| 1. |
|
|
| 2. |
- Korsgren, Olle, et al.
(författare)
-
Imagining a better future for all people with type 1 diabetes mellitus
- 2019
-
Ingår i: Nature Reviews Endocrinology. - : Springer Science and Business Media LLC. - 1759-5029 .- 1759-5037. ; 15:11, s. 623-624
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- For a person with type 1 diabetes mellitus, lifelong insulin treatment is the only therapeutic option. However, increased blood levels of glucose are just a symptom of impaired beta-cell function. Approaching the centenary of the first insulin injection, broadening of international therapeutic guidelines to improve diagnostics, as well as monitor and preserve beta-cell function, is warranted.
|
|
| 3. |
|
|
| 4. |
- Molin, Frida, et al.
(författare)
-
Hinder för och vägar till smärtdokumentation : en empirisk studie av äldre i särskilt boende eller med hemsjukvård
- 2009
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Gruppen äldre kommer att öka i antal och då smärta ökar med ålder kommer fler individer att ha ont. Fler äldre med smärta ställer större krav på hälso- och sjukvården. Studiers visar att sjuksköterskors bild och de äldres upplevelser av smärta inte alltid stämmer överens samt att det finns brister i smärtdokumentation. Syftet med studien var att belysa smärtdokumentation hos en grupp äldre i särskilt boende eller med hemsjukvård. Materialet analyserades med en kvantitativ beskrivande metod och en kvalitativ innehållsanalys. Urvalet bestod av individer med smärta 65 år och äldre. Resultatet visade att många äldre hade ont vid vila och aktivitet. De valde vila framför aktivitet som smärtlindrande åtgärd, trots att fanns nackdelar med vila. Resultatet visade även på brister i sjuksköterskors dokumentation av smärtan. Ett hinder för dokumentation var att en grupp äldre inte berättade om sin smärta vilket kunde bero på att de äldre bland annat inte ville vara till besvär eller att de ansåg att smärta var en del av att bli gammal.
|
|
| 5. |
- Neiman, Daniel, et al.
(författare)
-
Multiplexing DNA methylation markers to detect circulating cell-free DNA derived from human pancreatic β cells
- 2020
-
Ingår i: JCI Insight. - : American Society for Clinical Investigation. - 2379-3708. ; 5:14
-
Tidskriftsartikel (refereegranskat)abstract
- It has been proposed that unmethylated insulin promoter fragments in plasma derive exclusively from β cells, reflect their recent demise, and can be used to assess β cell damage in type 1 diabetes. Herein we describe an ultrasensitive assay for detection of a β cell–specific DNA methylation signature, by simultaneous assessment of 6 DNA methylation markers, that identifies β cell DNA in mixtures containing as little as 0.03% β cell DNA (less than 1 β cell genome equivalent). Based on this assay, plasma from nondiabetic individuals (N = 218, aged 4–78 years) contained on average only 1 β cell genome equivalent/mL. As expected, cell-free DNA (cfDNA) from β cells was significantly elevated in islet transplant recipients shortly after transplantation. We also detected β cell cfDNA in a patient with KATP congenital hyperinsulinism, in which substantial β cell turnover is thought to occur. Strikingly, in contrast to previous reports, we observed no elevation of β cell–derived cfDNA in autoantibody-positive subjects at risk for type 1 diabetes (N = 32), individuals with recent-onset type 1 diabetes (<4 months, N = 92), or those with long-standing disease (>4 months, N = 38). We discuss the utility of sensitive β cell cfDNA analysis and potential explanations for the lack of a β cell cfDNA signal in type 1 diabetes.
|
|
| 6. |
|
|
| 7. |
- Petersson, Jonathan, et al.
(författare)
-
Translating Glycated Hemoglobin A1c into Time Spent in Glucose Target Range : a Multicenter Study
- 2019
-
Ingår i: Pediatric Diabetes. - : Blackwell Publishing. - 1399-543X .- 1399-5448. ; 20:3, s. 339-344
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Approximately 90% of children and adolescents with type 1 diabetes in Sweden use continuous glucose monitoring (CGM), either as real-time CGM or intermittently scanned CGM to monitor their glucose levels. Time in target range (TIT) is an easily understandable metric for assessing glycemic control.Objective: The aim of this study was to examine the relation between TIT and hemoglobin A1c (HbA1c).Subjects and Methods: Subjects were recruited from three diabetes care centers in Sweden. Glucose data were collected for 133 children and adolescents with type 1 diabetes through CGM using Diasend. Subjects with registration time over 80% were included in the analysis. HbA1c was collected from SWEDIABKIDS, the Swedish pediatric diabetes quality registry. TIT was defined as 3.9 to 7.8 mmol/L (70-140 mg/dL) and time in range (TIR) as 3.9 to 10 mmol/L (70-180 mg/dL).Results: During the period of 60 days, 105 subjects provided complete data for analysis. Mean age was 12.2 (±3.3) years, mean HbA1c was 53.9 (±8.2) mmol/mol or 7.1% (±0.7%). Mean sensor glucose value was 8.6 (±1.3) mmol/L, mean coefficient of variation was 42.2% (±7.2%), mean TIT was 40.9% (±SD 12.2%), and mean TIR was 60.8% (±13.1%). There was a significant nonlinear relation between TIT during 60 days and HbA1c, R 2 = 0.69.Conclusion: This study suggests a nonlinear relation between time spent in glucose target range and HbA1c. The finding implies that time spent in TIT could be a useful metric in addition to HbA1c to assess glycemic control.
|
|
| 8. |
- Salö, Martin, et al.
(författare)
-
Evaluation of the microbiome in children’s appendicitis
- 2017
-
Ingår i: International Journal of Colorectal Disease. - : Springer Science and Business Media LLC. - 0179-1958 .- 1432-1262. ; 32:1, s. 19-28
-
Tidskriftsartikel (refereegranskat)abstract
- Background/aim: The role of the microbiome has been widely discussed in the etiology of appendicitis. The primary aim was to evaluate the microbiome in the normal appendix and in appendicitis specifically divided into the three clinically and histopathologically defined grades of inflammation. Secondary aims were to examine whether there were any microbiome differences between proximal and distal appendices, and relate the microbiome with histopathological findings. Methods: A prospective pilot study was conducted of children undergoing appendectomy for appendicitis. The diagnosis was based on histopathological analysis. Children with incidental appendectomy were used as controls. The proximal and distal mucosa from the appendices were analyzed with 16S rRNA gene sequencing. Results: A total of 22 children, 3 controls and 19 appendicitis patients; 11 phlegmonous, 4 gangrenous, and 4 perforated appendices, were prospectively included. The amount of Fusobacterium increased and Bacteroides decreased in phlegmonous and perforated appendicitis compared to controls, but statistical significance was not reached, and this pattern was not seen in gangrenous appendicitis. No relation could be seen between different bacteria and the grade of inflammation, and there was a wide variation of abundances at phylum, genus, and species level within every specific group of patients. Further, no significant differences could be detected when comparing the microbiome in proximal and distal mucosa, which may be because the study was underpowered. A trend with more abundance of Fusobacteria in the distal mucosa was seen in appendicitis patients with obstruction (25 and 13 %, respectively, p = 0.06). Conclusion: The pattern of microbiome differed not only between groups, but also within groups. However, no statistically significant differences could be found in the microbiome between groups or clinical conditions. No correlation between a specific bacteria and grade of inflammation was found. In the vast majority of cases of appendicitis, changes in microbiome do not seem to be the primary event. Since there seem to be differences in microbiome patterns depending on the sample site, the exact localization of biopsy sampling must be described in future studies.
|
|
| 9. |
- Sundberg, Frida, et al.
(författare)
-
A decade of improved glycemic control in young children with type 1 diabetes: A population-based cohort study
- 2021
-
Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 22:5, s. 742-748
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Early-onset type 1 diabetes (T1D) is associated with high risk of early cardiovascular complications and premature death. The strongest modifiable risk factor is HbA1c. Other modifiable factors, such as overweight, also increase the risk of complications. During the last decade, the introduction of continuous glucose monitoring (CGM) has offered new options in the treatment of T1D. Objective: To compare treatment outcomes in children younger than 7 years with T1D in Sweden in two separate cohorts: one in 2008 and one in 2018. Methods: All children in the national pediatric diabetes registry (SWEDIABKIDS) younger than 7 years with T1D were included. Data from 2008 and 2018 were analyzed. Results: Data were available on 666 children (45% girls) in 2008 and 779 children (45% girls) in 2018. Mean age was 5.6 (1.4) versus 5.5 (1.4) years and mean diabetes duration 2.3 (1.4) versus 2.2 (1.4) years. The use of CGM increased from 0% to 98% and the use of an insulin pump from 40% in 2008 to 82% (p < 0.01)in 2018.Mean HbA1c was 58 mmol/mol (7.4%) in 2008 and 50 mmol/mol (6.7%) in 2018 (p < 0.01). The frequency of overweight and obesity was the same in 2008 and 2018(26% vs. 29%). Conclusion: During this decade, usage of CGM and insulin pump increased and HbA1c decreased. However, HbA1c remained higher than the physiological level and thus continued to represent a cardiovascular risk, especially in combination with overweight or obesity. The frequency of overweight and obesity remained unchanged. © 2021 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.
|
|
| 10. |
|
|
| 11. |
- Sundberg, Frida, et al.
(författare)
-
Children younger than 7 years with type 1 diabetes are less physically active than healthy controls.
- 2012
-
Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 101:11, s. 1164-9
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To examine if children younger than 7years with type 1 diabetes are less physically active and spend more time sedentary than healthy children. Methods: Using a repeated measures case-control study design, physical activity (PA) was measured by continuous combined accelerometer and heart rate registration for 7days at two time points during 1year (autumn and spring). PA data were expressed as time spent sedentary, in moderate and vigorous intensity PA and total PA. Differences between groups and gender were analysed with mixed linear regression models. In this study there were 24 children (12 girls) with type 1 diabetes mellitus and 26 (14 girls) healthy controls, all younger than 7years at inclusion. Results: Children with diabetes were less active overall (p=0.010) and spent 16min less in moderate-to-vigorous PA (p=0.006). The difference in sedentary time (21min less) between groups was not significant (p=0.21). Overall PA (12.1 counts/min per day, p=0.004) and time in moderate and vigorous PA (16.0min/day, p=0.002) was significantly higher in boys than in girls. A significant effect of age was observed. Conclusion: Physical activity is significantly reduced in young children with type 1 diabetes.
|
|
| 12. |
- Sundberg, Frida, et al.
(författare)
-
Continuous Glucose Monitoring in Healthy Children Aged 2-8 Years.
- 2018
-
Ingår i: Diabetes technology & therapeutics. - : Mary Ann Liebert Inc. - 1557-8593 .- 1520-9156. ; 20:2, s. 113-116
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to add the missing information on glycemic levels and patterns as measured by continuous glucose monitoring (CGM) in the daily life of healthy children aged 2-8 years. These data are needed when studying glycemic patterns and treatment outcome in children aged 2-8 years with diabetes.Each of the 15 healthy children aged 2-7.99 years used a CGM device (Dexcom G4 Platinum) for 7 days.A total of 15 children (10 girls) aged 5.4±1.6 years registered a mean of 1976±15 counts. Mean sensor glucose was 5.3±1.0mmol/L (95±18mg/dL) and 89% of values were in the range 4-7.8mmol/L (72-140mg/dL), 9% of sensor glucose values were <4.0mmol/L (72mg/dL), and 2% of sensor glucose values were >7.8mmol/L (140mg/dL).We present glycemic data as measured by CGM in healthy children aged 2-8 years.
|
|
| 13. |
|
|
| 14. |
- Sundberg, Frida
(författare)
-
Diabetes under seven (DU7). Aspects of glycaemic control, hypoglycaemia, nutrition and physical activity in children younger than seven years with type 1 diabetes mellitus
- 2014
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this thesis is to elucidate the specific challenges in insulin treatment for children younger than seven years with type 1 diabetes, with a focus on glycaemic control, hypoglycaemia, nutrition and physical activity. Methods: There were 24 children younger than seven years with type 1 diabetes and 27 healthy children from Gothenburg in the observational study that forms the basis of this thesis. Continuous glucose monitors, glucometer memories, accelerometers, food diaries, logbooks and questionnaires were used to collect data on the everyday life of these children. Results: In Paper I we showed that children with type 1 diabetes are less physically active than healthy children. In Paper II we found that most hypoglycaemic events in very young children with type 1 diabetes are asymptomatic and go undetected despite on average 10 plasma glucose tests per day. In Paper III we observed that both children with type 1 diabetes and healthy children eat too much saturated fat and too little fruit, vegetables and fibre. In Paper IV we found that young children with type 1 diabetes have lower health-related quality of life than healthy children of the same age and gender. Conclusion: The circumstances and health-related quality of life of young children with type 1 diabetes need more attention from the health care system. Modern technical tools should be used to improve hypoglycaemia detection and to reduce glycaemic variability. These children´s low physical activity and their food intake habits are associated with high cardiovascular risk and warrant further family-based support from the diabetes team.
|
|
| 15. |
- Sundberg, Frida, et al.
(författare)
-
Health-related quality of life in preschool children with Type 1 diabetes.
- 2015
-
Ingår i: Diabetic medicine : a journal of the British Diabetic Association. - : Wiley. - 1464-5491. ; 32:1, s. 116-119
-
Tidskriftsartikel (refereegranskat)abstract
- To describe health-related quality of life in children aged < 7 years with Type 1 diabetes mellitus compared with healthy children of the same age, and to investigate how health-related quality of life was correlated with aspects of insulin treatment and glycaemic control.
|
|
| 16. |
|
|
| 17. |
- Sundberg, Frida, et al.
(författare)
-
Managing diabetes in preschool children.
- 2017
-
Ingår i: Pediatric diabetes. - : Hindawi Limited. - 1399-5448 .- 1399-543X. ; 18:7, s. 499-517
-
Tidskriftsartikel (refereegranskat)
|
|
| 18. |
|
|
| 19. |
- Szypowska, Agnieszka, et al.
(författare)
-
Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry.
- 2016
-
Ingår i: Pediatric diabetes. - : Hindawi Limited. - 1399-5448 .- 1399-543X. ; 17 Suppl 23, s. 38-45
-
Tidskriftsartikel (refereegranskat)abstract
- Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control.To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI.This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out.Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P < .0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P < .0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P < .0001).Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.
|
|
| 20. |
- Teixeira, Pedro F., et al.
(författare)
-
Assisting the implementation of screening for type 1 diabetes by using artificial intelligence on publicly available data
- 2024
-
Ingår i: DIABETOLOGIA. - : SPRINGER. - 0012-186X .- 1432-0428.
-
Tidskriftsartikel (refereegranskat)abstract
- The type 1 diabetes community is coalescing around the benefits and advantages of early screening for disease risk. To be accepted by healthcare providers, regulatory authorities and payers, screening programmes need to show that the testing variables allow accurate risk prediction and that individualised risk-informed monitoring plans are established, as well as operational feasibility, cost-effectiveness and acceptance at population level. Artificial intelligence (AI) has the potential to contribute to solving these issues, starting with the identification and stratification of at-risk individuals. ASSET (AI for Sustainable Prevention of Autoimmunity in the Society; www.asset.healthcare) is a public/private consortium that was established to contribute to research around screening for type 1 diabetes and particularly to how AI can drive the implementation of a precision medicine approach to disease prevention. ASSET will additionally focus on issues pertaining to operational implementation of screening. The authors of this article, researchers and clinicians active in the field of type 1 diabetes, met in an open forum to independently debate key issues around screening for type 1 diabetes and to advise ASSET. The potential use of AI in the analysis of longitudinal data from observational cohort studies to inform the design of improved, more individualised screening programmes was also discussed. A key issue was whether AI would allow the research community and industry to capitalise on large publicly available data repositories to design screening programmes that allow the early detection of individuals at high risk and enable clinical evaluation of preventive therapies. Overall, AI has the potential to revolutionise type 1 diabetes screening, in particular to help identify individuals who are at increased risk of disease and aid in the design of appropriate follow-up plans. We hope that this initiative will stimulate further research on this very timely topic.
|
|
| 21. |
- Temple, Alastair, et al.
(författare)
-
Development of Experimental Method for Assessing Risk of Lithium Fires Related with Fusion Reactor Lithium Cooling Loops
- 2021
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this project is to provide the basis for risk assessments relating to the risk of lithium leaks in the DONES project. This report firstly summarizes the current knowledge of risks and reaction features at different scales with liquid lithium. Note that the review is limited to fire behaviour of lithium in its liquid state and does not consider additional risks connected with breeding tritium or corrosive effects of impurities. Some of the questions important for this project are to limit the lithium reaction with water, limit the spread of fire started by a reaction with lithium and extinguish flame of lithium induced fires. The second part of the report consists discussion of some initial small-scale experiments, undertaken to provide a basis for limiting the extent for further larger tests, and a proposal for an experimental device where lithium reactions can be studied in a controlled environment, i.e. with controlled amount of oxygen, nitrogen or humidity in the experiment. This will then be the basis for risk assessment for liquid lithium loop in the DONES facility.
|
|
