This study aimed to assess the impact of recurrent individualized education on the management of hypoglycemia, hypoglycemia awareness, and metabolic control of diabetes in children and adolescents living with type 1 diabetes (T1D). A prospective quantitative study involving participants aged 8 to 18 years with T1D was conducted. Three established hypoglycemia screening tools were employed: the Hypoglycemia Fear Survey (HFS), the Gold Hypoglycemia Awareness Questionnaire, and the Edinburgh Hypoglycemia Symptoms Scale. The participants used blinded continuous glucose monitoring (b-CGM) devices to document glucose values, meals, insulin doses, exercise periods, symptomatic hypoglycemia episodes, and glucose levels during hypoglycemia, experienced symptoms, and treatment approaches for hypoglycemia. Following this initial phase, the participants received education from healthcare professionals. The same procedures were repeated six weeks after the educational intervention. Prior to education, approximately half (n = 21) of the 47 participants were present with impaired hypoglycemia awareness (IHA), and half of the IHA group applied the appropriate hypoglycemia self-treatment. After education, almost all participants demonstrated an improved ability to manage hypoglycemia effectively. Following education, improvements in the frequency of fingerstick glucose measurement per day, time spent within the target glucose range (70–180 mg/dL), glycemic variability (GV), hypoglycemia perception, appropriate hypoglycemia self-treatment, and hypoglycemia fear were observed, both in participants with hypoglycemia awareness and those with IHA. The results indicate that children and adolescents living with T1D benefit from recurrent self-management education. The benefits were observed in both participants with hypoglycemia awareness and those with IHA. Education positively impacts diabetes management and enhances hypoglycemia awareness.

Purpose: It was aimed to compare circulating levels of ghrelin, leptin, peptide YY (PYY), and neuropeptide (NPY) between girls with idiopathic central precocious puberty (ICPP) and prepubertal girls, as well as to evaluate alterations in these hormone levels and body composition during leuprolide acetate treatment in girls with ICPP. Methods: This prospective study was conducted on girls with isolated premature thelarche (IPT), girls with ICPP, and age-matched prepubertal controls. Anthropometric measurements, body composition analysis and appetite-regulating hormone level measurements were performed in each group and also at the 6th and 12th months of the leuprolide acetate treatment for the girls with ICPP. Results: Seventy-three girls participated in the study (24 girls with ICPP, 28 with IPT, and 21 prepubertal controls). No significant differences were observed in ghrelin, leptin, PYY, and NPY levels among the three groups. Leuprolide acetate treatment resulted in increased leptin, decreased PYY and NPY levels, and no significant changes in ghrelin. Despite no significant change in body mass index standard deviation score (BMI SDS), body fat percentage increased during treatment. Conclusion: While appetite-regulating hormones do not seem to directly contribute to precocious puberty pathogenesis, puberty blockade was shown to lead to altered levels of these hormones along with changes in body composition.

The global prevalence of type 1 diabetes mellitus (T1DM) is steadily increasing, particularly among children and young adults. Health-related myths can significantly influence patients’ dietary behaviors and treatment adherence, thereby compromising disease management and metabolic outcomes. This cross-sectional study included 190 adolescents and young adults with T1DM attending a pediatric endocrinology outpatient clinic. Data on demographics, BMI, HbA1c values, and nutrition-related myths were collected through face-to-face interviews. Statistical analyses, including chi-square tests and Spearman correlation coefficients, were performed using SPSS 22.0 software. Logistic regression analysis was conducted to identify independent predictors of metabolic control status (p < 0.05). Participants had a mean diabetes duration of 7.5 ± 4.63 years, with a mean HbA1c of 7.9 ± 1.44%. Approximately 27.0% of adolescents and 20.0% of young adults were overweight or obese. Only 29.0% of individuals had good metabolic control (HbA1c <%7), while 71.0% had HbA1c ≥ 7. An increase in diabetes duration was found to elevate the risk of poor metabolic control by 1.107 times, whereas a higher total number of answers was associated with a 0.696-fold decrease in this risk (p < 0.05). Improved knowledge about nutrition myths is associated with better metabolic control among adolescents and young adults with T1DM. Structured education programs tailored to this population may contribute to improved glycemic outcomes. A multidisciplinary team approach is essential to effectively deliver educational content and reinforce evidence-based dietary practices.

Amaç: Tip 1 diabetes mellitus, insülin eksikliği ve hiperglisemi ile karakterize kronik bir hastalıktır. İyi bir glisemik kontrolün için yaşam boyunca günde ortalama en az sekiz defa kan şekeri ölçümü, sağlıklı besinlerin seçimi, porsiyon kontrolü ve düzenli egzersiz gerekmektedir ve tüm bunlar diyabetli bireylerin birçoğunda kaygıya neden olmakta ve yeme bozuklukları riskini arttırmaktadır. Diabulimia, diyabetli bireylerde, vücut ağırlığında kayıp sağlama amacıyla, kasıtlı olarak insülin dozunu azaltmak ve/veya atlamayı ifade eder. Bu çalışmanın amacı diyabete özgü yeme bozukluğu olan diabulimia açısından riskli adölesanların sıklığını araştırmak, yeme bozukluğu gelişmesi riski ile metabolik kontrol ve vücut kitle indeksi arasındaki ilişkisini değerlendirmektir. Gereç ve Yöntem: Çalışmaya Tip 1 diabetes mellitus tanısıyla izlenen 10-18 yaş arası 129 olgu dahil edildi. Katılımcılara DEPS-R (Diabetes Eating Problem Survey, Diyabette Yeme Sorunları Anketi) yüz yüze uygulandı. Demografik, antropometrik parametrelere ilişkin veriler ve HbA1c değerleri hastaların tıbbi dosyalarından elde edildi. Bulgular: Katılımcıların DEPS-R puanları incelendiğinde riskli olguların %53,2‟si (n=25) kız, %46,8‟i (n=22) erkek, toplamda 47 olguda (%36,4) bozulmuş yeme davranışı riski saptandı. Olgular DEPS-R puanına göre yeme davranışı bozukluğu açısından risksiz ve riskli iki gruba ayrılarak incelendiğinde HbA1c ve vücut kitle indeksi riskli grupta anlamlı olarak yüksek saptandı. DEPS-R skoru ile diyabet yaşı, vücut kitle indeksi ve HbA1c değeri arasında zayıf korelasyon saptandı. Sonuç: Riskli diyabetli bireylerde diabulimia gelişmesini önlemek ve hali hazırda yeme bozukluğu geliştirmiş çocukların saptanmasında rutin tarama önem kazanmaktadır. Bu konu ile ilgili daha fazla çalışmaya ihtiyaç olmakla beraber özellikle açıklanamayan kilo kaybı ve kötü metabolik kontrolde diabulimia olasılığı akılda tutulmalıdır ve etkili tedavi için klinisyenlerin farkındalığı arttırmalıdır

Background: The prevalence of overweight and obesity in young people with type 1 diabetes (T1D) has been increasing despite current advancements in the management of T1D. Objectives: This study aimed to assess the prevalence of overweight/obesity using bioelectrical impedance analysis (BIA) in children and adolescents with T1D and evaluate the validity of new anthropometric indices, which have been recommended for defining overweight and obesity. Methods: A cross-sectional study was performed on subjects with T1D between the ages of 5 and 21 years. The patients' anthropometric measurements were obtained, and Body Mass Index (BMI), waist/height ratio (WHtR), Tri-Ponderal Mass Index (TMI), Body Adiposity Index (BAI), Body Shape Index (ABSI), Body Roundness Index (BRI), Abdominal Volume Index (AVI), and Conicity Index (CI) were calculated. The percentage of body fat (PBF) was measured with BIA. Results: Our study included 133 subjects (48.1% male, 77.4% pubertal) with a median age of 14.0 years (11.3 - 16.5) and a median duration of T1D of 4.5 years (1.5 - 7.3). The prevalence of overweight/obesity was 21.8% according to BMI-SDS and 30.1% according to BIA. BMI-SDS, WC, WHtR, TMI, AVI, BRI, and BAI were effective methods in differentiating overweight/obesity. BMI-SDS demonstrated a sensitivity of 78.79%, a positive predictive value of 72.22%, a negative predictive value of 89.71%, and an AUC of 0.895 at a cut point of 0.63, highlighting its effectiveness in distinguishing overweight/obesity. Conclusions: In children and adolescents with T1D, the prevalence of obesity/overweight identified using BIA was significantly higher compared to BMI-SDS. When reference methods are unavailable, BMI-SDS is the optimal anthropometric method for determining overweight/obesity in this population, independent of sex and puberty. These findings suggest that BMI-SDS can be a reliable alternative for body composition assessment, ensuring accurate identification and management of overweight/obesity in this population.