BMJ: Children with type one diabetes do just as well with jags as pumps

 BMJ 13 April 19

Pumps versus Multiple Daily Injections

Across various centres in England and Wales, 294 new onset type one diabetes patients were randomised to receive either pumps or MDI from the very start after diagnosis. The age range was just 7 months to 15 years. There were 144 in the pump group and 147 in the MDI group.

At one year the average HbA1c was around 60 (7.6%) for both groups. There were 14 serious events such as diabetic ketoacidosis or severe hypoglycaemia in the pump group and 8 such events in the MDI group.

It cost £1,863 more to treat the pump group but they had no better outcomes or improvement in quality of life compared to the MDI group. Indeed adverse events were a bit more common in the pump group even though there were fewer of them.

My comment: Looks like they were not advised about low carb diets given the relatively high HbA1Cs at a time that the honeymoon phase can be protective.

BMJ 16 Feb 19

Type one children performed just as well as their schoolmates in exams

Although both high and low blood sugar can affect concentration and memory and cognitive function, Danish researchers found that in national exams, type one children performed just as well as other children.

Enterovirus may act as a trigger for Coeliac Disease

Norwegian researchers looked at infection with adenoviruses and enteroviruses in childhood and later diagnosis of coeliac disease.

They tested children who were already at risk due to a particular genotype. They were recruited between 2001 and 2007 and were followed up till 2016.

They found that infection with enteroviruses but not adenoviruses were associated with higher onset of coeliac later on.

My comment: Enterovirus infection has been associated with the onset of type one diabetes too. People with type one are also more likely to develop coeliac. There could be common genetic susceptibility and environmental triggers.