enzyme) Inhibitors and Statins in Adolescents With Type 1 Diabetes

An increased albumin-creatinine ratio within the normal range can identify adolescents at higher risk of developing adverse cardio-renal outcomes as they progress into adulthood. Utilizing a parallel randomized controlled trial and observational cohort study, we characterized the progression of vascular phenotypes throughout this important period and investigated the effect of ACE (angiotensin-converting enzyme) inhibitors and statins in high-risk adolescents.

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.

Medication adherence during adjunct therapy with statins and ACE inhibitors in adolescents with type 1 diabetes

We report an overall good adherence to ACE inhibitors and statins during a clinical trial, although there was a clear decline in adherence over time

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

Longitudinal trajectories of BMI z-score: an international comparison of 11,513 Australian, American and German/Austrian/Luxembourgian youth with type 1 diabetes

This multinational study presents unique body mass index z score trajectories in youth with type 1 diabetes across three continents

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

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

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

A new strategy for vascular complications in young people with type 1 diabetes mellitus

These findings present an opportunity to move towards the personalized care of adolescents with type 1 diabetes mellitus

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

Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management

Study findings have suggested that hypoglycaemia is associated with an increased risk of cardiovascular events and mortality

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

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

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

Children and adolescents with type 1 diabetes in Australasia: An online survey of model of care, workforce and outcomes

Survey of the model of care and workforce that manages children and adolescents with type 1 diabetes in Australasia along with glycaemic outcomes

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: Assessment and management of hypoglycemia in children and adolescents with diabetes

Hypoglycemia is the commonest acute complication of type 1 diabetes

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

Renal and Cardiovascular Risk According to Tertiles of Urinary Albumin-to-Creatinine Ratio: The Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT)

Urinary albumin-to-creatinine ratios at the higher end of the normal range at the age of 10-16 years is associated with an increased risk of progression to microalbuminuria

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

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 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

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

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

Defining relevant hypoglycemia measures in children and adolescents with type 1 diabetes

As the choices of therapies in diabetes care multiply, it is essential to standardize the approach to measuring and recording hypoglycemia risk

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

Reduction in hypoglycemia with the predictive low-Glucose management system: A long-term randomized controlled trial in adolescents with type 1 diabetes

Short-term studies with automated systems that suspend insulin when hypoglycemia is predicted have shown a reduction, but safety and efficacy aren't established

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

International consensus on use of continuous glucose monitoring

This article summarizes the ATTD consensus recommendations and represents the current understanding of how CGM results can affect outcomes.

Prevalence of celiac disease in 52,721 youth with type 1diabetes: International comparison across three continents

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.

ACE inhibitors and statins in adolescents with type 1 diabetes

We hypothesized that adolescents with high levels of albumin excretion might benefit from ACE inhibitors and statins, drugs that have not been fully evaluated

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

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

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

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.

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

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.

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

Exercise management in type 1 diabetes: A consensus statement

This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly.

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

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

Australasian Diabetes Data Network: Building a Collaborative Resource

A national collaboration was formed to provide longitudinal collection of T1D patient characteristics and outcomes, the Australasian Diabetes Data Network

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

Continuous glucose monitoring adherence and patterns of use are individualized

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

Outcome measures for artificial pancreas clinical trials: A consensus report

Research on and commercial development of the artificial pancreas (AP) continue to progress rapidly, and the AP promises to become a part of clinical care.

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...

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.

Minimizing Hypoglycemia in Diabetes

Hypoglycemia caused by treatment with a sulfonylurea, a glinide, or insulin coupled with compromised defenses against the resulting falling plasma glucose...

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...

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.

Effect of antecedent moderate-intensity exercise on the glycemia-increasing effect of a 30-sec maximal sprint: a sex comparison

This study investigated whether a prior bout of moderate-intensity exercise attenuates the glycemia-increasing effect of a maximal 30-sec sprint.

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.

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

Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): Urinary screening and baseline biochemical and cardiovascular assessments

In adolescents with type 1 diabetes, the group with the highest tertile of albumin excretion showed more evidence of early renal and CV disease

A Cost-Effectiveness Analysis of Sensor-Augmented Insulin Pump Therapy and Automated Insulin Suspension versus Standard Pump Therapy

A clinical trial-based economic evaluation was performed in which the net costs and effectiveness of the two treatment modalities were calculated and...

Assessment and management of hypoglycemia in children and adolescents with diabetes

This paper provides clinical practice guidelines for treating low blood sugar in children and adolescents with Type 1 diabetes.

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...

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...

Multinodular goiter in children: An important pointer to a germline DICER1 mutation

This paper is a clinical report of a boy presenting with a kidney cyst. Family history and genetic analysis revealed the family had a mutation in the DICER1...

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...

Prepubertal Gynecomastia in Boys with Peutz-Jeghers Syndrome

Peutz-Jeghers syndrome (PJS) is an autosomal-dominant disorder that arises as a consequence of mutations in the STK11 gene that encodes LKB1.

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.

Environmental determinants of islet autoimmunity (ENDIA): a pregnancy to early life cohort study in children at-risk of type 1 diabetes

These observations suggest factors in the modern environment promote pancreatic islet autoimmunity and destruction of insulin-producing beta cells.

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.

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.

The effect of short-term use of the Guardian RT continuous glucose monitoring system on fear of hypoglycaemia in patients with type 1 diabetes mellitus

This study examines whether the short-term use of a continuous glucose monitor can reduce the fear of hypoglycaemia in individuals with type 1 diabetes...

Anaphylaxis triggered by benzyl benzoate in a preparation of depot testosterone undecanoate

We report the first case of an anaphylactic reaction to Reandron 1000 (depot testosterone undecanoate with a castor oil and benzyl benzoate vehicle).

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...

Contribution of an intrinsic lag of continuous glucose monitoring systems

Current continuous glucose monitoring (CGM) systems measure glucose levels in the interstitial fluid to estimate blood glucose concentration.

Effect of short-term use of a continuous glucose monitoring system with a real-time

The objective of this study was to examine whether setting the low glucose alarm of a Guardian® REAL-Time continuous glucose monitoring system (CGMS) to 80 mg/d

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

Clinical evaluation of a noninvasive alarm system for nocturnal hypoglycemia

The aim of this study was to evaluate the performance of a prototype noninvasive alarm system (HypoMon) for the detection of nocturnal hypoglycemia.

Hypoglycemia alarm enhancement using data fusion

The acceptance of closed-loop blood glucose (BG) control using continuous glucose monitoring systems (CGMS) is likely to improve.

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.

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.