Introduction:Recent data show that the prevalence of diabetes among children and adolescents is increasing in some ethnic groups. The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of type 2 diabetes (T2D) in youth.Methods:The aim of this study was to describe the baseline characteristics of children and adolescents diagnosed ≤18 years who had features of T2D and presented at Changing Diabetes in Children, Paediatric Diabetes Clinic at Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine, and Metabolic Disorders. All patients who were newly diagnosed and came to the clinic from March 2011 to March 2015 were included.Results:Among 939 newly registered patients, 77 (8%) had a diagnosis of T2D. The age at diagnosis was 9–10 years in 11 patients (14%), 11–14 years in 46 (60%) and 15–17 years in other 20 patients (26%). Majority of the children had a positive family history of T2D (94%) and 58% were obese. Median fasting insulin (27.9 [17.3–99.3]) was high in 76% patients. Insulin was started initially along with metformin in 40 patients and could be stopped in six patients in 3 months.Conclusion:Our study reflects that T2D is emerging as a problem in children and adolescents in Bangladesh.

Background:Fasting (Sawm) during Ramadan, one of the five pillars of Islam is obligatory for all healthy adult and adolescent Muslims from the age of 12 years. Some children with diabetes, despite their exemption insist on fasting in Ramadan. We evaluated the safety of fasting among children with type 1 diabetes.Materials and Mathods:A prospective observational study was designed for diabetic children and adolescents who wish to fast during Ramadan 2012. Patients with their caregivers were given intensive education and instructions were provided by diabetic educators, dieticians and physicians on insulin adjustment, home blood glucose monitoring and dietary adjustments prior to Ramadan.Results:A total of 33 children and adolescents were included in this study. Of these, 16 were male and 17 were female. Majority (60.6%) of the patients could complete their fasting during the Ramadan. Patients were divided into two groups, those who completed fasting were considered as Group-I, whereas patients who broke the fast were in Group-ll. Blood glucose, hemoglobin A1c weight, and insulin dose before and after Ramadan in two groups showed no significant difference.Conclusion:Children older than 11 years of age with type 1 diabetes mellitus with conventional twice-a-day regimen can fast safely during Ramadan provided they have proper education and intensive follow-up during Ramadan.

Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characteristics and outcomes related to neonatal jaundice in Bangladesh has not been studied so far. This study addressed the outcomes, characteristics and risks of the jaundiced newborn admitted into hospital. The babies who had significant jaundice and required phototherapy and /or exchange transfusion were investigated. A detailed history of delivery with gestational age was noted and clinical examination of the admitted newborn was done. Birth weight was recorded. The investigations included complete blood count, ABO and Rh compatibility, serum bilirubin, glucose 6 phosphate dehydrogenase (G6PD), thyroid stimulating hormone (TSH) and ultrasonography (USG) of brain. The newborns were closely monitored for the prognosis. The requirement of individualized phototherapy and exchange transfusion were also noted. Finally, the outcomes were recorded. Overall, 60 (m v. f = 58.3 v. 41.7%) newborns were found who developed significant jaundice and were investigated. Of them, 35% had gestational age less than 32wks and only 32% had equal to or greater than 35wks. Regarding delivery, 83.3 % had the history of caesarean section. ABO-and Rh-incompatibilities were found in 13.3% and 3.3%, respectively. Septicemia was diagnosed among 26.7% though blood culture yielded growth only in 20%. Compared with the higher gestational age-group (≥ 35 wks) the lower group (<32 wks) showed significantly higher rate of septicemia (12.5 v. 68.8%, p<0.005). G6PD deficiency was found in only one (1.7%) case. Birth asphyxia was found as a concomitant factor in three patients. Exchange transfusion was done only in 2 (3.3%) babies. Among them one was preterm IDM with septicemia and other had G6PD deficiency. None of these babies developed kernicterus. Five (8.3%) babies died, all of them had septicemia and one baby also had intraventricular hemorrhage (IVH) with PDA. The study revealed that a substantial number of neonatal jaundice had the history of lower gestational age in Bangladeshi newborns; and the lower gestational age is significantly associated with septicemia and possibly with hyperbilirubinemia. More study is needed to establish the study findings.Ibrahim Med. Coll.

Introduction:The prevalence of childhood obesity has increased over the last two decades. Obesity is a major risk factor for chronic diseases and plays a central role in insulin resistance or metabolic syndrome.Methods:The aim of the study was to assess the prevalence of obesity and abdominal obesity by means of body mass index (BMI) and waist-to-height ratio (WHtR) in adolescent girls in a district school in Bangladesh. Based on age and sex specific BMI percentiles, the students were classified as normal weight (5th–<85th percentile), overweight (85th–<95th percentiles), and obese (≥95th percentile). Central obesity was categorized as WHtR ≥ 0.5. Adolescent girls (aged 9–17 years) attending the sixth to twelfth grades (n = 501) in a Bengali medium school participated in the study.Results:The prevalence of obesity and overweight were 23% and 14% among the girls. The prevalence of central obesity was 26%. Around 14% of girls in the normal weight group were centrally obese. There was a significant relationship between WHtR and BMI status (P = 0.0001).Conclusion:Our study provides evidence showing a high prevalence of overall and central obesity in adolescent girls in our population. We emphasize the need for further large scale surveillance programs and preventive strategies in our population to reduce the incidence of obesity.

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