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Printable Handouts
Navigable Slide Index
- Introduction
- Conflict statement
- Outline
- The SEARCH study
- The latency period in the development of T1D
- Time to diabetes by number of Abs
- TrialNet and immune tolerance network
- Trial Net intervention studies
- Prevention and early diagnosis
- The diagnosis of T1D in children and youth
- Work up of diabetes type in youth
- Catastrophe at diagnosis - DKA
- The diagnosis
- Diabetes is hard to manage
- What is the course of type 1 diabetes
- DCCT, EDIC and rate of severe hypoglycemia
- The importance of glycemic control
- The insulin pump: more like a healthy pancreas
- Insulin pump therapy improves control
- CSII reduces incidents of severe hypoglycemia
- Continuous glucose monitoring
- Early control and beta-cell preservation
- STAR 3 study sites
- Study population
- A1C at 3, 6, 9, 12 months: all patients
- A1C at 3, 6, 9, 12 months: adults >= 19 years
- A1C at 3, 6, 9, 12 months: pediatrics 7–18 years
- A1C reduction is correlated with sensor use
- Cumulative severe hypoglycemia and DKA
- The benefit of early control
- Mean A1C values, SAP and crossover groups
- Prevalence of CVD risk factors in youth
- Helping the student with diabetes succeed
- The role of healthcare provider in treatment
- Evolution of a fully-automated delivery system
- How does LGS work?
- Low glucose suspend does what it is meant to do
- Subset of data mining
- Initial observations: children and adolescents
- Alert and suspend settings, all ages vs. pediatric
- Distribution of LGS events, all ages v pediatric (1)
- Distribution of LGS events, all ages v pediatric (2)
- LGS – glucose rate of change (ROC)
- Conclusions about LGS first automated feature
- Trial Net intervention studies (2)
- The closed loop system
- Overnight closed-loop glucose control
- The closed-loop in pediatric subjects
- Glucose values: home SCII vs. closed loop
- Closed-loop Insulin delivery – RCT
- Conclusions
Topics Covered
- The SEARCH study
- The latency period in the development of T1D
- Time to diabetes by number of Abs
- TrialNet and Immune Tolerance Network international consortia
- Prevention and early diagnosis
- The diagnosis of T1D in children and youth
- Work up of diabetes type in youth
- Catastrophe at diagnosis: DKA
- What is the course of type 1 diabetes
- DCCT, EDIC and rate of severe hypoglycemia
- The importance of glycemic control
- The insulin pump: more like a healthy pancreas
- CSII reduces incidents of severe hypoglycemia
- Continuous glucose monitoring
- Early control and beta-cell preservation
- STAR 3 study
- A1C reduction is correlated with sensor use
- Prevalence of CVD risk factors in youth
- The role of healthcare provider in treatment
- Evolution of a fully-automated delivery system
- How does LGS work?
- The closed-loop system
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Kaufman, F. (2013, May 22). The treatment of type 1 diabetes in children and youth [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 5, 2024, from https://doi.org/10.69645/FVUI1829.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Francine Kaufman has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Metabolism & Nutrition
Transcript
Please wait while the transcript is being prepared...
0:00
I will discuss the treatment of
type 1 diabetes in
children and youth.
0:06
I'm the Chief Medical Officer
of Medtronic Diabetes.
0:11
This is an outline of my talk.
First, I'll discuss the
screening, prevention,
and early interdiction
of the type 1 process,
and ask the question,
can this actually
be accomplished?
Next, I'll discuss
the diagnosis of
type 1 diabetes and what
tests should be done
to assure that
a child does have type 1
versus type 2 diabetes.
Treating type 1 diabetes
Asking the question,
is intensive management
now the standard of care?
And of course, emphasizing
the importance of
being aware of the
co-morbidities of this disease.
Then finally, I'll conclude
with the cure and discuss
the first automated
function and then
the dream of a full
artificial pancreas.
0:52
This slide shows the results of
The SEARCH trial
which has been done
in multiple centers
in the United States.
It shows that the
overall prevalence rate
is 1.8 cases per 1000 youth,
approximately about 160
or 170,000 children now
in the country
with this disease.
There are about 16,000 new
cases of type 1 per year
and 3800 new cases of
type 2 diabetes per year.
On the left, zero to
nine years of age
has a prevalence rate
of about 0.8 per 1000.
The different races
and ethnicities from
Non-Hispanic White,
African American, Hispanic,
Asian Pacific Islander,
and American Indian youth.
In those zero to
nine years of age,
almost all the
diabetes is due to
type 1 diabetes
compared to type 2 or
other form of diabetes.
It turns out that, however,
even in American Indian youth
in this young age range,
there's now starting to be
an increase in those who
have type 2 diabetes.
On the right side, you can see
the children of 10 to 19
years of age, and that
the prevalence rate is much
higher at 2.8 per 1000.
Again, across the different
races and ethnicities,
I think you can see now that
of those who do have diabetes in
African American, Hispanic,
and Asian Pacific
Islander youth,
about a third actually
have type 2 diabetes.
For American Indians,
it's almost two-thirds
that have type 2
compared to type 1.
But please note that
in the Non-Hispanic White youth,
the predominant is
type 1 diabetes,
and less than 8%
actually have type 2.
The bottom shows that
there has been an increase
in type 1 per year,
about 3% per year.
And in those very
young children,
it's about 5% per year.
This compares to about
a 10-fold increase
in type 2 diabetes
over the last decade.