"Children who get obesity-related diabetes face a much higher risk of kidney failure and death by middle age than people who develop diabetes as adults, a study suggests.

…It involved a group of Indians whom National Institutes of Health researchers have been tracking since 1965. Of the 1,865 participants with Type 2 diabetes, 96 developed it in childhood. The average age of youth-onset diabetes was about 17 years, although the disease was diagnosed in children as young as 3 1/2. During at least 15 years of follow-up, 15, or 16 percent, of those with childhood-onset type 2 diabetes developed end-stage kidney failure or died from diabetic kidney disease by age 55. That compared with 133, or 8 percent, of those who developed diabetes after age 20.

The researchers calculated that the incidence of end-stage kidney failure and death by age 55 was nearly five times higher in people who developed type 2 diabetes before age 20 than in those who developed diabetes in adulthood.”

"Managing diabetes in children and adolescents is most effective when the entire family gets involved.

…Diabetes is stressful for both the children and their families. Parents should be alert for signs of depression or eating disorders and seek appropriate treatment. While all parents should talk to their children about avoiding tobacco, alcohol, and other drugs, this is particularly important for children with diabetes. Smoking and diabetes each independently increase the risk of cardiovascular disease and people with diabetes who smoke have a greatly increased risk of heart disease and circulatory problems.”

The tragedy of Sudden Infant Death Syndrome (SIDS) can strike anywhere. But researchers have known for some time that the risk of such tragedy increases markedly when babies are taken out of the home and placed in non-parental child care. And now a new study indicates that efforts to eliminate the distinctively high SIDS risk of out-of-home child care have achieved little.

Scrutinizing data for all SIDS deaths occurring in 2001 in thirteen geographically diverse states (including California, Idaho, Massachusetts, and Louisiana), scholars from George Washington University (GWU) and the Children’s National Medical Center (CNMC) recently looked with particular care at those deaths occurring in child-care settings. The researchers began their investigation aware that a 2000 study based on 1995-1997 data found that 20.4% of all SIDS deaths for that period had occurred in child-care settings, a percentage that was “much higher than the 7% to 8% that could be expected to occur in organized child-care settings, on the basis of data about child-care attendance.” The researchers wondered if they would see the same pattern in the 2001 data given that the overall incidence of SIDS dropped 53% between 1992 and 2001 and that pediatricians and public health officials invested considerable effort in the last years of the twentieth century in “educating child-care providers about the importance of the supine sleep position [known to reduce the risk of SIDS] and a safe sleep environment.”

Despite all the efforts made to drive down the risk of SIDS in out-of-home child care, the GWU and CNMC scholars conclude that for the year in question the risk of SIDS ran decidedly higher among children in out-of-home child care than among children cared for at home. “In our sample,” the authors of the new study report, “79, or 16.5%, [of SIDS deaths] occurred in various child-care settings.” Since the GWU and CNMC scholars calculate on the basis of 2001 Census Bureau data that only about 8% of SIDS deaths would have statistically been predicted to occur in out-of-home child care that year, the researchers must conclude that “the current percentage [of SIDS deaths occurring in out-of-home child care] is still higher than would be anticipated.”

The reason that out-of-home care continues to markedly elevate the risk of SIDS eludes the researchers. They note that because of successful educational campaigns with child-care workers “sleep position no longer is a significant factor in child-care SIDS death.” What is more, the researchers could see “no significant difference” between at-home care of infants and out-of-home care “with regard to bed sharing, soft bedding, and sleep surface.” Indeed, infants in out-of-home child care are actually “less likely [than infants in at-home care] to experience secondhand smoke exposure, which has been shown in multiple studies to be an important risk factor for SIDS.”

Baffled, the researchers can only remark that “it is unclear why child care places infants at risk for SIDS, when the demographic characteristics and sleep environment suggest that these infants should be at the same and perhaps even lower risk for SIDS.” The researchers’ puzzlement is only deepened by seeing how their results parallel those for a recent Dutch study reporting that “infants who died of SIDS in child care settings were more likely to be found in safer sleep environments than those who died at home.”

Why can modern epidemiologists simply not understand that no set of medical or hygienic protocols will ever take the danger out of removing a baby from in-home maternal care?