Showing posts with label children. Show all posts
Showing posts with label children. Show all posts

Saturday, 24 October 2026

How common is delayed type 1 diabetes diagnosis in children?

From diabetesincontrol.com

A delayed type 1 diabetes diagnosis can allow early warning signs to progress into a medical emergency. Yet children with excessive thirst, frequent urination, and unexplained weight loss may leave healthcare visits without the correct diagnosis. Why do these familiar symptoms go unnoticed? A scoping review of 27 studies reveals troubling gaps in clinical recognition, testing, and diabetes classification. The findings highlight opportunities for healthcare professionals to identify type 1 diabetes earlier and reduce potentially preventable diabetic ketoacidosis (DKA).

What Research Reveals About Delays in Diagnosing Type 1 Diabetes

A scoping review published October 12, 2026, in BMC Paediatrics examined delayed diagnosis and misdiagnosis among children and adolescents with type 1 diabetes. Researchers analysed 27 studies selected from 1,936 screened records.

The published scoping review reported substantial variation in diagnostic delays across healthcare settings.

Among studies that did not separate patients by DKA status, delayed diagnosis occurred in 14.1% to 46.6% of cases. Meanwhile, 16.0% to 38.7% of patients had their diagnosis missed during their first healthcare contact.

For patients presenting with DKA, reported diagnostic delays ranged from 43.0% to 98.1%. However, these figures reflect different study populations, definitions, and measurement methods.

Importantly, they should not be interpreted as a single overall rate of missed diagnoses.

The review also identified diabetes-type misclassification rates ranging from 1.4% to 22.7%.

Together, these findings suggest that diagnostic uncertainty remains a significant challenge in paediatric diabetes care. Furthermore, the review identified missed symptoms, incorrect symptom interpretation, and problems with laboratory testing as recurring clinical errors.

Common Type 1 Diabetes Symptoms Clinicians May Overlook

Early type 1 diabetes symptoms can resemble common childhood illnesses. Consequently, healthcare professionals may initially consider other explanations.

Frequent urination may be mistaken for a urinary tract infection. Increased thirst can appear related to warm weather, exercise, or dehydration. Similarly, fatigue and weight loss may be attributed to infection, stress, or changing eating habits.

However, these symptoms become more concerning when they appear together.

Classic warning signs include excessive thirst, frequent urination, night-time bedwetting after previously staying dry, unexplained weight loss, increased hunger, and persistent tiredness.

Younger children may present additional diagnostic challenges because they cannot clearly describe their symptoms.

As insulin deficiency progresses, nausea, vomiting, abdominal pain, and rapid breathing may develop. Unfortunately, these symptoms can resemble gastrointestinal or respiratory illnesses.

Because these symptoms overlap with other childhood illnesses, clinicians may overlook type 1 diabetes, particularly when blood glucose testing is not performed.

For healthcare professionals, symptom patterns matter more than any single complaint. A child with unusual thirst, frequent urination, and weight loss warrants prompt diabetes evaluation, even when another illness seems possible.

Why Diagnostic Mistakes and Diabetes Misclassification Matter

Missing the initial diagnosis is only one concern. Incorrectly identifying the type of diabetes can also delay appropriate treatment.

The review found that type 1 diabetes and type 2 diabetes were sometimes confused, particularly when clinical presentations were unusual.

For example, clinicians may associate excess body weight with type 2 diabetes. However, children with overweight or obesity can also develop autoimmune type 1 diabetes.

Conversely, some young patients with type 2 diabetes may present with ketosis or DKA. Therefore, neither body weight nor DKA alone establishes diabetes type.

The 2024 ISPAD clinical guidelines emphasize evaluating clinical characteristics and pancreatic autoantibodies when distinguishing diabetes types.

Tests for GAD65, IA-2, and other islet autoantibodies can support classification when appropriate. C-peptide testing may also help assess insulin production in the right clinical setting.

However, clinicians should not delay urgent insulin treatment while awaiting classification results in a patient with suspected significant insulin deficiency.

Misclassification can lead to inappropriate treatment decisions and prolonged hyperglycemia. In severe cases, insufficient insulin treatment may contribute to DKA.

Previous Diabetes in Control coverage of type 1 diabetes diagnosis similarly emphasized that autoimmune diabetes can occur in patients with obesity.

These findings reinforce the importance of clinical assessment rather than assumptions based on appearance or age.

How Earlier Recognition Can Help Prevent Diabetic Ketoacidosis

Avoiding delays in diagnosing type 1 diabetes starts with recognizing warning signs and ordering timely glucose testing.

For children with classic symptoms, prompt blood glucose assessment provides a practical starting point. Point-of-care glucose testing can identify concerning hyperglycaemia immediately, while laboratory plasma glucose testing supports formal diagnosis.

A random plasma glucose of at least 200 mg/dL (11.1 mmol/L) in a patient with classic symptoms meets established diagnostic criteria.

Additionally, ketone testing is essential when insulin deficiency or DKA is suspected.

Children experiencing vomiting, abdominal pain, dehydration, deep breathing, or altered mental status require urgent evaluation for DKA. Assessment may include blood ketones, electrolytes, and acid-base status.

Importantly, clinicians should not wait for HbA1c results before addressing a suspected metabolic emergency.

Healthcare teams can also reduce diagnostic errors by improving communication between primary care, emergency departments, and paediatric diabetes specialists.

Clear referral pathways and documented follow-up plans may help prevent patients from being lost between appointments.

Patient and caregiver education remains equally important.

Families should understand that persistent thirst, frequent urination, and unexplained weight loss are not symptoms to ignore.

Earlier recognition may allow treatment before serious metabolic deterioration develops. Indeed, previous Diabetes in Control reporting on pediatric DKA prevention highlighted the value of symptom education and structured monitoring.

Although the scoping review did not establish how many DKA cases could be prevented, its findings identify important opportunities to improve clinical practice.

Conclusion

When type 1 diabetes goes unrecognized, children and adolescents face a greater risk of serious complications, including diabetic ketoacidosis.

The 27-study scoping review demonstrates that missed symptoms, inconsistent testing, and incorrect diabetes classification can contribute to diagnostic uncertainty and treatment errors.

For clinicians, the message is clear: recognize classic symptom patterns, assess glucose promptly, investigate possible DKA, and avoid relying on assumptions about diabetes type.

Better awareness, timely testing, and coordinated care may help patients receive appropriate treatment before preventable complications develop.

Frequently Asked Questions

1. What are the most commonly missed symptoms of type 1 diabetes?

Frequent urination, excessive thirst, unexplained weight loss, fatigue, and new bedwetting are important warning signs. These symptoms may be mistaken for other childhood conditions, especially when they develop gradually.

2. How common is delayed type 1 diabetes diagnosis in children?

The 2026 scoping review reported delayed diagnosis in 14.1% to 46.6% of cases in studies without DKA stratification. Rates varied significantly across populations and study methods.

3. Can type 1 diabetes be mistaken for type 2 diabetes?

Yes. Type 1 diabetes can occur in children with overweight or obesity. Clinical assessment and appropriate antibody testing can help clinicians distinguish between diabetes types.

4. Why does a missed diagnosis increase the risk of DKA?

Without sufficient insulin, the body breaks down fat and produces ketones. Rising ketone levels can cause dangerous blood acidity, dehydration, and life-threatening complications. Prompt diagnosis and treatment reduce the opportunity for this deterioration.

5. What should clinicians do when they suspect type 1 diabetes?

Healthcare professionals should promptly assess blood glucose, evaluate ketones when indicated, and arrange urgent specialist care when diabetes or DKA is suspected. Treatment of metabolic emergencies should never be delayed while awaiting diabetes-type classification.

This content is not medical advice. For any health issues, always consult a healthcare professional. In an emergency, call 911 or your local emergency services.

https://www.diabetesincontrol.com/delayed-type-1-diabetes-diagnosis-missed-symptoms/ 

Monday, 14 September 2026

How parents fuel diabetes and obesity in children with poor food choices

From punchng.com

By Janet Ogundepo 

From the first meal of the morning to school break and after-school snacks, biscuits, sweets, sugary drinks and other packaged foods have become a regular part of many Nigerian children’s diets. While parents cite convenience, affordability, availability and children’s preferences, child health experts warn that frequent consumption of such foods increases children’s risk of diabetes and obesity. JANET OGUNDEPO reports

“My boy can drink six packs of a children’s-sized juice in a day,” a baker and mother of two, identified only as Boluwatife, said.

The 150ml juice has become a pacifier for her 18-month-old son, who gets it whenever he becomes restless, allowing her to focus on her tasks.

When Boluwatife’s children wake up, she gives them a cup of water and a healthy breakfast, but the day is filled with consuming several wraps of biscuits, sweets, and drinks.

In their lunchbox, the baker packs several snacks and drinks alongside the homemade food she carefully prepares for her four- and one-year-olds.

But the mother of two has begun to notice that the frequent consumption of the snacks and drinks is affecting her son’s eating habits.

“He eats less and takes junk food frequently. He does not eat normal nutritional food; he now prefers snacks,” she said.

Although Boluwatife told PUNCH Healthwise that she ensures her children eat fruit daily, she described their consumption of packaged snacks as “too much.”

Despite the quantity of these products her children consume, the baker and mother of two said she has never checked the nutritional value.

Instead, she checks only the “production and expiry dates.”

Unarguably, because Boluwatife does not check the nutritional value of each packed and processed juice and snack her children consume, she is unaware of how much sugar her under-five-year-olds consume.

Illness after consuming unnamed drink

Sometime in May 2026, a mother of three and resident of Yaba in Lagos State, Mrs Ada Chukwuka, noticed her four-year-old son had been using the toilet frequently. She wondered what had caused the loose stool and runny stomach.

After asking her 10-year-old about what her youngest child had bought as snacks on his way to school, she learned of an unbranded juice the child had bought.

Chukwuka eventually went to the store where the children had bought the juice, and she discovered that the product was unbranded and unnamed, leaving her in the dark about the ingredients, nutritional value, production and expiry dates and the manufacturer’s location.

The Yaba resident told PUNCH Healthwise that her pre-schooler suffered from diarrhoea for four days and she had to take him to the hospital as he began to appear weaker by the day.

That episode brought fear into her heart about the safety of what her children consumed, but the ease of getting the snacks and the more time it affords her to engage in personal tasks are perks that have hindered her from weaning her children off the snacks.

“I wonder how this drink got into the stores of those who usually sell things to children. I was really bothered when I saw the colour of the drink and package,” the Yaba resident said.

What WHO says

The World Health Organisation recommends that children limit their daily intake of free sugars to less than 10 per cent of their total energy intake, with an ideal target of below 5 per cent for additional health benefits.

Furthermore, WHO and paediatric guidelines advise that children under 2 years of age should not consume any sugar-sweetened beverages or foods with added free sugars.

The agency noted that consumption of free sugars is a major risk factor for overweight, obesity and dental caries.

Findings by PUNCH Healthwise reveal that many children’s products contain sugar, sometimes above the recommended threshold by regulators.


Convenience fuelling intake

Some Nigerian mothers who spoke with PUNCH Healthwise said that biscuits, sweets, sugary drinks and other packaged snacks have become an easy answer when children are hungry, restless, throwing tantrums or simply demanding a treat.

For some, the products are convenient school snacks, while others use them as rewards for good behaviour, to pacify children or keep them occupied.

But as the snacks become a regular part of children’s routines, some mothers are noticing that their children are beginning to eat less of their proper meals.

For a remote worker in Lagos, Victoria Nwahiri, packaged snacks are a regular feature of her three-year-old daughter’s school lunchbox.

The child eats cereal or bread and tea for breakfast before leaving home. At school, her lunch may include rice, spaghetti or noodles with fish and egg, accompanied by biscuits and juice.

When she returns home, she eats whatever the family is having, including swallow and soup, akara and bread or rice.

But while her mother is conscious of the contents of some packaged foods, she admits that convenience, price and her daughter’s preference influence what goes into the child’s lunchbox.

Nwahiri said she checks nutritional information on food packs but does not always check for the National Agency for Food and Drug Administration and Control number.

“I checked for the nutritional value information, but NAFDAC number no,” she said.

The mother said she was aware that some packaged foods contain unhealthy sweeteners that could harm children when consumed excessively.

“Yes, I do,” she responded when asked if she knew about the potential harm from unhealthy sweeteners.

Despite this awareness, her daughter consumes biscuits, juice, and other packaged snacks during school days, with such foods going to school with her about five days a week.

Nwahiri also admitted that she sometimes uses juice or similar treats to pacify her daughter.

“A time it happened was when she came across the pack of juice and insisted I give her one of them. I had to, because she wouldn’t stay still,” she said.

A mother of one and entrepreneur, Sabirat Murtala, said her child eats biscuits every day, while sweets and sugary drinks are given less frequently.

She said convenience and availability were major reasons she relied on packaged snacks, particularly when her child was throwing tantrums.

“I think what made the package attractive is the convenience and definitely the availability, because I can easily buy it and keep it in the house to give to the child any time he throws a tantrum or just to keep him busy,” she said.

The Alimosho resident said the child’s typical day begins with milk, followed by pap, while biscuits or sweets may be taken in the afternoon. Other meals include plantain porridge or other solid food prepared at home, with biscuits or cheeseballs sometimes served as evening snacks.

Murtala said the child also eats eggs, cereal at night and drinks water between meals.

Another mother, who identified herself as Adedoyin, a stay-at-home mother living in Port Harcourt, also said convenience influenced her decision to give her children packaged snacks.

She said her children take pap and milk before school, eat rice for their morning meal, and may have leftover rice, yam, beans or pasta for lunch, while dinner is usually eba with vegetables.

However, she said packaged snacks remained part of their school-day routine.

“Every school day. We no longer take juice,” she said when asked how often her children consumed biscuits, sweets, sugary drinks or other packaged snacks.

Adedoyin admitted that she sometimes uses snacks as a reward.

“When I’m going out, I promise to buy them snacks, if they don’t quarrel before my return,” she said.

Adedoyin said she was concerned that her children could feel excluded because other children consumed packaged snacks.

“Other kids take them in school, and I don’t want my kids to feel left out,” she said.

Adedoyin recalled an incident involving a small yoghurt drink in a blue package she gave her “first son. He vomited and purged for 2 days.”

Adedoyin, however, said she does not check the nutritional information of whatever snacks she gave her children, adding that she was aware that some packaged foods and drinks could contain unhealthy sweeteners.

For Mrs Temitope Olamide, a self-employed businesswoman who lives in Asese, packaged snacks serve a different but equally familiar purpose.

Olamide, who has a nine-year-old son and a one-year-old daughter, said she gives her children biscuits, sweets and drinks but tries to limit their intake because she knows that some of the products may contain unhealthy sweeteners.

“Yes, I know. That is why I didn’t give them essence. I used to give them once a day,” she said.

Her children’s day begins with breakfast such as custard, tea and bread. She prepares meals such as rice and plantain for school and adds biscuits or cookies to their lunchboxes.

At home, she may give them bread and butter after school before preparing dinner for the family.

Although she said the children eat proper meals, snacks have become part of their school routine, particularly during break periods.

“At home, I used to give them once,” she said, adding that they consume more snacks while in school.

Olamide also gives her children pocket money and says she instructs them on what they can buy. However, she acknowledged that children could still use the money to buy snacks while at school.

Her decision to include snacks in her children’s routine is partly driven by a desire to ensure they do not feel excluded when they see other children eating them.

She explained that snacks were often treated as refreshments after meals rather than substitutes for food.

According to the mother, the school’s short break has also become associated with snack consumption.

She added that buying snacks is also a way of making her children happy and strengthening the bond between them.

“It makes them happy, and it fosters closeness to their mother,” she said.

What NAFDAC says

The National Agency for Food and Drug Administration and Control Marketing of Foods and Non-Alcoholic Beverages to Children Regulations 2024 sets nutrient thresholds for foods and beverages marketed to children.

Under the regulation’s nutrient profile model, marketing is prohibited where products exceed specified sugar thresholds per 100g or 100ml, depending on the category.

It sets the threshold for total sugars in chocolate and sugar confectionery, energy bars, sweet toppings and desserts, cakes, sweet biscuits, pastries and other sweet bakery products, including cookies and breakfast biscuits, to 6g per 100g.

It adds that for breakfast cereals, the total sugar threshold is 9g per 100g, for 100 per cent fruit and vegetable juices and smoothies, the threshold is 6g per 100g, while for water-based flavoured and unflavoured drinks, including carbonated and non-carbonated soft drinks, juice drinks, powdered juices, concentrates and syrups, the total sugar threshold is 0g.

NAFDAC noted that the regulation was set to discourage the marketing of beverages containing added sugar to children.

However, findings by PUNCH Healthwise reveal that while some juice drinks explicitly list sugar, acesulfame-K and sucralose among their ingredients, the nutritional information panels examined by PUNCH Healthwise provide the total carbohydrate content without a separate declaration of the sugar quantity.

The absence of a separate sugars figure makes it difficult for parents to determine how much sugar a particular drink contains from the nutritional information provided on the pack. Consequently, parents may be unable to accurately quantify the amount of sugar their children are consuming from the drinks.

As children return to school for the new academic session tomorrow, child and nutrition experts have urged parents to be conscious of what they put in their children’s lunch boxes.

Sugar drinks expose children to obesity, diabetes — Paediatrician

A Professor of Paediatrics at the University of Ilorin, Kwara State, Aishatu Gobir, warned that regular consumption of sugary beverages and highly processed snacks could predispose children to obesity and diabetes, while also shaping their food preferences from an early age.

Gobir explained that many beverages and snacks contain refined sugar, which could condition children’s taste buds and increase their preference for sugary foods.

“Many beverages and snacks in the market contain sugar that helps to condition the taste buds of children and increase their consumption of sugar. From an early age, giving children these drinks can predispose them to obesity and diabetes,” she said.

The paediatrician said once a child became overweight or obese, reduced physical activity could worsen the risk of developing diabetes, heart disease and arthritis.

She noted that children tended to develop a preference for foods they were regularly exposed to, urging parents to encourage the consumption of fruits and vegetables instead of sugary and highly processed foods.

“It is what the children are fed with that they grow to love. Feeding them sugary foods will make them love them and leave out healthy fruits and vegetables that are better for their guts and systems,” Gobir said.

She also warned against keeping children indoors for prolonged periods, particularly while consuming high-calorie foods and engaging in sedentary activities such as playing video games.

“Parents should remember that children need to be physically active so as to burn calories. Feeding them high calories and keeping them indoors playing games increase health risks,” she said.

Gobir said paediatricians were concerned about the rising incidence of diabetes, overweight and obesity, and heart disease among children, adding that diet and lack of exercise appeared to be major factors behind the changes.

She described the fast-food culture, characterised by refined sugar and fried foods, as a driver of metabolic syndrome in Africa, noting that the continent faced a double burden of obesity and malnutrition.

Gobir advised parents of children aged two to five to provide two snack times between meals, preferably using healthier options such as fruits and vegetables.

She said biscuits, chocolates and candy bars should be occasional treats rather than foods routinely stocked at home.

“An occasional snack will do no harm,” she said, advising parents to be particularly mindful of their children’s diets if there was a family history of diabetes, heart disease or obesity.

The paediatrician suggested that a child’s lunchbox could contain rice with fish, meat or chicken, alongside portions of carrots, lettuce and avocado, as well as a banana or an apple.

She urged parents to prioritise healthy foods and dedicate time to preparing nutritious meals for their families, noting that children’s eating behaviour was influenced by family choices.

“The eating behaviour of the children is influenced by family choices,” she said.

Gobir also cautioned parents against relying solely on food labels when choosing packaged foods for children.

“The labels may not offer much information that might help parents. If people have access to vegetable- and fibre-based biscuits and fresh juices, they are better,” she said.

She further advised parents to limit children’s sugar consumption, noting that aside from the calories consumed, repeated exposure to sugary foods could condition children’s taste buds and influence their later food choices.

She also clarified that children may appear unusually active after consuming sugary foods and drinks, sometimes described as a “sugar rush”, but said this should not be confused with hyperactivity disorder, which has specific diagnostic criteria.

Sugar starts a cycle of unhealthy eating — Paediatrician

For children, particularly those under two, the safest approach is to avoid added sugar altogether, according to consultant paediatrician and child health advocate, Dr Ayodele Renner.

Renner said although completely eliminating sugar from children’s diets could be difficult for many families, parents should minimise their children’s consumption of sugary drinks, sweets and other products containing added sugar.

He explained that introducing children to sugary foods early could shape their taste preferences, making them increasingly inclined towards sweetened foods.

“Once a parent begins to give sugar to their children, the children develop a preference for sugary things, so their taste preference tilts towards sugary things,” he said.

According to the paediatrician, excessive consumption of sugary foods and drinks can contribute to childhood obesity, which can in turn increase the risk of several health problems, including early-onset type 2 diabetes, hypertension and metabolic syndrome.

He noted that the consequences could extend beyond childhood, with unhealthy dietary patterns potentially contributing to non-communicable diseases later in life.

Renner also dismissed the belief that children could consume as much sugar as they wanted because their high activity levels would enable them to burn off the calories.

“Children have high metabolism and high energy expenditure, that’s correct, but there is still the risk that they actually have a calorie excess if they consume a lot of sugary and sweet things,” he said.

He advised parents not to assume that every child would burn off excess calories through play, noting that individual children have different energy needs.

Beyond obesity and metabolic problems, Renner said excessive sugar consumption could also affect children’s oral health and contribute to tooth decay. He further linked childhood obesity with other physical and psychological consequences, including early-onset osteoarthritis, anxiety, depression and bullying.

He urged parents to avoid keeping sugary snacks readily available at home, saying easy access could encourage children to consume them more frequently.

“What children don’t see, they will not eat,” he said, advising parents to keep sugary treats to a minimum and avoid using them as rewards for good behaviour.

He also encouraged caregivers to read food labels and pay attention to the amount of sugar contained in products before giving them to children.

Excess sugar can displace healthy foods

The Assistant Director of Dietetics at the Lagos State Health Service Commission, General Hospital, Badagry, Olusola Malomo, also identified excessive consumption of sugary foods and drinks as a concern for children’s health.

Malomo said while sugar could provide quick energy, excessive consumption could have several disadvantages, particularly when sugary products become a regular part of a child’s diet.

He said repeated consumption of sweet foods could make children develop a preference for sweet-tasting foods, particularly when parents use sweets and other sugary products as rewards.

The dietician-nutritionist linked excessive sugar intake with weight gain and childhood obesity, noting that the problem was no longer restricted to urban areas or affluent families.

According to him, childhood obesity could predispose children to conditions including diabetes and hypertension, while severe obesity could also place additional strain on body organs.

He also highlighted tooth decay as another consequence of excessive sugar consumption.

“Sugar feeds bacteria in the mouth, and it creates an acid that destroys the teeth enamel,” Malomo said.

Another concern, he said, was that sugary snacks could fill children up without providing the vitamins, minerals, proteins and other nutrients they need from healthier meals.

“When they eat sugary things, they tend to skip their meals. It tends to skip healthy meals,” he said.

Malomo explained that when children regularly fill up on sugary, nutrient-poor foods, they could develop a pattern of avoiding more nutritious foods.

He further noted that excessive sugar intake could be followed by an energy crash, leaving some children dull or moody after the initial increase in energy.

The dietician-nutritionist urged parents to focus on healthier options, including fruits, vegetables, milk, nuts and naturally sweet foods such as dates.

He said foods such as pineapple and watermelon could be packed as alternatives to sweets and other sugary snacks, while yoghurt could also serve as an alternative.

Parents need to read labels

The nutritionist stressed the importance of parental awareness when choosing packaged foods for children.

Malomo said consumers needed to pay attention to nutritional labelling on processed foods, including information on calories, sugar, carbohydrates and fats.

He noted that understanding the information on food labels could help parents determine what their children were consuming.

He also called for increased consumer education and awareness in schools, faith-based organisations and communities.

Malomo further urged regulators and manufacturers to pay greater attention to the sugar content of food products targeted at children and called for stronger enforcement to protect consumers.

https://punchng.com/how-parents-fuel-diabetes-obesity-in-children-with-poor-food-choices/?amp

Saturday, 22 August 2026

Attaining a healthy weight range linked to lower risk of type 1 diabetes progression

From medicalxpress.com

A Baylor College of Medicine-led team found that moving into a normal weight range was associated with about half the risk of progressing to clinical type 1 diabetes (T1D), particularly in youth. This observational study, published in Diabetes Care, was conducted in individuals with early signs of type 1 diabetes.

"T1D is an autoimmune disease in which the body's immune system attacks the insulin-producing cells of the pancreas, called islets of Langerhans," said first and corresponding author Dr. María Redondo, professor of paediatrics in diabetes and endocrinology at Baylor College of Medicine and Texas Children's Hospital. "Without insulin, cells in the body cannot use sugar circulating in the blood for energy, which can lead to diabetic ketoacidosis, a life-threatening complication, and potentially death if untreated. Over the long term, T1D can also increase the risk of complications affecting the eyes, kidneys, nerves, heart and blood vessels."

Redondo and her colleagues examined whether, among individuals with overweight or obesity who were already at increased risk for T1D, subsequent normalization of body mass index (BMI, measured as weight relative to height) was associated with a different risk of progression to clinical T1D.

                                                    Graphical Abstract. Credit: Diabetes Care (2026). DOI: 10.2337/dc26-083

Major advances now allow people at increased risk for T1D to be identified years before symptoms appear and, in some cases, to receive an approved therapy to delay the onset of clinical disease. One way to identify people at risk is by measuring islet autoantibodies in the blood, as they are evidence of the autoimmune process that destroys islet cells. However, despite the advances, outcomes remain suboptimal and additional approaches to delay disease progression are needed.

Previous studies, including some led by Redondo, have linked higher BMI with more rapid progression toward T1D. However, it has been unclear whether subsequent BMI normalization is associated with lower risk of disease progression.

In this study, Redondo and her colleagues studied 833 participants in the TrialNet study, which is focused on preventing T1D. The participants included children and adults who had islet autoantibodies and who were overweight or obese when they entered the study.

"We followed the participants for about 4 years," Redondo said. "In this period, about 27% of participants moved from the overweight or obese range into the normal BMI range. As we had hypothesized, people who achieved a normal BMI had about a 48% lower risk of progressing to clinical T1D compared with those who remained overweight or obese."

The association was most evident in children and adolescents. The strongest associations were seen in boys younger than 12 years and girls ages 12–17. In adults, however, BMI normalization was not clearly associated with lower risk of progression to T1D. The researchers are investigating factors that may explain this difference.

Since this is an observational study, the findings do not establish that lowering BMI will prevent or delay T1D. "Our study shows an association, not causation," Redondo said. "The findings provide a strong rationale for a prospective intervention trial to determine whether intentionally promoting a healthy BMI trajectory can alter progression of T1D." Importantly, in children, reaching a normal BMI range does not necessarily mean losing weight; it can also happen when weight gain slows or stabilizes as the child grows taller.

Other contributors to this work include Raquel Gupta, Alejandro F. Siller, Sridevi Devaraj and Ashok Balasubramanyam at Baylor College of Medicine. David Cuthbertson and Kendra Vehik are with University of South Florida, and Heba M. Ismail is with Indiana University.

Publication details

Maria J. Redondo et al, BMI Normalization Is Associated With Lower Risk of Progression to Type 1 Diabetes, Primarily in Youth, Diabetes Care (2026). DOI: 10.2337/dc26-0833

https://medicalxpress.com/news/2026-08-healthy-weight-range-linked-diabetes.html#google_vignette 

Sunday, 14 June 2026

USA: FDA Clears First Over-the-Counter Continuous Glucose Monitor for Children

From fda.gov/news-events

June 12, 2026: The U.S. Food and Drug Administration today cleared for marketing the first over-the-counter (OTC) continuous glucose monitor (CGM) for children, Dexcom Inc.’s Stelo Glucose Biosensor System, an integrated CGM (iCGM) indicated for people two years of age and older who do not use insulin. The FDA previously cleared the Stelo Glucose Biosensor System OTC for individuals 18 years and older in March 2024.

“Children deserve access to the best tools available to manage their health," said Center for Devices and Radiological Health Director Michelle Tarver, M.D., Ph.D. "Today's clearance reflects the FDA's commitment to fostering innovation for paediatric patients and supporting the safe and effective use of medical devices where children live, learn, and play.”

Prediabetes is increasingly impacting children in the United States, placing millions at heightened risk for progressing to Type 2 diabetes. OTC CGMs can play a critical role in addressing this public health concern for paediatric users who do not use insulin. By providing real-time glucose data, these devices can help paediatric patients and their caregivers build greater glycaemic awareness, track patterns in response to meals and exercise, and make informed adjustments to support healthier long-term outcomes and quality of life.

The product is indicated for children, including those with diabetes, who receive oral medication to manage their condition and people who want to understand how diet, exercise, and other lifestyle changes affect their glucose levels.

The Stelo Glucose Biosensor System uses a wearable sensor, paired with an application installed on a compatible smartphone, or other smart device, such as a parent’s or caregiver’s smartphone, to continuously measure, record, analyse and display glucose values. Each sensor lasts for up to 15 days before it must be replaced, although sensor wear time may be shorter in paediatric users than in adults due to several interconnected physiological and behavioural factors. The app displays glucose measurements and trends every 15 minutes. Users and their caregivers should consult their health care provider before making any medication adjustments based on the device’s output.

This clearance is an example of the FDA’s use of real-world evidence (RWE) to support regulatory decision-making. Dexcom and the FDA used previous clinical study data from both paediatrics and adults, along with RWE derived from real-world data on current iCGM use among both groups, to understand expected device performance in paediatric users over the full 15-day wear period.

Participants in the previous study reported mild adverse events including local infection, skin irritation, and pain or discomfort.

For children, the device should be used under the supervision of an adult caregiver. Importantly, this system is not for people with problematic hypoglycaemia (low blood sugar) because it is not designed to alert users when this potentially dangerous condition occurs. This system is also not for people on dialysis. People with a history of disordered eating or eating disorders should talk with their health care provider before using Stelo.

This clearance is also aligned with the FDA’s Home as a Health Care Hub Initiative, which focuses on advancing the development of innovative, patient-centred devices that fit more seamlessly into people’s daily lives at home.

https://www.fda.gov/news-events/press-announcements/fda-clears-first-over-counter-continuous-glucose-monitor-children