Fetus

• Children’s Hospital Los Angeles ( CHLA ) has created the innovative Regional NICU Nursing Leadership Roundtable, comprised of CHLA and 20 community hospital neonatal intensive care units (NICU) in Los Angeles, Ventura and Kern counties.
• The initiative was developed by Kathy Van Allen, MSN, RN, CPN, the Administrative Director of CHLA’s Fetal and Neonatal Institute .
• View the full release here: https://www.businesswire.com/news/home/20240510231203/en/
  Kathy Van Allen, administrative director of the Fetal and Neonatal Institute at Children's Hospital Los Angeles.
• “The roundtable provides a forum to discuss critical issues impacting NICU nursing practice and to create a supportive network for the NICU leaders,” says Van Allen.

• We want to provide them with the support that they require to effectively manage their PPP.
• ORMALVI™ is an oral carbonic anhydrase inhibitor indicated for the treatment of primary hyperkalemic periodic paralysis, primary hypokalemic periodic paralysis, and related variants.
• Simply Stated: Research Updates in Periodic Paralysis - Quest | Muscular Dystrophy Association [online] Available at: https://mdaquest.org/simply-stated-research-updates-in-periodic-paralysis Accessed 23 Nov. 2023.
• The impact of permanent muscle weakness on quality of life in periodic paralysis: a survey of 66 patients.

• However, the FDA recently announced that the most common brand of this medication, RhoGAM(R), is in shortage .
• Utilizing cell-free DNA in maternal plasma, the UNITY Fetal RhD Non-Invasive Prenatal Test can determine fetal RhD status," said Jennifer Hoskovec, MS, Certified Genetic Counselor and Senior Director of Medical Affairs at BillionToOne.
• The UNITY Fetal RhD NIPT offers a reliable and convenient alternative to traditional methods of determining fetal RhD status, such as paternal testing and invasive procedures like amniocentesis.
• The UNITY Fetal RhD NIPT accurately determines the RhD status of the fetus from maternal blood as early as 10 weeks gestation.

• You may have heard of Ozempic, the “miracle drug” for weight loss, but did you know that it was actually designed as a new treatment to manage diabetes?
• In Canada, diabetes affects approximately 10 per cent of the general population.

Locks and keys

• Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells.
• This equilibrium needs to be tightly controlled and is regulated by a lock and key system.
• Cells cover themselves with locks that respond perfectly to insulin keys to facilitate the entry of sugar into cells.
• The body can encounter difficulties producing an adequate number of insulin keys, and/or the locks can become stubborn and unresponsive to insulin.

Severe insulin-deficient diabetes: We’re missing keys!

• In the severe insulin-deficient diabetes (SIDD) subtype, the key factories — the beta cells — are on strike.
• Why the beta cells go on strike remains largely unknown, but since there is an insulin deficiency, treatment often involves insulin injections.

Severe insulin-resistant diabetes: But it’s always locked!

• In the severe insulin-resistant diabetes (SIRD) subtype, the locks are overstimulated and start ignoring the keys.
• There are many treatment avenues for these patients but no consensus about the optimal approach; patients often require high doses of insulin.

Mild obesity-related diabetes: The locks are sticky!

• Mild obesity-related (MOD) diabetes represents a nuanced aspect of Type 2 diabetes, often observed in individuals with higher body weight.
• The locks are “sticky,” so it is challenging for the key to click in place and open the lock.

Mild age-related diabetes: I’m tired of controlling blood sugar!

Mild age-related diabetes (MARD) happens more often in older people and typically starts later in life. With time, the key factory is not as productive, and the locks become stubborn. People with MARD find it tricky to manage their blood sugar, but it usually doesn’t lead to severe complications. Among the different subtypes of diabetes, MARD is the most common.

Unique locks, varied keys

• In Canada, unique cases of Type 2 diabetes were identified in Indigenous children from Northern Manitoba and Northwestern Ontario by Dr. Heather Dean and colleagues in the 1980s and 90s.
• Read more:
  Indigenous community research partnerships can help address health inequities

  Childhood-onset Type 2 diabetes is on the rise across Canada, but disproportionately affects Indigenous youth.

• Acknowledging this distinct subtype of Type 2 diabetes in First Nations communities has led to the implementation of a community-based health action plan aimed at addressing the unique challenges faced by Indigenous Peoples.

A mosaic of conditions

• Type 2 diabetes is not uniform; it’s a mosaic of conditions, each with its own characteristics.
• Since diabetes presents so uniquely in every patient, even categorizing into subtypes does not guarantee how the disease will evolve.

Lili Grieco-St-Pierre receives funding from Fonds de recherche du Québec - Santé (FRQS). Jennifer Bruin receives funding from the Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada (NSERC), JDRF, Diabetes Canada.