Diabetes complications and comorbidities in specific populations

Severe hypoglycemia in people with type 2 diabetes is associated with later mortality from a wide range of causes, including those for which there is no obvious underlying mechanism, say researchers.

Continuous glucose monitoring is well accepted and reduces time in hypoglycemia among older individuals with type 1 diabetes, report researchers in JAMA.

A major study of children from three continents suggests that diabetic ketoacidosis remains unacceptably high among those newly identified with type 1 diabetes and shows few signs of improving.

Implementing a nursing protocol that includes point-of-care testing at triage reduces the time to diabetic ketoacidosis diagnosis and the number of unnecessary intravenous placements in the pediatric emergency department, say researchers.

Children with type 1 diabetes are more likely than their non-diabetic peers to seek primary care for a number of specific conditions in the year before their diagnosis, which could aid detection before the onset of diabetic ketoacidosis, say researchers.

The effect of sleep duration on glucose regulation and cardiometabolic risk is becoming an increasingly high-profile issue. medwireNews takes a look at the latest evidence, which shows the gravity of the problem but also offers some solutions.

Insulin manipulation, the practice of deliberately under- or overdosing insulin, is strongly associated with psychiatric comorbidity in children and young adults with type 1 diabetes, Austrian research shows.

Zhu B et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1181-4

Neither the rate of administration nor the sodium chloride content of replacement fluids given to children with diabetic ketoacidosis influences their neurologic outcomes, show the results of the PECARN DKA FLUID Study.

Oriot P et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1170-7

Maskarinec G et al. Eur J Clin Nutr 2018. doi: 10.1038/s41430-018-0188-9

Nichol AD, Holle MJ, An R. Eur J Clin Nutr 2018. doi: 10.1038/s41430-018-0170-6

Owusu Adjah ES et al. Cardiovasc Diabetol 2018; 17: 70. doi: 10.1186/s12933-018-0712-1

The excess mortality risk associated with high or very low glycated hemoglobin values is modified by glycemic variability in diabetes patients aged 70 years or more, shows an analysis of The Health Improvement Network database.

As the utility and availability of devices surges, so too do patient expectations. Advisory Board member Katharine Barnard provides key consultation questions to help determine your patients’ greatest needs and obstacles.

This review takes a practical approach to the assessment, nursing care, and medical treatment of diabetes in the elderly, highlighting major challenges and suggesting solutions to common clinical problems.

Dickens LT, Naylor RN. Curr Diab Rep 2018; 18: 12. doi: 10.1007/s11892-018-0982-8

The drive to achieve lower HbA1c targets in older patients is not without concern or risk. Our UK Board address concerns highlighted by recent trials and discuss whether current guidelines do enough to mitigate the risks of overtreatment.

How would you diagnose and treat the third patient in our series of case studies on atypical forms of diabetes? Editorial board member Jay Shubrook challenges you.