Establishing the incidence and timing of hypoglycemia at a residential diabetes camp.

AIMS: To establish the incidence and timing of hypoglycemia at a week-long residential diabetes camp for children. We hypothesized that hypoglycemia would occur more frequently during the first two days of camp and following evening all-camp games. METHODS: 225 children (mean age 12.0 ±â€¯2.3 years, 56% female, mean hemoglobin A1c 8.4% [71.6 mmol/mol]) had blood glucose (BG) levels obtained before meals, at bedtime, and as needed to detect hypoglycemia. Insulin adjustments were made by medical staff according to camp protocol and at the discretion of medical staff during camper check-in. RESULTS: Mild hypoglycemia (BG 50-69 mg/dL [3.9 mmol/L]) occurred ≥ 1 time in 90% of campers while 43% had ≥ 1 episode of BG < 50 mg/dL (2.8 mmol/L). No episodes of hypoglycemia requiring glucagon occurred. More campers experienced ≥ 1 overnight hypoglycemia event during the first 48 hours of camp compared to later in the week (p = 0.01). Evening all-camp games did not impact hypoglycemia rates overnight. CONCLUSIONS: Nocturnal hypoglycemia occurred more frequently during the first two nights, establishing this period as high risk and supporting implementation of a standard protocol to lower insulin doses. Rates of hypoglycemia were unaffected by all-camp games, indicating current practices are effective at minimizing hypoglycemia.

Impacts of short-term food restriction on immune development in altricial house sparrow nestlings.

Food limitation is a common ecological scenario for nestling altricial birds, and reductions in growth and maintenance have been observed in resource-limited nestlings. Substantial development of the immune system occurs during the nestling period, yet the resource dependence of this immune development is understudied. We examined constitutive immune system development as well as acute-phase responses to lipopolysaccharide (LPS) injection after 48 h of food restriction in house sparrows at 7 and 13 d posthatch. We also examined nestlings that were restricted early (5-7 d) but refed and tested at 13 d posthatch to determine whether altered immune function and growth early in the nestling period were recovered upon return to adequate resource supply. Induced acute-phase protein response was reduced in food-restricted birds, yet no lasting reductions in acute-phase protein levels were observed in previously restricted nestlings that were challenged with LPS after refeeding. Food restriction did not significantly impact constitutive levels of complement-mediated lysis or circulating IgY antibodies. As a comparator to immune measures, we found that organ and tarsus size, as well as muscle size and citrate synthase enzyme activity (an index of muscle cellular aerobic capacity), were significantly reduced in food-restricted nestlings. Reductions in flight muscle mass and function persisted in birds refed after early food restriction, which may have contributed to persistent body temperature reductions observed in refed birds.