Search

Describes a tool used by liaison nurses in the children's diabetes team at Leeds Hospital Trust in England to assess the needs of children with diabetes. Details of the development of the Integrated Needs Assessment at Leeds; Outcomes of case studies; Benefits gained from the tool. INSETS: Case study 1;Case study 2.

Abstract Aims Several studies on space–time clustering have been reported in childhood diabetes, but the findings are conflicting. The present study was undertaken to examine whether such clustering could be detected at either birth or the time of diagnosis in the far South-west of England. Methods A cohort of 518 children aged 0–15 years and diagnosed with Type 1 diabetes from 1975 to 1996 contained in the population-based Cornwall and Plymouth Children's Diabetes Register (CPCDR) were included in the analyses. The case ascertainment for this register is estimated to be 94.4% complete. Mantel's modification of Knox's method was employed. A method based on K -function was also used, for the first time, to investigate the space–time clustering of diabetes. Results Significant space–time clustering at diagnosis was found by the Knox's test in the following combinations of critical cut-off thresholds: 25, 35 and 50 km and 90, 270 and 360 days (all P < 0.05), with the highest significance found at 35 km and 360 days ( P = 0.0011). K -function analysis also confirmed the overall clustering ( P = 0.013). Conclusions There is strong evidence of space–time clustering in the onset of childhood Type 1 diabetes in Devon and Cornwall, England. These results lend some support to the hypothesis that viral infections and some unknown localized environmental factors play a role in the development of childhood Type 1 diabetes. Diabet. Med. 19, 667–672 (2002). [ABSTRACT FROM AUTHOR]

Aims/Hypothesis. To examine the prevalence of subclinical islet autoimmunity in children from two countries with a twofold to threefold difference in incidence of childhood Type I (insulin-dependent) diabetes mellitus.¶Methods. Sera were collected from 2860 English and 3053 Lithuanian non-diabetic schoolchildren according to the same protocol. Occult diabetes was excluded by blood glucose measurement. Antibodies to GAD and the protein tyrosine phosphatase IA-2 were measured with standardised radiobinding assays in a single laboratory. Islet cell antibodies and insulin autoantibodies were additionally measured in all samples with GAD and/or IA-2 antibody levels above the 97.5th centile of the English schoolchildren.¶Results. Of Lithuanian schoolchildren 2.7 % had GAD antibodies above the 97.5th centile of the English schoolchildren but only 0.2 % had antibodies to IA-2 above this threshold (p < 0.001). Islet cell and/or insulin autoantibodies above the 97.5th centile were found in 22 Lithuanian and 16 English schoolchildren and the overall prevalence of two or more antibodies on or above the 97.5th centile was similar [0.7 % (0.5–1.1) vs 0.6 % (0.4–1.0)] in the two cohorts.¶Conclusion/interpretation. The prevalence of multiple antibody markers was similar in the cohorts from the two populations, despite the two to three-fold difference in incidence of diabetes. The unexpectedly high prevalence of subclinical islet autoimmunity suggests that the incidence of diabetes in Lithuania is likely to increase in the near future. [Diabetologia (2001) 44: 16–21] [ABSTRACT FROM AUTHOR]

A calendar of meetings related to pediatric endocrinology and metabolism from May 2010 to May 2012 is presented including the Lawson Wilkins Pediatric Endocrine Society (LWPES) Annual Meeting in Vancouver, British Columbia, 26th International Pediatric Association Congress in Johannesburg, South Africa, and Excellence in Paediatrics in London, England.