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1. Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy

Author

Giorgetti C., Ferrito L., Zallocco F., Iannilli A., Cherubini V., Maghnie M., Rabbone I., Lera R., De Luna L., Kienberger B., Gualtieri A., Zecchino C., Piccino E., Ortolani F., Zucchini S., Maltoni G., Pasquino B., Reinstadler P., Prandi E., Zattoni V., Gallo F., Morganti G., Guerraggio L., Ripoli C., Frongia M., Pusceddu P., La Loggia A., Scanu P., Cardinale G., Ponzi G., Tomaselli L. G., Rapisarda V., Citriniti F., Soprani T., Tumini S., Lazzaro N., De Donno V., Banin P., Toni S., Lenzi L., Mainetti B., Coccioli M. S., D'Annunzio G., Minuto N., Montani E., Maccioni R., Marongiu U., Beccaria L., Bruzzese M., Mammi F., Pardi D., Lombardo F., Ventrici C., Scaramazza A., Ferrari M., Bonfanti R., Rigamonti A., Iughetti L., Predieri B., Iafusco D., Confetto S., Zanfardino A., Prisco F., Francese A., De Nitto E., Cadario F., Milia A., Piredda G., Mereu L., Soro M., Correddu A., Pipia A., Monciotti C., Cardella F., De Berardinis F., Santoro G., Chiari G., Berioli M. G., Federico G., Zanette G., Marsciani A., Pedini A., Patera I. P., Schiaffini R., Bitti M., Lidano R., Pietrosanti S., Delvecchio M., Trada M., Marinaro A., Meloni G., Galero A., Fichera G., Bulciolu P., Ignaccolo G., Cauvin V., Franceschi R., Faleschini E., Tornese G., Salvatoni A., Cardani R., Maffeis C., Marigliano M., Sabbion A., Arnaldi C., Giorgetti, Chiara, Ferrito, Lucia, Zallocco, Federica, Iannilli, Antonio, Cherubini, Valentino, Maghnie, Mohamad, Rabbone, Ivana, Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Toni, S., Lenzi, L., Mainetti, B., Coccioli, M. S., D’Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, Dario, Confetto, S., Zanfardino, A., Prisco, Francesco, Francese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., Arnaldi, C., Study Group for Diabetes of, Isped, Tornese, Gianluca, Giorgetti, C., Ferrito, L., Zallocco, F., Iannilli, A., Cherubini, V., Maghnie, M., D'Annunzio, G., Mammi, F., Iafusco, D., and Prisco, F.

Subjects
Male, medicine.medical_specialty, Type 1 diabete, Adolescent, MEDLINE, Staffing, Distribution (economics), Legislation, diabetes, children, T1D, Italy, Pediatrics, Regional Medical Program, Prevalence, Surveys and Questionnaire, Medicine, Regional legislation, Practice Patterns, Physicians', Disease management (health), Child, Organization of care, Pediatric diabetes centers, Type 1 diabetes, Pediatrics, Perinatology and Child Health, business.industry, Incidence, Incidence (epidemiology), Research, Disease Management, Perinatology and Child Health, medicine.disease, Diabetes Mellitus, Type 1, diabete, Family medicine, Female, Organizational structure, Pediatric diabetes center, business, Delivery of Health Care, Human
Abstract

Background: The incidence of type 1 diabetes in childhood is increasing by 3 % per year, placing growing demands on healthcare professionals and medical expenditures. Aim of this study wars to assess the organization of care to children with diabetes in Italy. Methods: During 2012 a structured questionnaire was sent to all of the members of Italian Society of Paediatric Endocrinology and Diabetology (ISPED). Questions examined organizational structure of Centers, personnel dedicated to the care of children with diabetes, number of subjects followed, local legal legislation supporting centres. Results: A total of 68 centers taking care to 15,563 children and adolescents with diabetes under 18 years of age were identified with a prevalence of 1.4 per 1,000 people. A wide variation in the organizational background was also reported. Fourty-four centers were organized as outpatient departments, 17 as simple units, 5 as complex units and 2 as simple departmental structures. Most centers had a multidisciplinary team. Ten out of twenty Italian regions had introduced supportive regional legislation, but it was fully applied only in six of them. Conclusion: Great differences between regions were found in organizational structures, staffing levels and supportive legislation. The national legislation on diabetes was broadly implemented throughout the country regions. Further efforts are needed to improve standards and consistency of pediatric diabetes care in Italy.

Published
2015

2. Epidemiologia della chetoacidosi diabetica in Italia

Author

Cherubini, Valentino, Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., D'Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, Lorenzo, Predieri, Barbara, Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., Arnaldi, C., Cherubini, Valentino, Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., D'Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, Dario, Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

Subjects
endocrine system diseases, Type 1 diabete, Endocrinology, Diabetes and Metabolism, nutritional and metabolic diseases, Risk of complication, Diabetes and Metabolism, Type 1 diabetes, Nation-wide retrospective observational study, Endocrinology, Risk factors, Diabetic ketoacidosis, Children, Internal Medicine, Diabetic ketoacidosi, Risk factor
Abstract

Ketoacidosis is a potentially life-threatening complication in patients with type 1 diabetes mellitus (T1DM), particularly children. If diabetic ketoacidosis (DKA) is diagnosed late, the child risks cerebral edema, permanent neurological damage or even death. There have been only few studies of DKA in Italy.From January-May 2014 a nation-wide observational, retrospective study of DKA at diabetes onset was done by the Pediatric Diabetology Study Group (PDSG) of the Italian Society of Pediatric Endocrinology and Diabetes (ISPED), involving 76 Italian centers. DKA was defined using ISPAD criteria; 7457 new cases of T1DM were recruited from mainland Italy and the island of Sicily and 770 from Sardinia, in the period 2004-2013. On the mainland and in Sicily, DKA at diabetes onset was about 32.9% (95% CI 31.8-34.0%), and there was 6.6% (95% CI 6.02-7.20%) of the severe form. Mild and severe DKA risk was significantly higher in children aged 0-4 years; no significant temporal trend was found in the study period. Patients living in Sardinia or having a firstdegree relative with T1DM were at significantly lower risk of DKA at diabetes onset. In the ten-year study period three children died of DKA at onset and four suffered permanent neurological lesions. From November 2011-April 2012 the PDSG conducted a retrospective study based on a sample of 2025 patients with T1DM, aged 0-18 years, involving 29 national centers for pediatric diabetes. The incidence of DKA was 2.4% (IC 95% 1.8-3.1), with children older than ten years at significantly higher risk, probably due to shortages of insulin. Multiple analysis showed a higher risk of DKA in those using a rapid-acting insulin analog and in those with high HbA1c. Young mothers and low levels of education were also associated with DKA.In conclusion, although a wide network of specialized home pediatricians and pediatric diabetes centers is spread across the country, the incidence of DKA at diabetes onset is still high. Further social and health-system efforts are needed to boost awareness of this risk and to reduce damages and costs related to the complication.

Published
2014

3. Erratum: Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy (Ital J Pediatr (2015) 41 (74) DOI:10.1186/s13052-015-0179-6)

Author

Giorgetti, C., Ferrito, L., Zallocco, F., Iannilli, A., Cherubini, V., Maghnie, M., Rabbone, I., Lera, R., De Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., De Donno, V., Banin, P., Toni, S., Lenzi, L., Mainetti, B., Coccioli, M. S., D(')Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mamm(`i), F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Francese, A., De Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., De Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Gaiero, A., Fichera, G., Bulciolu, P., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

Subjects
children, type 1 diabetes, children, adolescents, adolescents
Published
2016

4. Epidemiology of diabetic ketoacidosis in Italy,Epidemiologia della chetoacidosi diabetica in Italia

Author

Cherubini, V., Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., Giuseppe d'Annunzio, Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

Subjects
diabetic ketoacidosis, children, type 1 diabetes, risk factors, nation-wide retrospective observational study, risk of complication

5. Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

Author

Rabbone, Ivana, Savastio, Silvia, Pigniatiello, Ciro, Carducci, Chiara, Berioli, Maria Giulia, Cherubini, Valentino, Lo Presti, Donatella, Maltoni, Giulio, Mameli, Chiara, Marigliano, Marco, Minuto, Nicola, Mozzillo, Enza, Piccinno, Elvira, Predieri, Barbara, Rigamonti, Andrea, Ripoli, Carlo, Schiaffini, Riccardo, Lombardo, Fortunato, Tinti, Davide, Toni, Sonia, Zanfardino, Angela, Scaramuzza, Andrea Enzo, BassiBassi, Marta, Bonfanti, Riccardo, Bruzzi, Patrizia, Delvecchio, Maurizio, Giorda, Sara, Iafusco, Dario, Salzano, Giuseppina, Maffeis, Claudio, Redaelli, Francesca Chiara, Marino, Monica, Piccini, Barbara, Ricciardi, Maria Rossella, Rosanio, Francesco Maria, Tiberi, Valentina, Trada, Michela, Zanetta, Sara, Zucchini, Stefano, Calandretti, Michela, Daga, Federico Abate, Gesuita, Rosaria, Cavalli, Claudio, Rabbone, Ivana, Savastio, Silvia, Pigniatiello, Ciro, Carducci, Chiara, Berioli, Maria Giulia, Cherubini, Valentino, Lo Presti, Donatella, Maltoni, Giulio, Mameli, Chiara, Marigliano, Marco, Minuto, Nicola, Mozzillo, Enza, Piccinno, Elvira, Predieri, Barbara, Rigamonti, Andrea, Ripoli, Carlo, Schiaffini, Riccardo, Lombardo, Fortunato, Tinti, Davide, Toni, Sonia, Zanfardino, Angela, Scaramuzza, Andrea Enzo, Bonfanti, Riccardo, Rabbone, I., Savastio, S., Pigniatiello, C., Carducci, C., Berioli, M. G., Cherubini, V., Lo Presti, D., Maltoni, G., Mameli, C., Marigliano, M., Minuto, N., Mozzillo, E., Piccinno, E., Predieri, B., Rigamonti, A., Ripoli, C., Schiaffini, R., Lombardo, F., Tinti, D., Toni, S., Zanfardino, A., Scaramuzza, A. E., Bassibassi, Marta, Bruzzi, Patrizia, Delvecchio, Maurizio, Giorda, Sara, Iafusco, Dario, Salzano, Giuseppina, Maffeis, Claudio, Redaelli, Francesca Chiara, Marino, Monica, Piccini, Barbara, Ricciardi, Maria Rossella, Rosanio, Francesco Maria, Tiberi, Valentina, Trada, Michela, Zanetta, Sara, Zucchini, Stefano, Calandretti, Michela, Daga, Federico Abate, Gesuita, Rosaria, and Cavalli, Claudio

Subjects
Blood Glucose, Virtual educational camp, Type 1 diabete, Adolescent, Endocrinology, Diabetes and Metabolism, Emotions, Adolescents, Advanced hybrid closed loop, Children, Closed-loop control, Type 1 diabetes, Blood Glucose Self-Monitoring, Child, Humans, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Diabetes Mellitus, Type 1, Endocrinology, Diabetes Mellitus, Internal Medicine, Emotion, General Medicine, Type 1
Abstract

Objective To evaluate the six-month impact of the advanced automated functions of a closed-loop control (CLC) system (Control-IQ) and a virtual educational camp (vEC) on emotions and time in range (TIR) of children and adolescents with type 1 diabetes. Methods Children and their parents participated in a three-day vEC. Clinical, glucose, and emotion data were evaluated before, just after, and six months after the vEC. Emotions were evaluated using adapted Plutchik's and Geneva Emotion Wheels. Results Forty-three children and adolescents (7–16 years) showed significant improvements in positive emotions immediately and six months after the vEC (67% and 65% vs 38%, p < 0.05, respectively), while mixed emotions were reduced (32% and 15% vs 61%, p < 0.05 and p < 0.001, respectively). The median percentage TIR increased from 64% (IQR 54–72) to 75% (IQR 70–82) with Control-IQ (p < 0.001) six months after the vEC. Conclusions Positive emotions (joy, serenity, and satisfaction) significantly improved while mixed emotions were significantly worse six months after the initiation of a CLC system (Control-IQ) and a vEC.

Published
2022

6. A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

Author

F. De Berardinis, Fortunato Lombardo, G. Zanette, R. Cardani, Ivana Rabbone, C. Zecchino, Barbara Predieri, C. Arnaldi, Barbara Piccini, B. Felappi, Riccardo Bonfanti, D. Lo Presti, B. Mainetti, G. Ignaccolo, F. Stamati, Roberto Franceschi, G. Ponzi, M. S. Coccioli, F. Citriniti, C. Ripoli, F. Chiarelli, Valeria Calcaterra, M. Trada, Giovanni Federico, A. Sabbion, D. Cirillo, Enza Mozzillo, C. Salvo, Francesco Prisco, G. Piredda, Alessandro Salvatoni, Maurizio Delvecchio, R. A. Taccardi, Valentino Cherubini, Gianluca Tornese, G. Morganti, Giulio Maltoni, Nicola Minuto, Giovanni Chiari, S. Zonca, M. Bensa, Franco Meschi, V. De Donno, Martina Biagioni, Silvia Savastio, L. Guerraggio, A. Gualtieri, T. Suprani, A. Franzese, M. G. Berioli, D. Iafusco, Francesco Cadario, Andrea Scaramuzza, A. Favia, Luciano Beccaria, Gian Vincenzo Zuccotti, Sonia Toni, Riccardo Schiaffini, F. Cerutti, N. Lazzaro, Lorenzo Iughetti, B. Pasquino, Francesco Fontana, P. Banin, G. Cardinale, A. Marsciani, Anna Paola Frongia, S. Lucchesi, E. Schieven, R. Lera, R. De Marco, F. Cardella, F. Gallo, Vittoria Cauvin, P. Sogno Valin, E. Prandi, L. Tomaselli, Vanna Graziani, M Bruzzese, Lorenzo Lenzi, F. Mammì, Giuseppe d'Annunzio, Ippolita Patrizia Patera, Stefano Zucchini, C. Maffeis, A. Bobbio, A. Gaiero, V. Castaldo, Alfonso Galderisi, Stefano Tumini, P Buono, C. Monciotti, Elvira Piccinno, D. Pardi, Marco Cappa, Renata Lorini, Marco Marigliano, Zucchini, Stefano, Scaramuzza, Andrea E, Bonfanti, Riccardo, Buono, Pietro, Cardella, Francesca, Cauvin, Vittoria, Cherubini, Valentino, Chiari, Giovanni, D'Annunzio, Giuseppe, Frongia, Anna Paola, Iafusco, Dario, Maltoni, Giulio, Patera, Ippolita Patrizia, Toni, Sonia, Tumini, Stefano, Tornese, Gianluca, Rabbone, Ivana, Lera, R., Bobbio, A., Gualtieri, A., Piccinno, E., Zecchino, C., Pasquino, B., Felappi, B., Prandi, E., Gallo, F., Morganti, G., Ripoli, C., Cardinale, G., Ponzi, G., Castaldo, V., Stamati, F., Lo Presti, D., Tomaselli, L., Citriniti, F., Suprani, T., Bensa, M., Graziani, V., De Berardinis, F., Chiarelli, F., De Marco, R., Lazzaro, N., De Donno, V., Banin, P., Piccini, B., Lenzi, L., Mainetti, B., Coccioli, M. S., Minuto, N., Lorini, R., Trada, M., Sogno Valin, P., Beccaria, L., Lucchesi, S., Bruzzese, M., Mammì, F., Cirillo, D., Pardi, D., Taccardi, R. A., Lombardo, F., Zuccotti, G. V., Meschi, F., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, Enza., Prisco, F., Cadario, F., Savastio, S., Piredda, G., Monciotti, C., Galderisi, A., Salvo, C., Calcaterra, V., Berioli, M. G., Federico, G., Favia, A., Zanette, G., Marsciani, A., Schiaffini, R., Cappa, M., Delvecchio, M., Gaiero, A., Ignaccolo, G., Cerutti, F., Fontana, F., Guerraggio, L., Zonca, S., Franceschi, R., Tornese, G., Biagioni, M., Salvatoni, A., Cardani, R., Marigliano, M., Sabbion, A., Maffeis, C., Schieven, E., Arnaldi, C., Zucchini, S., Scaramuzza, A. E., Bonfanti, R., Buono, P., Cardella, F., Cauvin, V., Cherubini, V., Chiari, G., D'Annunzio, G., Frongia, A. P., Iafusco, D., Maltoni, G., Patera, I. P., Toni, S., Tumini, S., Rabbone, I., Mammi, F., Mozzillo, E., and Prisco, Francesco

Subjects
0301 basic medicine, Male, Pediatrics, Endocrinology, Diabetes and Metabolism, Endocrinology, endocrine system diseases, type 1 diabetes, Adolescent, Child, Child, Preschool, Diabetes Mellitus, Type 1, Diabetic Ketoacidosis, Female, Health Care Surveys, Humans, Infant, Infant, Newborn, Insulin, Italy, Rehydration Solutions, Retrospective Studies, Treatment Outcome, lcsh:Diseases of the endocrine glands. Clinical endocrinology, ketoacidosis, Retrospective Studie, Medicine, Diabetology, Diabetes and Metabolism, Newly diagnosed diabetes, Research Article, Type 1, Human, medicine.medical_specialty, Article Subject, Referral, Diabetic ketoacidosis, Diabetic Ketoacidosi, 03 medical and health sciences, children, Retrospective survey, Diabetes mellitus, Diabetes Mellitus, Preschool, Type 1 diabetes, lcsh:RC648-665, business.industry, Rehydration Solution, nutritional and metabolic diseases, Retrospective cohort study, Newborn, medicine.disease, 030104 developmental biology, Health Care Survey, business
Abstract

We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0–18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records(n=2453)of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n=1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05–0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers.

Published
2016

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