It is concluded that infants with PWS may have central sleep-disordered breathing, which, in some children, may cause frequent desaturations. Improvements in CAI and CEI as well as oxygenation were noted with O2 therapy. Longitudinal work with this patient group would help to establish the timing of onset of obstructive symptoms.

Background:  There is considerable evidence supporting the role of vitamin D deficiency in the pathogenesis of type 1 diabetes mellitus (T1DM). Vitamin D deficiency is also associated with impairment of insulin synthesis and secretion. There have been no formal studies looking at the relationship between 25(OH)‐vitamin D3 and the severity of diabetic ketoacidosis (DKA) in children at presentation with T1DM. Objective:  To determine the relationship between measured 25(OH)‐vitamin D3 levels and the degree of acidosis in children at diagnosis with T1DM. Subjects:  Children presenting with new‐onset T1DM at a tertiary children’s hospital. Methods:  25(OH)‐vitamin D3 and bicarbonate levels were measured in children at presentation with newly diagnosed T1DM. Those with suboptimal 25(OH)‐vitamin D3 levels (<50 nmol/L) had repeat measurements performed without interim vitamin D supplementation. Results:  Fourteen of the 64 children had low 25(OH)‐vitamin D3 levels at presentation, and 12 of these had low bicarbonate levels (<18 mmol/L) (p = 0.001). Bicarbonate explained 20% of the variation in vitamin D level at presentation (partial r2 = 0.20, p < 0.001) and ethnic background a further 10% (partial r2 = 0.10, p = 0.002). The levels of 25(OH)‐vitamin D3 increased in 10 of the 11 children with resolution of the acidosis. Conclusions:  Acid–base status should be considered when interpreting 25(OH)‐vitamin D3 levels in patients with recently diagnosed T1DM. Acidosis may alter vitamin D metabolism, or alternatively, low vitamin D may contribute to a child’s risk of presenting with DKA.

Our result suggests that CAI is rare in children with PWS.

Prader-Willi syndrome (PWS) is a chromosomal disorder and growth failure is a common presentation. Growth hormone (GH) treatment is beneficial in PWS although the optimal age for starting GH is unknown. We investigated whether GH response in PWS was associated with the age of GH commencement by comparing 16 children who commenced GH before 3 years of age (early group) with 40 children who commenced GH after 3 years of age (late group) from the Ozgrow database. Height SDS, body mass index (BMI) SDS, bone age (BA)-chronological age (CA) ratio, change in height (Δ Ht) SDS and change in BMI during 4 years of GH treatment were compared between the groups. The early group had better height SDS and Δ Ht SDS. BA delay was more pronounced in the early group but BA did not mature beyond CA with GH therapy in either group. Although the initial GH dose for the early group was lower than that of the late group, the former had better height outcome. The starting GH dose seen in the database is lower than the dose used by international centres.

Aim To determine patient/carer expectations of continuous glucose monitoring (CGM) and short‐term satisfaction, to assess the efficacy of CGM in improving: fear of hypoglycaemia and glycaemic control (HbA1c, ketosis, hypoglycaemia) and to determine time requirements of diabetes clinic staff in commencing and administering CGM. Methods We assessed CGM‐naïve patients starting on CGM at a Sydney Diabetes Centre following the introduction of a nationwide government subsidy for CGM. A standardised questionnaire was administered collecting demographic and glycaemic information in addition to Likert scale assessment of expectations and satisfaction. Clinic staff reported time dedicated to CGM education, commencement and follow‐up. Results A total of 55 patients or parents/carers completed baseline questionnaires, with 37 completing a 3‐month follow‐up questionnaire. There were high expectations of CGM prior to commencement and high satisfaction ratings on follow‐up. CGM improved fear of hypoglycaemia, and total daily insulin dose increased after commencement of CGM. There was a trend towards lower HbA1c that was not statistically significant and no statistically significant reduction in ketosis or hypoglycaemia. Comments were mostly positive, with some concern raised regarding technical issues and a lack of subsidy after 21 years of age. Staff time requirements were substantial, with an estimated average of 7.7 h per patient per year. Conclusions Patients and families have high expectations of CGM, and satisfaction levels are high in the short term. Total insulin delivery increased after CGM commencement. Time requirements by staff are substantial but are worthwhile if families' overall satisfaction levels are high.