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Aims: Several drug classes are now available to achieve a satisfactory metabolic control in patients with type 2 diabetes (T2DM), but patients’ preferences may differ. Methods: In a discrete-choice experiment, we tested T2DM patients’ preferences for recent antidiabetic drugs, in the event that their treatment might require intensification. The following attributes were considered: (a) route of administration; (b) type of delivery; (c) timing; (d) risk of adverse events; (e) effects on body weight. Twenty-two possible scenarios were built, transferred into 192 paired choices and proposed to 491 cases naïve to injectable treatments and 171 treated by GLP-1 receptor agonists (GLP-1RAs). Analyses were performed by descriptive statistics and random effects logit regression model. Results: Preferences according to dosing frequency, risk of nausea and urinary tract infections (UTls) were similar across groups, age, sex and BMI. Administration route and delivery type accounted for 1/3 of relative importance; the risk of UTIs, nausea and dosing frequency for ≈ 20% each, and weight loss for only 6%. Two significant interactions emerged (p < 0.01): type of delivery × group, and weight change × BMI class. Irrespective of previous treatment, the three preferred choices were injectable, coupled with weekly dosing and a ready-to-use device (first two choices). In a regression model, being naïve or non-naïve changed the ranking of preferences (p < 0.001), and the order was systematically shifted towards injectable medications in non-naïve subjects. Conclusion: Easy-to-deliver, injectable treatment is preferred in T2DM, independently of treatment history, and previous experience with GLP-1RAs strengthens patients’ willingness to accept injectable drugs.

The main objective of this study was to estimate the incidence rate and prevalence of pediatric type 1 diabetes mellitus (T1DM; population 0–18 years of age) in the northeastern Italian region Friuli Venezia Giulia and to characterize the subjects affected by the disease. This was a retrospective population-based study conducted through the individual-level linkage of several health administrative databases of the Friuli Venezia Giulia region. The incidence rate and prevalence were calculated in the population 0–18 years of age. Using the Mid-p exact method, 95 % confidence intervals for rates were calculated. The incidence rate of pediatric T1DM in the years 2010–2013 was 15.8 new cases/100,000 person-years, peaking in the age class 10–14 years. The rate has increased substantially as compared with the previous regional estimate that dated back to 1993. We observed a seasonal pattern both in the date of birth of the incident cases and in the date of onset of the disease. In the region in 2013, there were 294 prevalent cases (15.1/10,000 inhabitants). Most of them had at least one glycated hemoglobin test in the year. More than 15 % had co-existing autoimmune comorbidities. The incidence rate of pediatric T1DM in Friuli Venezia Giulia has increased in the last years, and the disease is a relevant public health issue in the region.

The relationship between urinary albumin excretion rate (UAE) and some metabolic and haemodynamic characteristics was studied in 62 (50 male, 12 female) type 2 (non-insulin-dependent) diabetic patients, with (26 male, 5 female) and without (24 male, 7 female) ischaemic heart disease (IHD), free from overt diabetic nephropathy. The overall population was subdivided into quartiles on the basis of UAE values (mg/24h): group 1 (16 subjects), 3.3–7 (range); group 2 (15 subjects), 7.22–11.8; group 3 (15 subjects), 11.9–30; group 4 (16 microalbuminuric subjects), 31.7–226. The groups were comparable with regard to age, duration of diabetes and prevalence of smokers. From group 1 to group 4 we found increasing levels of body mass index (BMI) (24.2±0.6, 26.6±0.7, 27.6±0.7, 27.6±0.9 kg/m2;P=0.007), HbA1c (5.99±0.2, 6.45±0.35, 7.02±0.41, 7.4±0.39%;P=0.017), total cholesterol (5.30±0.26, 5.51±0.34, 6.14±0.21, 6.32±0.26 mmol/l;P=0.026), triglycerides (1.37±0.20, 1.67±0.21, 2.07±0.29, 2.55±0.45 mmol/l;P=0.034) and prevalence of hypertension (50%, 67%, 67%, 81%;P=0.088). No significant differences were found between C-peptide, insulin resistance (K index of insulin tolerance test) and high-density lipoprotein (HDL)-cholesterol levels. Groups 1+2 had a lower prevalence of IHD in comparison with groups 3+4 (42% vs 58%,P=0.069). Using multiple regression analysis, only HbA1c was independently associated with log10 UAE in the overall population (P=0.002), including as independent variables age, duration of diabetes, BMI, total cholesterol, triglycerides and mean arterial pressure. In conclusion: (1) type 2 diabetic patients show higher BMI, HbA1c, total cholesterol, triglyceride levels and prevalence of hypertension with increasing UAE, even in the normoalbuminuric range; (2) the prevalence of IHD is higher in the groups with elevated UAE; (3) glycaemic control is the only metabolic characteristic independently associated with UAE.