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1. The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey

Author

Gesuita, Rosaria, Skrami, Edlira, Bonfanti, Riccardo, Cipriano, Paola, Ferrito, Lucia, Frongia, Paola, Iannilli, Antonio, Lombardo, Fortunato, Mozzillo, Enza, Paleari, Renata, Rabbone, Ivana, Sabbion, Alberto, Salvatoni, Alessandro, Scaramuzza, Andrea, Schiaffini, Riccardo, Sulli, Nicoletta, Toni, Sonia, Carle, Flavia, Cherubini, Valentino, IAFUSCO, Dario, Gesuita, R., Skrami, E., Bonfanti, R., Cipriano, P., Ferrito, L., Frongia, P., Iafusco, D., Iannilli, A., Lombardo, F., Mozzillo, E., Paleari, R., Rabbone, I., Sabbion, A., Salvatoni, A., Scaramuzza, A., Schiaffini, R., Sulli, N., Toni, S., Carle, F., Cherubini, V., Gesuita, Rosaria, Skrami, Edlira, Bonfanti, Riccardo, Cipriano, Paola, Ferrito, Lucia, Frongia, Paola, Iafusco, Dario, Iannilli, Antonio, Lombardo, Fortunato, Mozzillo, Enza, Paleari, Renata, Rabbone, Ivana, Sabbion, Alberto, Salvatoni, Alessandro, Scaramuzza, Andrea, Schiaffini, Riccardo, Sulli, Nicoletta, Toni, Sonia, Carle, Flavia, and Cherubini, Valentino

Subjects
Glycated Hemoglobin A, Adolescent, Endocrinology, Diabetes and Metabolism, Mothers, Pediatrics, socioeconomic status, Diabetic, Endocrinology, Insulin Infusion Systems, Cost of Illness, Diet, Diabetic, Internal Medicine, Humans, Hypoglycemic Agents, Insulin, Socioeconomic statu, Child, Glycated Hemoglobin, child, Perinatology and Child Health, Combined Modality Therapy, child – Hb A1c – qualityof life – socioeconomic status – type1 diabetes mellitus, Hypoglycemia, Diet, Diabetes and Metabolism, Cross-Sectional Studies, Diabetes Mellitus, Type 1, quality of life, Italy, Socioeconomic Factors, Health Care Surveys, Hyperglycemia, Pediatrics, Perinatology and Child Health, Hb A1c, quality of life, socioeconomic status, type 1 diabetes mellitus, Adolescent, Child, Combined Modality Therapy, Cost of Illness, Cross-Sectional Studies, Diet, Diabetic, Educational Status, Glycated Hemoglobin A, Health Care Surveys, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Insulin, Italy, Mothers, Socioeconomic Factors, Insulin Infusion Systems, Internal Medicine, Pediatrics, Perinatology and Child Health, Endocrinology, Diabetes and Metabolism, Quality of Life, Educational Status, Hb A1c, type 1 diabetes mellitus, Type 1 diabetes mellitu
Abstract

Objective: To identify the role of the family's socio-economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes. Methods: In this cross-sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA1c values

Published
2015

2. The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey.

Author

Gesuita, Rosaria, Skrami, Edlira, Bonfanti, Riccardo, Cipriano, Paola, Ferrito, Lucia, Frongia, Paola, Iafusco, Dario, Iannilli, Antonio, Lombardo, Fortunato, Mozzillo, Enza, Paleari, Renata, Rabbone, Ivana, Sabbion, Alberto, Salvatoni, Alessandro, Scaramuzza, Andrea, Schiaffini, Riccardo, Sulli, Nicoletta, Toni, Sonia, Carle, Flavia, and Cherubini, Valentino

Subjects
TYPE 1 diabetes, CONFIDENCE intervals, GLYCOSYLATED hemoglobin, INSULIN, MOTHERS, LOGISTIC regression analysis, SOCIOECONOMIC factors, EDUCATIONAL attainment, CROSS-sectional method, ODDS ratio, PREVENTION
Abstract

Objective To identify the role of the family's socio-economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes. Methods In this cross-sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA1c values <7.5% (<58 mmol/mol). A multiple correspondence analysis ( MCA) was performed to analyze the association between the socio-economic and clinical characteristics of the participants. A logistic regression analysis was performed to identify factors associated with the subjects metabolic control. In both analyses, the family's socio-economic status was represented, measured by the Hollingshead Four-Factor Index of Social Status ( SES) or by parental years of education. Results A total of 28.1% of subjects reached target HbA1c values. The MCA identified a strong association between at-target condition and several factors: high levels of SES or high levels of parental education, the use of the carbohydrate counting system, the use of insulin pumps, the use of the insulin delivery system over a short period of time, a normal body mass index. The logistic regression analysis showed that SES and the mother's years of education were significantly associated with the target condition [odds ratio ( OR): 1.01, 95% confidence interval ( CI): 1.01-1.03, p = 0.029; OR: 1.05, 95% CI: 1.01-1.10, p = 0.027, respectively). Conclusions Personal, clinical, and family characteristics were found to be associated with HbA1c target. Their identification can be crucial in addressing strategies to optimize metabolic control and improve diabetes management. [ABSTRACT FROM AUTHOR]

Published
2017
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3. Diabetic ketoacidosis at the onset of disease during a national awareness campaign: A 2-year observational study in children aged 0-18 years

Author

Rabbone I., Maltoni G., Tinti D., Zucchini S., Cherubini V., Bonfanti R., Scaramuzza A., Lera R., Bobbio A., Piccinno E., Reinstadler P., Felappi B., Prandi E., Gallo F., Frongia AP., Ripoli C., Lo Presti D., Tomaselli L., Cardinale G., Stamati FA., Citriniti F., Suprani T., Graziani V., De Berardinis F., Zampolli M., De Marco R., Cavalli C., Lazzaro N., De Donno V., Toni S., Piccini B., Lenzi L., Mainetti B., Coccioli MS., d'Annunzio G., Minuto N., Aloe S., Lucchesi D., Cirillo S., Sordelli M., Del Vecchio F., Salzano LG., Meschi F., Iughetti L., Predieri B., Franzese A., Mozzillo Enza., Iafusco D., Cadario F., Savastio S., Piredda G., Cardella F., Iovane B., Calcaterra V., Berioli MG., Biagioni M., Randazzo E., Patera I., Schiaffini R., Rutigliano I., Lasagni A., Innaurato S., Gaiero A., Fichera G., Trada M., Guerraggio L., Cauvin V., Franceschi R., Tornese G., Salvatoni A., Marigliano M., Sabbion A., Maffeis C., Arnaldi C., Rabbone, I., Maltoni, G., Tinti, D., Zucchini, S., Cherubini, V., Bonfanti, R., Scaramuzza, A., Lera, R., Bobbio, A., Piccinno, E., Reinstadler, P., Felappi, B., Prandi, E., Gallo, F., Frongia, Ap., Ripoli, C., Lo Presti, D., Tomaselli, L., Cardinale, G., Stamati, Fa., Citriniti, F., Suprani, T., Graziani, V., De Berardinis, F., Zampolli, M., De Marco, R., Cavalli, C., Lazzaro, N., De Donno, V., Toni, S., Piccini, B., Lenzi, L., Mainetti, B., Coccioli, Ms., D'Annunzio, G., Minuto, N., Aloe, S., Lucchesi, D., Cirillo, S., Sordelli, M., Del Vecchio, F., Salzano, Lg., Meschi, F., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, Enza., Iafusco, D., Cadario, F., Savastio, S., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, Mg., Biagioni, M., Randazzo, E., Patera, I., Schiaffini, R., Rutigliano, I., Lasagni, A., Innaurato, S., Gaiero, A., Fichera, G., Trada, M., Guerraggio, L., Cauvin, V., Franceschi, R., Tornese, G., Salvatoni, A., Marigliano, M., Sabbion, A., Maffeis, C., Arnaldi, C., Rabbone, Ivana, Maltoni, Giulio, Tinti, Davide, Zucchini, Stefano, Cherubini, Valentino, Bonfanti, Riccardo, Scaramuzza, Andrea, Lera, Riccardo, Bobbio, Adriana, Piccinno, Elvira, Reinstadler, Petra, Felappi, Barbara, Prandi, Elena, Gallo, Francesco, Frongia, Anna Paola, Ripoli, Carlo, Lo Presti, Donatella, Tomaselli, Letizia, Cardinale, Giuliana, Stamati, Filomena Andreina, Citriniti, Felice, Suprani, Tosca, Graziani, Vanna, De Berardinis, Fiorella, Zampolli, Maria, De Marco, Rosaria, Cavalli, Claudio, Lazzaro, Nicola, De Donno, Valeria, Toni, Sonia, Piccini, Barbara, Lenzi, Lorenzo, Mainetti, Benedetta, Coccioli, Maria Susanna, D’Annunzio, Giuseppe, Minuto, Nicola, Aloe, Monica, Lucchesi, Sonia, Cirillo, Dante, Sordelli, Silvia, Delvecchio, Maurizio, Lombardo, Fortunato, Salzano, Giusy, Meschi, Franco, Iughetti, Lorenzo, Predieri, Barbara, Franzese, Adriana, Mozzillo, Enza, Iafusco, Dario, Cadario, Francesco, Savastio, Silvia, Cardella, Francesca, Iovane, Brunella, Calcaterra, Valeria, Berioli, Maria Giulia, Biagioni, Martina, Randazzo, Emioli, Patera, Ippolita Patrizia, Schiaffini, Riccardo, Rutigliano, Irene, Lasagni, Anna, Innaurato, Silvia, Gaiero, Alberto, Fichera, Grazziella, Trada, Michela, Guerraggio, Lucia, Cauvin, Vittoria, Franceschi, Roberto, Tornese, Gianluca, Salvatoni, Alessandro, Marigliano, Marco, Sabbion, Alberto, Maffeis, Claudio, and Arnaldi, Claudia

Subjects
Blood Glucose, Male, medicine.medical_specialty, Pediatrics, endocrine system diseases, Diabetic ketoacidosis, Adolescent, 030209 endocrinology & metabolism, Disease, 03 medical and health sciences, 0302 clinical medicine, diabetic ketoacidosis, Patient Education as Topic, Diabetes mellitus, Epidemiology, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Child, Type 1 diabetes, diabetes, business.industry, Incidence (epidemiology), Incidence, epidemiology, Infant, Newborn, diabetic ketoacidosi, nutritional and metabolic diseases, Infant, medicine.disease, Diabetes Mellitus, Type 1, Italy, diabete, Child, Preschool, Pediatrics, Perinatology and Child Health, Observational study, Female, business, Prevention campaign
Abstract

ObjectiveAfter a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013–2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign.DesignProspective observational study.SettingMulticentre study throughout Italy.InterventionNational awareness campaign started in November 2015 and held until December 2017.PatientsDuring 2016 and 2017 we collected data on all patients aged 0–18 years with new-onset diabetes.Main outcome measuresDKA (pH ResultsRecords (n=2361) of children with newly diagnosed type 1 diabetes were collected from 58 out of 68 (85.3%) centres of the original survey participants and 100% of the previously surveyed tertiary centres. Overall, DKA was observed in 1124 patients, with an increased rate when compared with the previous survey (47.6% vs 38.5%, p=0.002), and severe DKA in 15.3%. In children below 6 years, DKA was observed in 323 out of 617 (52.5%) and severe DKA in 16.7%; in this age group, occurrence of DKA reduced by 21.3% (p=0.009). DKA treatment according to the ISPED guidelines was adopted in 95% of the centres, with a 27% improvement (p=0.025).ConclusionsDuring a 2-year awareness campaign, DKA at onset of diabetes in children and adolescents 0–18 years is still common and increased when compared with the 2013–2014 survey.

Published
2020

4. Randomized Summer Camp Crossover Trial in 5- to 9-Year-Old Children: Outpatient Wearable Artificial Pancreas Is Feasible and Safe

Author

Giordano Lanzola, Davide Tinti, Simone Del Favero, Alfonso Galderisi, Angelo Avogaro, Yenny Leal Moncada, Daniela Bruttomesso, Silvia Galasso, Andrea Rigamonti, Lalo Magni, Valeria Vallone, Daniel R. Cherñavvsky, Federico Di Palma, Federico Boscari, Dario Iafusco, Marco Marigliano, Novella Rapini, Claudio Cobelli, Eleonora Losiouk, Ivana Rabbone, Riccardo Schiaffini, Riccardo Bonfanti, Roberta Calore, Roberto Visentin, Mirko Messori, A. Sabbion, Angela Zanfardino, Del Favero, S., Boscari, F., Messori, M., Rabbone, I., Bonfanti, R., Sabbion, A., Iafusco, D., Schiaffini, R., Visentin, R., Calore, R., Moncada, Y. L., Galasso, S., Galderisi, A., Vallone, V., Di Palma, F., Losiouk, E., Lanzola, G., Tinti, D., Rigamonti, A., Marigliano, M., Zanfardino, A., Rapini, N., Avogaro, A., Chernavvsky, D., Magni, L., Cobelli, C., Bruttomesso, D., Del Favero, Simone, Boscari, Federico, Messori, Mirko, Rabbone, Ivana, Bonfanti, Riccardo, Sabbion, Alberto, Iafusco, Dario, Schiaffini, Riccardo, Visentin, Roberto, Calore, Roberta, Moncada, Yenny Leal, Galasso, Silvia, Galderisi, Alfonso, Vallone, Valeria, Di Palma, Federico, Losiouk, Eleonora, Lanzola, Giordano, Tinti, Davide, Rigamonti, Andrea, Marigliano, Marco, Zanfardino, Angela, Rapini, Novella, Avogaro, Angelo, Chernavvsky, Daniel, Magni, Lalo, Cobelli, Claudio, and Bruttomesso, Daniela

Subjects
Blood Glucose, Male, Pediatrics, Endocrinology, Diabetes and Metabolism, law.invention, Endocrinology, 0302 clinical medicine, Randomized controlled trial, law, Insulin, 030212 general & internal medicine, Child, education.field_of_study, Cross-Over Studies, Diabetes and Metabolism, Anesthesia, Child, Preschool, Artificial, Female, Algorithms, Type 1, Pancreas, Artificial, medicine.medical_specialty, Population, 030209 endocrinology & metabolism, Hypoglycemia, Artificial pancreas, 03 medical and health sciences, Insulin Infusion Systems, Internal Medicine, Advanced and Specialized Nursing, Diabetes mellitus, medicine, Summer camp, Diabetes Mellitus, Humans, Hypoglycemic Agents, education, Preschool, Pancreas, Type 1 diabetes, business.industry, Diabetes Mellitus, Type 1, Feasibility Studies, medicine.disease, Crossover study, business
Abstract

OBJECTIVE The Pediatric Artificial Pancreas (PedArPan) project tested a children-specific version of the modular model predictive control (MMPC) algorithm in 5- to 9-year-old children during a camp. RESEARCH DESIGN AND METHODS A total of 30 children, 5- to 9-years old, with type 1 diabetes completed an outpatient, open-label, randomized, crossover trial. Three days with an artificial pancreas (AP) were compared with three days of parent-managed sensor-augmented pump (SAP). RESULTS Overnight time-in-hypoglycemia was reduced with the AP versus SAP, median (25th–75th percentiles): 0.0% (0.0–2.2) vs. 2.2% (0.0–12.3) (P = 0.002), without a significant change of time-in-target, mean: 56.0% (SD 22.5) vs. 59.7% (21.2) (P = 0.430), but with increased mean glucose 173 mg/dL (36) vs. 150 mg/dL (39) (P = 0.002). Overall, the AP granted a threefold reduction of time-in-hypoglycemia (P < 0.001) at the cost of decreased time-in-target, 56.8% (13.5) vs. 63.1% (11.0) (P = 0.022) and increased mean glucose 169 mg/dL (23) vs. 147 mg/dL (23) (P < 0.001). CONCLUSIONS This trial, the first outpatient single-hormone AP trial in a population of this age, shows feasibility and safety of MMPC in young children. Algorithm retuning will be performed to improve efficacy.

Published
2016

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