A decade of improved glycemic control in young children with type 1 diabetes : A population-based cohort study

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

Governance hurdles for expansion of low trophic mariculture production in Sweden

The study examines the governance of low trophic species mariculture (LTM) using Sweden as a case study. LTM, involving species such as seaweeds and mollusks, offers ecosystem services and nutritious foods. Despite its potential to contribute to blue growth and Sustainable Development Goals, LTM development in the EU and OECD countries has stagnated. A framework for mapping governance elements (institutions, structures, and processes) and analyzing governance objective (effective, equitable, responsive, and robust) was combined with surveys addressed to the private entrepreneurs in the sector. Analysis reveals ineffective institutions due to lack of updated legislation and guidance, resulting in ambiguous interpretations. Governance structures include multiple decision-making bodies without a clear coordination agency. Licensing processes were lengthy and costly for the private entrepreneurs, and the outcomes were uncertain. To support Sweden’s blue bioeconomy, LTM governance requires policy integration, clearer direction, coordinated decision-making, and mechanisms for conflict resolution and learning.QC 20240613</p