Liz Davis

WA Aboriginal Child Health Survey (WAACHS) Data Linkage Study

This study is a partnership between researchers, the Aboriginal community and government to provide evidence for policy and practice addressing high priority health and wellbeing issues for Aboriginal children and families.

Healthway Chronic Conditions

The aim of this project is to develop and test a series of modules to promote mental health among young people with chronic conditions, using a positive psychology framework.

Using continuous glucose monitoring to detect early dysglycaemia in children participating in the ENDIA study (Sub Protocol)

Validation of Physical Activity Assessment in Type 1 Diabetes – an Essential Step to Incorporating Systematic Measurement of Activity as the Standard of Care in Youth

The effect of oral insulin on subcutaneous insulin requirements and glycaemia in T1DM

Priority-setting in youth with chronic conditions

Piloting a self-compassion program to promote physical and psychological wellbeing in youth with T1D

Characterising moment-to-moment fluctuation in stress, anxiety and blood glucose levels in adolescents with type 1 diabetes

UVR exposure, Vitamin D and type 1 diabetes

Western Australian DNA and Longitudinal Serum Bank for Weight Regulation

This resource will allow researchers to carry out studies which will look at the genetic causes of excessive weight gain and identify biomarkers

A Database of the Complications of Obesity in Children

The Obesity Database records the characteristics and medical complications of children with obesity who present to treatment at Princess Margaret Hospital

Western Australian Children’s Diabetes Database

This register was established at Princess Margaret Hospital in 1987 which stores data on all consenting patients attending the hospital’s diabetes clinic.

Longitudinal Type 1 and 2 Diabetes Plasma and Serum Repository

The Serum & Plasma bank was established to provide a store of samples from subjects with diabetes as well as their families.

Australian Childhood Diabetes DNA Repository

Collecting DNA samples from Australian families affected by diabetes.

Type 1 and Type 2 Diabetes DNA bank

A register which stores demographic and clinical data on all patients attending the diabetes clinic at Princess Margaret Hospital

Diabetes Translational Research

The year 2013 saw the progress in our research from purely lab-based studies towards taking a step closer to translational research.

Bioenteric Intragastric Balloon

The purpose of this randomized clinical trial is to determine whether the use of the BIB aids weight loss in obese adolescents.

Can exercise training Improve health in young people with type 2 diabetes?

We are studying exercise in young people with T2DM and obese young people at risk of developing type 2 diabetes

Epidemiology of T2DM in childhood and associated disease complications

Investigating the incidence of childhood Type 2 Diabetes in the Western Australian community

Oral Insulin Trial

To see if giving insulin by mouth (in a capsule) will delay or prevent T1DM in people at increased risk of developing diabetes.

Intranasal Insulin Trial II

If successful, this vaccine could prevent type 1 diabetes and the need for daily insulin injections in people at risk.

Neurocognitive outcomes of children with type 1 diabetes mellitus

To conduct an analysis of children with TIDM’s cognitive profile at an age in which both cognition and cortical development are still maturing

Aussi-AdDIT

Investigating changes in retinopathy, aortic intima media thickness & heart rate variability, indicators of macrovascular disease & autonomic neuropathy

Adolescent type 1 diabetes cardio-renal Intervention trial

An international clinical trial looking at intervention with Angiotensin Converting Enzyme Inhibitors (ACEI), Statins, or a combination of both

Safety evaluation of closed loop system during hypoglyaemic stimuli

The purpose of this study is to evaluate the safety of new system called the Medtronic MinimedTM 670G that has been designed for long term outpatient use.

Feasibility of 24-hour hybrid closed loop insulin delivery in free living conditions

The aim of this study is to see if the Medtronic hybrid closed loop system, a portable artificial pancreas is feasibly to use in the home.

Closed Loop Study – Day and Night Feasibility Study

A Closed-Loop System will potentially have a major impact upon acute and chronic complications of diabetes as well as upon their quality of life.

Closed Loop Study - Multicentre

A Closed-Loop System will potentially have a major impact upon acute and chronic complications of diabetes as well as upon their quality of life

Predictive low glucose suspend study – Randomised Controlled trial

Testing a feature of the MiniMed 640G insulin pump, which when used together with a real-time continuous glucose sensor can suspend and resume insulin delivery

Sprint proof of concept study

This study will evaluate the effect of two types of aerobic exercise

Effect of blood glucose levels on the amount of glucose needed to maintain stable blood glucose levels during and after moderate intensity exercise in young people with type 1 diabetes

Determining if hyperglycaemia prior to and during exercise affects the amount of carbohydrate required to maintain stable glucose levels during/after exercise

How do high protein and/or high fat meals affect postprandial glycaemic control in children using intensive insulin therapy?

Investigating the effect of fat and protein content of a standardised carbohydrate meal on the post-prandial glycaemic response in children with type 1 diabetes

Early environmental determinants of pancreatic islet autoimmunity: a pregnancy to early life cohort study in children at risk of type 1 diabetes

This study is looking for the causes of type 1 diabetes, so that we can find ways to prevent it.

TrialNet: Pathway to Prevention

This study is helping us to learn how type 1 diabetes develop and ways to delay and prevent it.

Investigating mortality rates and the incidence and risk factors of diabetes complications and co-morbidities during early adult life in a population based childhood onset diabetes cohort

Using the WA Data Linkage System to provide information of the incidence and relative risk of T1D co-morbidities and mortality during early adulthood.

Epidemiology of hypoglycaemia in childhood-onset diabetes in Western Australia

Investigating the demographic, lifestyle and diabetes management factors associated with the incidence of severe hypoglycemia

Epidemiology of childhood diabetes in Western Australia

The objectives of this study are to study the epidemiology of childhood diabetes in Western Australia from 1985 onwards.

Cohort profile: The WAACHS Linked Data Study

Despite the volume of accumulating knowledge from prospective Aboriginal cohort studies, longitudinal data describing developmental trajectories in health and well-being is limited.

"i Think i Could Have Used It Better": Experiences of Youth with High HbA1c Commencing Advanced Hybrid Closed-Loop Therapy in a Clinical Trial Setting - A Qualitative Research

Advanced hybrid closed-loop (AHCL) therapy improves glycemia. However, it is not known if there is an improvement in overall outcomes with AHCL for youth with type 1 diabetes (T1D) at high risk of diabetes-related complications. The study aimed to capture the experiences of youth with suboptimal glycemic control when commencing AHCL therapy in a clinical trial setting. 

Early Dysglycemia Is Detectable Using Continuous Glucose Monitoring in Very Young Children at Risk of Type 1 Diabetes

Continuous glucose monitoring (CGM) can detect early dysglycemia in older children and adults with presymptomatic type 1 diabetes and predict risk of progression to clinical onset. However, CGM data for very young children at greatest risk of disease progression are lacking. 

Contributions of digital technologies for resilience capacity in a type 1 diabetes transition clinic: A qualitative study

A type 1 diabetes (T1D) transition clinic in Sydney, Australia, provides age specific care for young adults (aged 16-25 years) and for adults (aged 21 years and above), and has reported improved clinical outcomes post transition to adult care over a 21-year period. This study investigated the contribution of digital technology to long-term resilient capacity of the clinic.

Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study

Dietary patterns characterised by high intakes of vegetables may lower the risk of pre-eclampsia and premature birth in the general population. The effect of dietary patterns in women with type 1 diabetes, who have an increased risk of complications in pregnancy, is not known. 

Protocol for the Australian Type 1 Diabetes National Screening Pilot: Assessing the feasibility and acceptability of three general population screening models in children

One third of Australian children diagnosed with type 1 diabetes present with life-threatening diabetic ketoacidosis (DKA) at diagnosis. Screening for early-stage, presymptomatic type 1 diabetes, with ongoing follow-up, can substantially reduce this risk (<5% risk). Several screening models are being trialled internationally, without consensus on the optimal approach. This pilot study aims to assess three models for a routine, population-wide screening programme in Australia.

Development of a Novel Mobile Health App to Empower Young People With Type 1 Diabetes to Exercise Safely: Co-Design Approach

Blood glucose management around exercise is challenging for youth with type 1 diabetes (T1D). Previous research has indicated interventions including decision-support aids to better support youth to effectively contextualize blood glucose results and take appropriate action to optimize glucose levels during and after exercise. Mobile health (mHealth) apps help deliver health behavior interventions to youth with T1D, given the use of technology for glucose monitoring, insulin dosing, and carbohydrate counting.

Benefits, implementation and sustainability of innovative paediatric models of care for children with type 1 diabetes: a systematic review

The evidence about the acceptability and effectiveness of innovative paediatric models of care for Type 1 diabetes is limited. To address this gap, we synthesised literature on implemented models of care, model components, outcomes, and determinants of implementation and sustainability.

Environmental Determinants of Islet Autoimmunity (ENDIA) longitudinal prospective pregnancy to childhood cohort study of Australian children at risk of type 1 diabetes: parental demographics and birth information

The Environmental Determinants of Islet Autoimmunity Study is an ongoing Australian prospective cohort study investigating how modifiable prenatal and early-life exposures drive the development of islet autoimmunity and type 1 diabetes in children. In this profile, we describe the cohort's parental demographics, maternal and neonatal outcomes and human leukocyte antigen genotypes. 

Behavior Change Techniques Involved in Physical Activity Interventions for Children with Chronic Conditions: A Systematic Review

Behavior change techniques (BCTs) have been extensively used in physical activity interventions for children, however, no systematic reviews have synthesized their effects.

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.

Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol

Premature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of care. We describe the methods for the codesign, implementation and evaluation of enhanced models of care with Aboriginal and Torres Strait Islander youth living with type 2 diabetes across Northern Australia. 

Developing type 1 diabetes resources: a qualitative study to identify resources needed to upskill and support community sport coaches

Community sport coaches in Western Australia lack an understanding, the confidence, and knowledge in supporting young people with Type 1 diabetes (T1D). This study aims to identify what T1D educational resources are required to upskill coaches in Western Australia. 

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).

Following in Banting’s footsteps or straying from the path? Observations from contemporary diabetes innovation

While advancements in the treatment of diabetes continue to rapidly evolve, many of the newer technologies have financial barriers to care, opposing the egalitarian ethos of Banting who sold his patent on insulin for a nominal cost to allow it to be made widely available. Inequity in access to new therapies drives disparity in diabetes burden with potential for these gaps to widen in the future.

Wellbeing and distress in young people with chronic conditions: how do positive psychology variables relate to mental health outcomes?

The aim of this study was to determine the unique and shared contributions of various positive psychology constructs (gratitude, optimism, hope, self-compassion, self-efficacy, and emotion regulation) to wellbeing and distress outcomes in young people living with a diverse range of chronic health conditions. 

The Right Advice, from the Right Person, in the Right Way: Non-Engaged Consumer Families’ Preferences for Lifestyle Intervention Design Relating to Severe Obesity in Childhood

Family-based lifestyle interventions for children/adolescents with severe levels of obesity are numerous, but evidence indicates programs fail to elicit short- or longer-term weight loss outcomes. Families with lived experience can provide valuable insight as we strive to improve outcomes from programs. Our aim was to explore elements that families desired in a program designed to treat severe levels of obesity in young people.

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.

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.

Continuous glucose monitoring has an increasing role in pre-symptomatic type 1 diabetes: Advantages, limitations, and comparisons with laboratory-based testing

Type 1 diabetes is well-recognised as a continuum heralded by the development of islet autoantibodies, progression to islet autoimmunity causing beta cell destruction, culminating in insulin deficiency and clinical disease. Abnormalities of glucose homeostasis are known to exist well before the onset of typical symptoms.

‘It’s been a lifelong thing for me’: parents’ experiences of facilitating a healthy lifestyle for their children with severe obesity

For parents and guardians, assisting children/adolescents with severe obesity to lose weight is often a key objective but a complex and difficult challenge. Our aim in this study was to explore parents' (and guardians') perspectives on the challenges they have faced in assisting their children/adolescents with severe obesity to lead a healthy lifestyle.

A surge in serum mucosal cytokines associated with seroconversion in children at risk for type 1 diabetes

Autoantibodies to pancreatic islet antigens identify young children at high risk of type 1 diabetes. On a background of genetic susceptibility, islet autoimmunity is thought to be driven by environmental factors, of which enteric viruses are prime candidates.

Childhood-onset type 1 diabetes in Western Australia: An update on incidence and temporal trends from 2001 to 2022

To determine the incidence and incidence trends over 2001-2022 of childhood-onset type 1 diabetes (T1D) in Western Australia and assess the impact of the COVID-19 pandemic.

“Sometimes Our Mob Don't Really Take It Serious Until It's Serious”: The Experiences of Western Australian Aboriginal Adolescents Living With Type 2 Diabetes, Their Parents, and Their Family Members

In Australia, Aboriginal children experience disproportionate rates of type 2 diabetes (T2D) compared with non-Aboriginal children. The aim of this qualitative study was to explore the experiences of Aboriginal adolescents with T2D and their family members to better understand the influences of T2D on self-management, with findings used to inform an enhanced service model of care.

Physical activity management for youth with type 1 diabetes: Supporting active and inactive children

Regular physical activity and exercise are important for youth and essential components of a healthy lifestyle. For youth with type 1 diabetes, regular physical activity can promote cardiovascular fitness, bone health, insulin sensitivity, and glucose management. However, the number of youth with type 1 diabetes who regularly meet minimum physical activity guidelines is low, and many encounter barriers to regular physical activity.

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.

Protocol for a nested case-control study design for omics investigations in the Environmental Determinants of Islet Autoimmunity cohort

The Environmental Determinants of Islet Autoimmunity (ENDIA) pregnancy-birth cohort investigates the developmental origins of type 1 diabetes (T1D), with recruitment between 2013 and 2019. ENDIA is the first study in the world with comprehensive data and biospecimen collection during pregnancy, at birth and through childhood from at-risk children who have a first-degree relative with T1D.

Experiences of Caregivers and At-Risk Children Enrolled in a Prospective Pregnancy-Birth Cohort Study into the Causes of Type 1 Diabetes: The ENDIA Study

We sought research experiences of caregivers and their children were enrolled in the Environmental Determinants of Islet Autoimmunity (ENDIA) study.

Perspectives of culturally and linguistically diverse families in the management of children with type 1 diabetes in Western Australia

Children with Type 1 diabetes (T1D) from different ethnic backgrounds are growing in proportion in clinical practice and tend to have a higher risk of poor health outcomes. The study aimed to investigate the perspectives of culturally and linguistically diverse families in the management of children with T1D in Western Australia.

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.

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

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

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.

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

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

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

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

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

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

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

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

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: Exercise in children and adolescents with diabetes

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

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

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

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

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

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

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).

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

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

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.

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.

Lower HbA1c targets are associated with better metabolic control

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

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.

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

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

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

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

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

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.

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.

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

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

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

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

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

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

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

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.

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

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

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.

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

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

Clustering of psychosocial symptoms in overweight children

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

The role of family and maternal factors in childhood obesity

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

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

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

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

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

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

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

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.

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.

Advances in Exercise and Nutrition as Therapy in Diabetes

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

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.

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

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

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

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

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.

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

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

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.

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

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

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

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

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

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

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

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

Advances in Exercise, Physical Activity, and Diabetes

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

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

Improved frequency of sensor use improves glycaemic control

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

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

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

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.

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

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

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

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

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

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

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

Childhood Overweight and Obesity: Maternal and Family Factors

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

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

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

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

Continuous glucose monitoring adherence and patterns of use are individualized

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

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

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

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

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

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

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

Inverted-U relationship between exercise intensity and glucose requirement

Exercise training improves vascular function in adolescents with type 2 diabetes

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

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

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

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

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

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

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

Feasibility of Outpatient 24-Hour Closed-Loop Insulin Delivery

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The purpose of this study was to investigate whether antecedent hypoglycaemia impairs the glycaemia-raising effect of a 10 s sprint in individuals with type...

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

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

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

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

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

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

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

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

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

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

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

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

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

The aim of this study was to examine the incidence rates and risk factors associated with severe hypoglycaemia in a contemporary cohort of children and...

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

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

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

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

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

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

How training affects Australian paediatricians' management of obesity

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

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

We assessed the impact of an acute bout of hyperglycaemia on nitric oxide (NO)-mediated microvascular function in the skin of adolescents with type 1...

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The aim of this study was to reexamine the neurocognitive function of a cohort of young adults with early-onset type 1 diabetes and compare their cognitive...

Lower cardiorespiratory fitness in children with Type 1 diabetes

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

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

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

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

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

Fatness, fitness, and increased cardiovascular risk in young children

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

Birthweight and the risk of childhood-onset type 1 diabetes

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

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.