Clinical Study Characteristics and Determinants of Partial Remission in Children with Type 1 Diabetes Using the Insulin-Dose-Adjusted A1C Definition

To evaluate the characteristics and determinants of partial remission (PR) in Belgian children with type 1 diabetes (T1D), we analyzed records of 242 children from our center. Clinical and biological features were collected at diagnosis and during follow-up. PR was defined using the insulin-dose-adjusted A1C definition. PR occurred in 56.2% of patients and lasted 9.2 months (0.5 to 56.6). 25.6% of patients entered T1D with DKA, which correlated with lower PR incidence (17.6% versus 82.3% when no DKA). In our population, lower A1C levels at diagnosis were associated with higher PR incidence and in young children (0-4 years) initial A1C levels negatively correlated with longer PR. Early A1C levels were predictive of PR duration since 34% of patients had long PRs (>1 year) when A1C levels were ≤6% after 3 months whereas incidence of long PR decreased with higher A1Cs. C-peptide levels were higher in patients entering PR and remained higher until 3 years after diagnosis. Initial antibody titers did not influence PR except for anti-IA2 titers that correlated with A1C levels after 2 years. Presence of 2 versus 1 anti-islet antibodies correlated with shorter PR. PR duration did not influence occurrence of severe hypoglycemia or diabetes-related complications but was associated with lower A1C levels after 18 months. We show that, at diagnosis of T1D, parameters associated with -cell mass reserve (A1C, C-peptide, and DKA) correlate with the occurrence of PR, which affects post-PR A1C levels. Further research is needed to determine the long-term significance of PR

Regulation of growth hormone receptor and its transduction pathways by hormones and nutrients

Thèse de doctorat en sciences biomédicales (SBIM 3)--UCL, 200

Premature pubarche: When should we be worried about? [Pubarche prématurée: Quand faut-il s’inquiéter?]

La survenue d’une pilosité pubienne précoce est souvent une source d’inquiétude, tant pour les familles que pour les médecins. Dans la majorité des cas, il ne s’agit que d’une variante de la normale ou prémature adrenarche. Cependant, cette situation peut être en rapport avec des pathologies potentiellement graves comme une hyperplasie congénitale des surrénales ou une tumeur surrénalienne ou gonadique qu’il convient de diagnostiquer et de prendre en charge

Prise en charge de l'enfant et adolescent en excès de poids

L’obésité en âge pédiatrique s’associe à un taux de complications médicales et psychologiques élevé dès l’enfance et à l’âge adulte, et ce indépendamment du poids à l’âge adulte. Une prise en charge précoce, positive, partant des compétences des familles est indispensable et doit éviter que le jeune et sa famille ne soient confrontés à une série d’échecs qui leur laissera penser que l’obésité de leur enfant est une fatalité. Cette prise en charge cherchera à rééquilibrer la balance énergétique mais inclura aussi un support familial, une approche adaptée à l’enfant et visera des modifications graduelles à long terme[Management of overweight children and adolescents] The rising prevalence of obesity among children and adolescents raises the question as to how to treat these children in an optimal manner. While most obese children exhibit no specific medical disorder responsible for their obesity, they do, in fact, suffer from obesity-related co-morbidities. This highlights the need for an early identification and appropriate management of overweight children, which should involve the entire family