Author: "Mozzillo, E" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

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1. Continuous Subcutaneous Insulin Infusion in Italy: Third National Survey

Author: Bruttomesso D., Laviola L., Lepore G., Bonfanti R., Bozzetto L., Corsi A., Di Blasi V., Girelli A., Grassi G., Iafusco D., Rabbone I., Schiaffini R., Montani V., Colleluori P., Paciotti V., Alfidi P., Grosso J., Tumini S., Cipriano P., Vitacolonna E., Di Vieste G., Minnucci A., Antenucci D., La Penna G., Taraborrelli M., Macerala B., Citro G., De Morelli G., Gnasso A., Irace C., Citriniti F., Lazzaro N., Bruzzese M., Mammi F., De Berardinis F., Santoro E., Corigliano G., Corigliano M., Parillo M., Schettino M., Fresa R., Annuzzi G., Bassi V., Santinelli C., Buono P., Mozzillo E., De Feo E., Esposito K., Petrizzo M., Foglia A., Gatti A., Gentile S., Guarino G., Zanfardino A., Lambiase C., Vitale A., Zucchini S., Maltoni G., Forlani G., Moscatiello S., Suprani T., Bensa M., Tomasi F., Monesi M., Nizzoli M., Acquati S., Chierici G., Milli B., Iughetti L., Predieri B., Cavani R., Romano S., Manicardi V., Michelini M., Cimicchi M. C., Ugolotti D., Zavaroni I., Dei Cas A., Dall'Aglio E., Papi M., Tardio S. M., Calderini M. C., Riboni S., D'Amato L., Zavaroni D., Gastaldi L., Di Bartolo P., Pellicano F., Cirillo A., Graziani V., Di Secli C., Amarri S., Lasagni A., Marsciani A., Pedini A., Pagliani U., Rossi C., Tortul C., Brunato B., Assaloni R., Zanette G., Livolsi P., Petrucco A., Tercelj K., Manca E., Candido R., Tommasi E., Tornese G., Faleschini E., Tonutti L., Agus S., Zanatta M., Rosolen A., Comici A., Graziano F. M., Misischi I., Pozzilli P., Maurizi A. R., Falasca P., Tuccinardi F., Ricciardi G. P., Di Masa P., Ragonese M., Cipolloni L., Buzzetti R., Moretti C., Leto G., Crino A., Bocchini S., Di Perna P., Giuliano M., Frontoni S., Malandrucco I., Pitocco D., Scalpone R., Toscanella F., Cappa M., Ventura C., Bonato V., De Bernardinis M., Cavallo M. G., Leonetti F., Morano S., Mandosi E., Cicconetti E., Ciampittiello G., Marini M. A., Sabato D., Napoli A., Giraudo F., Toscano V., Massimiani F., Fava D., Gargiulo P., Mecca N., Tubili C., Nardone M. R., Morviducci L., Manca-Bitti M. L., Arcano S., Leotta S., Suraci C., Chiaramonte F., Visalli N., Forte E., Palmacci C., Arnaldi C., Tosini D., Querci F., Trevisan R., Bonfadini S., Prandi E., Felappi B., Locatelli F., Fuso V., Rocca A., Meneghini E., Massafra C., Terni T., Elli P., Ruggeri P., Carrai E., Musacchio N., Lovagnini Scher C. A., Marelli G., Vilei V., Richini D., Inversini C., Franzetti I., Bonacina M., Ciucci A., Sciangula L., Duratorre E., Bonomo M., Bertuzzi F., Chebat E., Muratori M., Scaramuzza A., Zuccotti G. V., Bollati P. M., Colapinto P., Orsi E., Palmieri E., Laurenzi A., Molinari C., Frontino G., Veronelli A., Zecchini B., Bianchi A., Torchio G., Lovati E., Ghilardi G., Dagani R., Carugo D., Berra C., Favacchio G., Fochesato E., Pissarelli A., Bucciarelli L., Bulgheroni M., Guerraggio L., Zonca S., Bossi A. C., Berzi D., Mangone I., Cazzaniga E., Rabini R. A., Boemi M., Faloia E., Boscaro M., Sternari G., Iannilli A., Cherubini V., Busciantella Ricci N., Cartechini M. G., Tesei A. M., Maolo G., Galetta M., Vespasiani G., Tinti G., Manfrini S., Aiello A., Di Vincenzo S., Vitale C., Di Caro P., Lera R., Secco A., Lesina A., Romeo F., Origlia C., Giorda C., Chiambretti A. M., Fornengo R., De Donno V., Gallarotti F., Manti R., Marafetti L., Cadario F., Savastio S., Barbieri P., Massucco P., Ali A., Gottero C., Degiovanni M., Bertaina S., Maghenzani G., Tinti D., Fontana F., Giorgino F., Stefanelli G., Cavallo L., Zecchino C., Piccinno E., Ortolani F., Gallo F., Moramarco F., Marino A., Sparasci G., Mileti G., Lamacchia O., Picca G., Coccioli M. S., Micale F., Serra R., Romano I., Savino T., De Cosmo S., Rauseo A., Delvecchio M., Lapolla R., Braione A. F., Papagno G., Baroni M., Melis M., Cossu E., Songini M., Cambuli V. M., Lo Presti D., Timpanaro T. A., Chiavetta A., Garofalo M. R., Tommaselli L., Tumminia A., Scarpitta A. M., Di Benedetto A., Giunta L., Lombardo F., Salzano G., Cardella F., Roppolo R., Provenzano V., Fleres M., Migliorini S., De Luca A., Leopardi A., Beltrami C., Toni S., Guasti G., Lenzi L., Lamanna C., Mannucci E., Lucchesi S., Dicianni G., Aragona M., Del Prato S., Fattor B., Eisath J., Pasquino B., Reinstadler P., Kaufmann P., Incelli G., Rauch S., Romanelli T., Cauvin V., Franceschi R., Soldani C., Scattoni R., Norgiolini R., Celleno R., Torlone E., Bolli G. B., Lalli C., Scarponi M., Bobbio A., Bechaz M., Pianta A., Marangoni A., Arico C. N., Alagona C., Confortin L., Rossi E., Boscolo Bariga A., Nogara A., Bettio M., Frison V., Guidoni G. L., Fongher C., Contin M. L., Cosma A., Vianello S., Bondesan L., Morea A., Volpi A., Coracina A., Panebianco G., Lombardi S., Costa S., Cipponeri E., Vedovato M., Scotton R., Monciotti C. M., Galderisi A., Dalfra M. G., Lapolla A., Zanon M., Lisato G., Mollo F., Calcaterra F., Miola M., Paccagnella A., Sambataro M., Moro E., Trombetta M., Negri C., Sabbion A., Maffeis C., Strazzabosco M., Mesturino C. A., Mingardi R., Bruttomesso, D., Laviola, L., Lepore, G., Bonfanti, R., Bozzetto, L., Corsi, A., Di Blasi, V., Girelli, A., Grassi, G., Iafusco, D., Rabbone, I., Schiaffini, R., Montani, V., Colleluori, P., Paciotti, V., Alfidi, P., Grosso, J., Tumini, S., Cipriano, P., Vitacolonna, E., Di Vieste, G., Minnucci, A., Antenucci, D., La Penna, G., Taraborrelli, M., Macerala, B., Citro, G., De Morelli, G., Gnasso, A., Irace, C., Citriniti, F., Lazzaro, N., Bruzzese, M., Mammi, F., De Berardinis, F., Santoro, E., Corigliano, G., Corigliano, M., Parillo, M., Schettino, M., Fresa, R., Annuzzi, G., Bassi, V., Santinelli, C., Buono, P., Mozzillo, E., De Feo, E., Esposito, K., Petrizzo, M., Foglia, A., Gatti, A., Gentile, S., Guarino, G., Zanfardino, A., Lambiase, C., Vitale, A., Zucchini, S., Maltoni, G., Forlani, G., Moscatiello, S., Suprani, T., Bensa, M., Tomasi, F., Monesi, M., Nizzoli, M., Acquati, S., Chierici, G., Milli, B., Iughetti, L., Predieri, B., Cavani, R., Romano, S., Manicardi, V., Michelini, M., Cimicchi, M. C., Ugolotti, D., Zavaroni, I., Dei Cas, A., Dall'Aglio, E., Papi, M., Tardio, S. M., Calderini, M. C., Riboni, S., D'Amato, L., Zavaroni, D., Gastaldi, L., Di Bartolo, P., Pellicano, F., Cirillo, A., Graziani, V., Di Secli, C., Amarri, S., Lasagni, A., Marsciani, A., Pedini, A., Pagliani, U., Rossi, C., Tortul, C., Brunato, B., Assaloni, R., Zanette, G., Livolsi, P., Petrucco, A., Tercelj, K., Manca, E., Candido, R., Tommasi, E., Tornese, G., Faleschini, E., Tonutti, L., Agus, S., Zanatta, M., Rosolen, A., Comici, A., Graziano, F. M., Misischi, I., Pozzilli, P., Maurizi, A. R., Falasca, P., Tuccinardi, F., Ricciardi, G. P., Di Masa, P., Ragonese, M., Cipolloni, L., Buzzetti, R., Moretti, C., Leto, G., Crino, A., Bocchini, S., Di Perna, P., Giuliano, M., Frontoni, S., Malandrucco, I., Pitocco, D., Scalpone, R., Toscanella, F., Cappa, M., Ventura, C., Bonato, V., De Bernardinis, M., Cavallo, M. G., Leonetti, F., Morano, S., Mandosi, E., Cicconetti, E., Ciampittiello, G., Marini, M. A., Sabato, D., Napoli, A., Giraudo, F., Toscano, V., Massimiani, F., Fava, D., Gargiulo, P., Mecca, N., Tubili, C., Nardone, M. R., Morviducci, L., Manca-Bitti, M. L., Arcano, S., Leotta, S., Suraci, C., Chiaramonte, F., Visalli, N., Forte, E., Palmacci, C., Arnaldi, C., Tosini, D., Querci, F., Trevisan, R., Bonfadini, S., Prandi, E., Felappi, B., Locatelli, F., Fuso, V., Rocca, A., Meneghini, E., Massafra, C., Terni, T., Elli, P., Ruggeri, P., Carrai, E., Musacchio, N., Lovagnini Scher, C. A., Marelli, G., Vilei, V., Richini, D., Inversini, C., Franzetti, I., Bonacina, M., Ciucci, A., Sciangula, L., Duratorre, E., Bonomo, M., Bertuzzi, F., Chebat, E., Muratori, M., Scaramuzza, A., Zuccotti, G. V., Bollati, P. M., Colapinto, P., Orsi, E., Palmieri, E., Laurenzi, A., Molinari, C., Frontino, G., Veronelli, A., Zecchini, B., Bianchi, A., Torchio, G., Lovati, E., Ghilardi, G., Dagani, R., Carugo, D., Berra, C., Favacchio, G., Fochesato, E., Pissarelli, A., Bucciarelli, L., Bulgheroni, M., Guerraggio, L., Zonca, S., Bossi, A. C., Berzi, D., Mangone, I., Cazzaniga, E., Rabini, R. A., Boemi, M., Faloia, E., Boscaro, M., Sternari, G., Iannilli, A., Cherubini, V., Busciantella Ricci, N., Cartechini, M. G., Tesei, A. M., Maolo, G., Galetta, M., Vespasiani, G., Tinti, G., Manfrini, S., Aiello, A., Di Vincenzo, S., Vitale, C., Di Caro, P., Lera, R., Secco, A., Lesina, A., Romeo, F., Origlia, C., Giorda, C., Chiambretti, A. M., Fornengo, R., De Donno, V., Gallarotti, F., Manti, R., Marafetti, L., Cadario, F., Savastio, S., Barbieri, P., Massucco, P., Ali, A., Gottero, C., Degiovanni, M., Bertaina, S., Maghenzani, G., Tinti, D., Fontana, F., Giorgino, F., Stefanelli, G., Cavallo, L., Zecchino, C., Piccinno, E., Ortolani, F., Gallo, F., Moramarco, F., Marino, A., Sparasci, G., Mileti, G., Lamacchia, O., Picca, G., Coccioli, M. S., Micale, F., Serra, R., Romano, I., Savino, T., De Cosmo, S., Rauseo, A., Delvecchio, M., Lapolla, R., Braione, A. F., Papagno, G., Baroni, M., Melis, M., Cossu, E., Songini, M., Cambuli, V. M., Lo Presti, D., Timpanaro, T. A., Chiavetta, A., Garofalo, M. R., Tommaselli, L., Tumminia, A., Scarpitta, A. M., Di Benedetto, A., Giunta, L., Lombardo, F., Salzano, G., Cardella, F., Roppolo, R., Provenzano, V., Fleres, M., Migliorini, S., De Luca, A., Leopardi, A., Beltrami, C., Toni, S., Guasti, G., Lenzi, L., Lamanna, C., Mannucci, E., Lucchesi, S., Dicianni, G., Aragona, M., Del Prato, S., Fattor, B., Eisath, J., Pasquino, B., Reinstadler, P., Kaufmann, P., Incelli, G., Rauch, S., Romanelli, T., Cauvin, V., Franceschi, R., Soldani, C., Scattoni, R., Norgiolini, R., Celleno, R., Torlone, E., Bolli, G. B., Lalli, C., Scarponi, M., Bobbio, A., Bechaz, M., Pianta, A., Marangoni, A., Arico, C. N., Alagona, C., Confortin, L., Rossi, E., Boscolo Bariga, A., Nogara, A., Bettio, M., Frison, V., Guidoni, G. L., Fongher, C., Contin, M. L., Cosma, A., Vianello, S., Bondesan, L., Morea, A., Volpi, A., Coracina, A., Panebianco, G., Lombardi, S., Costa, S., Cipponeri, E., Vedovato, M., Scotton, R., Monciotti, C. M., Galderisi, A., Dalfra, M. G., Lapolla, A., Zanon, M., Lisato, G., Mollo, F., Calcaterra, F., Miola, M., Paccagnella, A., Sambataro, M., Moro, E., Trombetta, M., Negri, C., Sabbion, A., Maffeis, C., Strazzabosco, M., Mesturino, C. A., Mingardi, R., Bruttomesso, D, Laviola, L, Lepore, G, Bonfanti, R, Bozzetto, L, Corsi, A, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Rabbone, I, Schiaffini, R, Montani, V, Colleluori, P, Paciotti, V, Alfidi, P, Grosso, J, Tumini, S, Cipriano, P, Vitacolonna, E, Di Vieste, G, Minnucci, A, Antenucci, D, La Penna, G, Taraborrelli, M, Macerala, B, Citro, G, De Morelli, G, Gnasso, A, Irace, C, Citriniti, F, Lazzaro, N, Bruzzese, M, Mammi, F, De Berardinis, F, Santoro, E, Corigliano, G, Corigliano, M, Parillo, M, Schettino, M, Fresa, R, Annuzzi, G, Bassi, V, Santinelli, C, Buono, P, Mozzillo, E, De Feo, E, Esposito, K, Petrizzo, M, Foglia, A, Gatti, A, Gentile, S, Guarino, G, Zanfardino, A, Lambiase, C, Vitale, A, Zucchini, S, Maltoni, G, Forlani, G, Moscatiello, S, Suprani, T, Bensa, M, Tomasi, F, Monesi, M, Nizzoli, M, Acquati, S, Chierici, G, Milli, B, Iughetti, L, Predieri, B, Cavani, R, Romano, S, Manicardi, V, Michelini, M, Cimicchi, M, Ugolotti, D, Zavaroni, I, Dei Cas, A, Dall'Aglio, E, Papi, M, Tardio, S, Calderini, M, Riboni, S, D'Amato, L, Zavaroni, D, Gastaldi, L, Di Bartolo, P, Pellicano, F, Cirillo, A, Graziani, V, Di Secli, C, Amarri, S, Lasagni, A, Marsciani, A, Pedini, A, Pagliani, U, Rossi, C, Tortul, C, Brunato, B, Assaloni, R, Zanette, G, Livolsi, P, Petrucco, A, Tercelj, K, Manca, E, Candido, R, Tommasi, E, Tornese, G, Faleschini, E, Tonutti, L, Agus, S, Zanatta, M, Rosolen, A, Comici, A, Graziano, F, Misischi, I, Pozzilli, P, Maurizi, A, Falasca, P, Tuccinardi, F, Ricciardi, G, Di Masa, P, Ragonese, M, Cipolloni, L, Buzzetti, R, Moretti, C, Leto, G, Crino, A, Bocchini, S, Di Perna, P, Giuliano, M, Frontoni, S, Malandrucco, I, Pitocco, D, Scalpone, R, Toscanella, F, Cappa, M, Ventura, C, Bonato, V, De Bernardinis, M, Cavallo, M, Leonetti, F, Morano, S, Mandosi, E, Cicconetti, E, Ciampittiello, G, Marini, M, Sabato, D, Napoli, A, Giraudo, F, Toscano, V, Massimiani, F, Fava, D, Gargiulo, P, Mecca, N, Tubili, C, Nardone, M, Morviducci, L, Manca-Bitti, M, Arcano, S, Leotta, S, Suraci, C, Chiaramonte, F, Visalli, N, Forte, E, Palmacci, C, Arnaldi, C, Tosini, D, Querci, F, Trevisan, R, Bonfadini, S, Prandi, E, Felappi, B, Locatelli, F, Fuso, V, Rocca, A, Meneghini, E, Massafra, C, Terni, T, Elli, P, Ruggeri, P, Carrai, E, Musacchio, N, Lovagnini Scher, C, Marelli, G, Vilei, V, Richini, D, Inversini, C, Franzetti, I, Bonacina, M, Ciucci, A, Sciangula, L, Duratorre, E, Bonomo, M, Bertuzzi, F, Chebat, E, Muratori, M, Scaramuzza, A, Zuccotti, G, Bollati, P, Colapinto, P, Orsi, E, Palmieri, E, Laurenzi, A, Molinari, C, Frontino, G, Veronelli, A, Zecchini, B, Bianchi, A, Torchio, G, Lovati, E, Ghilardi, G, Dagani, R, Carugo, D, Berra, C, Favacchio, G, Fochesato, E, Pissarelli, A, Bucciarelli, L, Bulgheroni, M, Guerraggio, L, Zonca, S, Bossi, A, Berzi, D, Mangone, I, Cazzaniga, E, Rabini, R, Boemi, M, Faloia, E, Boscaro, M, Sternari, G, Iannilli, A, Cherubini, V, Busciantella Ricci, N, Cartechini, M, Tesei, A, Maolo, G, Galetta, M, Vespasiani, G, Tinti, G, Manfrini, S, Aiello, A, Di Vincenzo, S, Vitale, C, Di Caro, P, Lera, R, Secco, A, Lesina, A, Romeo, F, Origlia, C, Giorda, C, Chiambretti, A, Fornengo, R, De Donno, V, Gallarotti, F, Manti, R, Marafetti, L, Cadario, F, Savastio, S, Barbieri, P, Massucco, P, Ali, A, Gottero, C, Degiovanni, M, Bertaina, S, Maghenzani, G, Tinti, D, Fontana, F, Giorgino, F, Stefanelli, G, Cavallo, L, Zecchino, C, Piccinno, E, Ortolani, F, Gallo, F, Moramarco, F, Marino, A, Sparasci, G, Mileti, G, Lamacchia, O, Picca, G, Coccioli, M, Micale, F, Serra, R, Romano, I, Savino, T, De Cosmo, S, Rauseo, A, Delvecchio, M, Lapolla, R, Braione, A, Papagno, G, Baroni, M, Melis, M, Cossu, E, Songini, M, Cambuli, V, Lo Presti, D, Timpanaro, T, Chiavetta, A, Garofalo, M, Tommaselli, L, Tumminia, A, Scarpitta, A, Di Benedetto, A, Giunta, L, Lombardo, F, Salzano, G, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Migliorini, S, De Luca, A, Leopardi, A, Beltrami, C, Toni, S, Guasti, G, Lenzi, L, Lamanna, C, Mannucci, E, Lucchesi, S, Dicianni, G, Aragona, M, Del Prato, S, Fattor, B, Eisath, J, Pasquino, B, Reinstadler, P, Kaufmann, P, Incelli, G, Rauch, S, Romanelli, T, Cauvin, V, Franceschi, R, Soldani, C, Scattoni, R, Norgiolini, R, Celleno, R, Torlone, E, Bolli, G, Lalli, C, Scarponi, M, Bobbio, A, Bechaz, M, Pianta, A, Marangoni, A, Arico, C, Alagona, C, Confortin, L, Rossi, E, Boscolo Bariga, A, Nogara, A, Bettio, M, Frison, V, Guidoni, G, Fongher, C, Contin, M, Cosma, A, Vianello, S, Bondesan, L, Morea, A, Volpi, A, Coracina, A, Panebianco, G, Lombardi, S, Costa, S, Cipponeri, E, Vedovato, M, Scotton, R, Monciotti, C, Galderisi, A, Dalfra, M, Lapolla, A, Zanon, M, Lisato, G, Mollo, F, Calcaterra, F, Miola, M, Paccagnella, A, Sambataro, M, Moro, E, Trombetta, M, Negri, C, Sabbion, A, Maffeis, C, Strazzabosco, M, Mesturino, C, Mingardi, R, Bruttomesso, Daniela, Laviola, Luigi, Lepore, Giuseppe, Bonfanti, Riccardo, Bozzetto, Lutgarda, Corsi, Andrea, Di Blasi, Vincenzo, Girelli, Angela, Grassi, Giorgio, Iafusco, Dario, Rabbone, Ivana, Schiaffini, Riccardo, and Tornese, Gianluca
Subjects: Blood Glucose, Male, Pediatrics, Glucose control, IMPACT, Cost-Benefit Analysis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, CHILDREN, Practice Patterns, Infusions, Subcutaneous, law.invention, Settore MED/13, Endocrinology, Randomized controlled trial, law, Surveys and Questionnaires, Insulin, Practice Patterns, Physicians', Child, Adult, Diabetes Mellitus, Type 1, Female, Guideline Adherence, Health Care Surveys, Humans, Hypoglycemic Agents, Italy, Medical Laboratory Technology, Medicine (all), PUMP THERAPY, Subcutaneous, Diabetes, Diabetes and Metabolism, TERM METABOLIC-CONTROL, Human, Type 1, Infusions, medicine.medical_specialty, Keywords KeyWords Plus:TERM METABOLIC-CONTROL, BOLUS CALCULATOR, PEDIATRIC-PATIENTS, CONTROLLED-TRIAL, CSII, Diabetes mellitus, Diabetes Mellitus, medicine, term metabolic-control, bolus calculator, pump therapy, pediatric-patients, controlled-trial, children, impact CSII, Glucose sensors, Cost-Benefit Analysi, Intensive care medicine, Type 1 diabetes, Physicians', Hypoglycemic Agent, business.industry, medicine.disease, Subcutaneous insulin, Infusions, Subcutaneou, Multicenter study, Health Care Survey, business
Abstract: Background: Continuous subcutaneous insulin infusion (CSII) is increasing worldwide, mostly because of improved technology. The aim of this study was to evaluate the current status of CSII in Italy. Materials and Methods: Physicians from 272 diabetes centers received a questionnaire investigating clinical features, pump technology, and management of patients on CSII. Results: Two hundred seventeen centers (79.8%) joined the study and, by the end of April 2013, gave information about 10,152 patients treated with CSII: 98.2% with type 1 diabetes mellitus, 81.4% adults, 57% female, and 61% with a conventional pump versus 39% with a sensor-augmented pump. CSII advanced functions were used by 68% of patients, and glucose sensors were used 12 days per month on average. Fifty-eight percent of diabetes centers had more than 20 patients on CSII, but there were differences among centers and among regions. The main indication for CSII was poor glucose control. Dropout was mainly due to pump wearability or nonoptimal glycemic control. Twenty-four hour assistance was guaranteed in 81% of centers. A full diabetes team (physician+ nurse + dietician + psychologist) was available in 23% of adult-care diabetes centers and in 53%of pediatric diabetes units. Conclusions: CSII keeps increasing in Italy. More work is needed to ensure uniform treatment strategies throughout the country and to improve pump use.
Published: 2015
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2. Insulin pump failures in Italian children with Type 1 diabetes: retrospective 1-year cohort study

Author: Rabbone, I., Minuto, N., Bonfanti, R., Marigliano, M., Cerutti, F., Cherubini, V., d(')Annunzio, G., Frongia, A. P., Iafusco, D., Ignaccolo, G., Lombardo, F., Schiaffini, R., Toni, S., Tumini, S., Zucchini, S., Pistorio, A., Scaramuzza, A. E., Scaramuuzza, A. E., Lera, R., Secco, A., Bobbio, A., Bechaz, M., Piccinno, E., Natale, M. P., Ortolani, F., Zecchino, C., Lonero, A., Maltoni, G., Pasquino, B., Gallo, F., Frongia, P., Ripoli, C., Lo Presti, D., Timpanaro, T., Citriniti, F., Suprani, T., Carinci, S., Cipriano, P., Lazzaro, N., De Donno, V., Gallarotti, F., Lenzi, L., Piccini, B., Vittorio, L., Russo, C., Borea, R., Mamm(`i), F., Bruzzese, M., Ventrici, C., Salzano, G., Frontino, G., Bonura, C., Favalli, V., Scaramuzza, A., Zuccotti, G. V., Ferrari, M., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, E., Buono, P., Confetto, S., Zanfardino, A., Cadario, F., Savastio, S., Fiorito, C., Barbieri, P., Piredda, G., Cardella, F., Ropolo, R., Federico, G., Marchi, B., Benevento, D., Carducci, C., Mancabitti, M. L., Delvecchio, M., Lapolla, R., Gaiero, A., Fichera, G., Ignaccolo, M. G., Tinti, D., Cauvin, V., Franceschi, R., Biagioni, M., Salvatoni, A., Scolari, A., Maffeis, C., Sabbion, A., Arnaldi, C., Tosini, D., Rabbone, I, Minuto, N., Bonfanti, R., Marigliano, M., Cerutti, F., Cherubini, V., D'Annunzio, G., Frongia, A. P., Iafusco, Dario, Ignaccolo, G., Lombardo, F., Schiaffini, R., Toni, S., Tumini, S., Zucchini, S., Pistorio, A., Scaramuzza, A. E., Rabbone, I., Iafusco, D., Lera, R., Secco, A., Bobbio, A., Bechaz, M., Piccinno, E., Natale, M. P., Ortolani, F., Zecchino, C., Lonero, A., Maltoni, G., Pasquino, B., Gallo, F., Frongia, P., Ripoli, C., Lo Presti, D., Timpanaro, T., Citriniti, F., Suprani, T., Carinci, S., Cipriano, P., Lazzaro, N., De Donno, V., Gallarotti, F., Lenzi, L., Piccini, B., Vittorio, L., Russo, C., Borea, R., Mammi, F., Bruzzese, M., Ventrici, C., Salzano, G., Frontino, G., Bonura, C., Favalli, V., Scaramuzza, A., Zuccotti, G. V., Ferrari, M., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, E., Buono, P., Confetto, S., Zanfardino, A., Cadario, F., Savastio, S., Fiorito, C., Barbieri, P., Piredda, G., Cardella, F., Ropolo, R., Federico, G., Marchi, B., Benevento, D., Carducci, C., Mancabitti, M. L., Del Vecchio, M., Lapolla, R., Gaiero, A., Fichera, G., Ignaccolo, M. G., Tinti, D., Cauvin, V., Franceschi, R., Biagioni, M., Salvatoni, A., Scolari, A., Maffeis, C., Sabbion, A., Arnaldi, C., Tosini, D., Rabbone, Minuto, Mammì, F., and Mozzillo, Enza.
Subjects: Blood Glucose, Male, Pediatrics, Adolescent, Blood Glucose Self-Monitoring, Child, Child, Preschool, Diabetes Mellitus, Type 1, Equipment Failure, Female, Humans, Infant, Insulin, Italy, Retrospective Studies, Insulin Infusion Systems, type 1 diabetes, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Internal Medicine, Endocrinology, 0302 clinical medicine, Retrospective Studie, Medicine, 030212 general & internal medicine, Diabetes, Diabetology, failure, Diabetes and Metabolism, children and adolescents, insulin pump, Cohort study, Type 1, Human, Insulin pump, medicine.medical_specialty, Disease duration, 030209 endocrinology & metabolism, 03 medical and health sciences, Diabetes mellitus, Diabetes Mellitus, Preschool, Type 1 diabetes, business.industry, Diabetes, Type1, Pump, Insulin, Type1, Retrospective cohort study, Pump, medicine.disease, Surgery, Insulin Infusion System, business
Abstract: Aims Insulin pump failure and/or malfunction requiring replacement have not been thoroughly investigated. This study evaluated pump replacement in children and adolescents with Type 1 diabetes using insulin pump therapy. Methods Data were collected for all participants younger than 19 years, starting insulin pump therapy before 31 December 2013. For each child, age, disease duration, date of insulin pump therapy initiation, insulin pump model, failure/malfunction/replacement yes/no and reason were considered for the year 2013. Results Data were returned by 40 of 43 paediatric centres belonging to the Diabetes Study Group of the Italian Society of Paediatric Endocrinology and Diabetology. In total, 1574 of 11 311 (13.9%) children and adolescents with Type 1 diabetes were using an insulin pump: 29.2% Animas VIBE™, 9.4% Medtronic MiniMed 715/515™, 34.3% Medtronic MiniMed VEO™, 24.3% Accu-Check Spirit Combo™ and 2.8% other models. In 2013, 0.165 insulin pump replacements per patient-year (11.8% due to pump failure/malfunction and 4.7% due to accidental damage) were recorded. Animas VIBE™ (22.1%) and Medtronic MiniMed VEO™ (17.7%) were the most replaced. Conclusions In a large cohort of Italian children and adolescents with Type 1 diabetes, insulin pump failure/malfunction and consequent replacement are aligned with rates previously reported and higher in more sophisticated pump models. This article is protected by copyright. All rights reserved.
Published: 2017

3. Identification of candidate children for maturity-onset diabetes of the young type 2 (MODY2) gene testing: a seven-item clinical flowchart (7-iF)

Author: Pinelli, M, Acquaviva, F, Barbetti, F, Caredda, E, Cocozza, S, Delvecchio, M, Mozzillo, E, Pirozzi, D, Prisco, F, Rabbone, I, Sacchetti, L, Tinto, N, Toni, S, Zucchini, S, Iafusco, D, Italian Study Group on Diabetes of the Italian Society of Pediatric Endocrinology, Diabetology, Biagioni, M, Carloni, I, Cester, Am, Cherubini, V, Giorgetti, C, Iannilli, A, Bruzzese, M, Mammì, F, Guasti, M, Lenzi, L, Pepe, R, Piccini, B, Benelli, M, Cadario, F, Calcaterra, V, Cerutti, F, Sicignano, S, Mammì, C, Lazzaro, N, Comberiati, P, Scaramuzza, A, Zuccotti, G, Redaelli, F, Gallo, F, Cappa, M, Patera, P, Schiaffini, R, Cardella, F, Salvo, C, De Marco, R, Chessa, M, Frongia, P, Ricciardi, Mr, Ripoli, C, Zedda, Ma, Citriniti, F, Chiarelli, F, Tumini, S, Coccioli, Ms, De Berardinis, F, Santoro, E, DE LUCA, Filippo, Lombardo, Fortunato, Salzano, Giuseppina, Felappi, B, Prandi, E, Frezza, E, Piccinno, E, Torelli, C, Zecchino, C, Galderisi, A, Monciotti, C, Ingletto, D, Kaufmann, P, Pasquino, B, Lera, R, Lucchesi, S, Perrotta, A, Salardi, S, Scipioni, M, Luceri, S, Stamati, F, Pianese, L, Piceno, A, Tomaselli, L, Vergerio, A, Casaburo, F, Cocca, A, Confetto, S, Forgione, E, Pelliccia, C, Picariello, S, Pisani, F, Piscopo, A, Villano, P, Zanfardino, A, Buono, P, Franzese, A, Nugnes, R, Valerio, G, Maffeis, C, Marigliano, M, Chiari, G, Iovene, B, Vanelli, M., Pinelli, Michele, Acquaviva, Fabio, Barbetti, F, Caredda, E, Cocozza, Sergio, Delvecchio, M, Mozzillo, Enza, Pirozzi, Daniele, Prisco, F, Rabbone, I, Sacchetti, Lucia, Tinto, Nadia, Toni, S, Zucchini, S, and Iafusco, D.
Subjects: Genetics and Molecular Biology (all), Pediatrics, medicine.medical_specialty, Science, Cost-Benefit Analysis, Decision tree, Medicine (all), Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), Biochemistry, Maturity onset diabetes of the young, Settore MED/13 - Endocrinologia, Quality of life, Surveys and Questionnaires, Glucokinase, medicine, Humans, Genetic Testing, Prospective Studies, Age of Onset, Prospective cohort study, Child, Wasting, Children, Genetic testing, Retrospective Studies, Glycated Hemoglobin, Multidisciplinary, MODY2, medicine.diagnostic_test, business.industry, Decision Trees, Retrospective cohort study, medicine.disease, Test (assessment), Diabetes Mellitus, Type 2, Italy, Child, Preschool, Mutation, Quality of Life, Medicine, Female, medicine.symptom, business, gene testing, Research Article
Abstract: MODY2 is the most prevalent monogenic form of diabetes in Italy with an estimated prevalence of about 0.5-1.5%. MODY2 is potentially indistinguishable from other forms of diabetes, however, its identification impacts on patients' quality of life and healthcare resources. Unfortunately, DNA direct sequencing as diagnostic test is not readily accessible and expensive. In addition current guidelines, aiming to establish when the test should be performed, proved a poor detection rate. Aim of this study is to propose a reliable and easy-to-use tool to identify candidate patients for MODY2 genetic testing. We designed and validated a diagnostic flowchart in the attempt to improve the detection rate and to increase the number of properly requested tests. The flowchart, called 7-iF, consists of 7 binary "yes or no" questions and its unequivocal output is an indication for whether testing or not. We tested the 7-iF to estimate its clinical utility in comparison to the clinical suspicion alone. The 7-iF, in a prospective 2-year study (921 diabetic children) showed a precision of about the 76%. Using retrospective data, the 7-iF showed a precision in identifying MODY2 patients of about 80% compared to the 40% of the clinical suspicion. On the other hand, despite a relatively high number of missing MODY2 patients, the 7-iF would not suggest the test for 90% of the non-MODY2 patients, demonstrating that a wide application of this method might 1) help less experienced clinicians in suspecting MODY2 patients and 2) reducing the number of unnecessary tests. With the 7-iF, a clinician can feel confident of identifying a potential case of MODY2 and suggest the molecular test without fear of wasting time and money. A Qaly-type analysis estimated an increase in the patients' quality of life and savings for the health care system of about 9 million euros per year.
Published: 2012

4. Abdominal adiposity and cardiovascular risk factors in adolescents with type 1 diabetes

Author: Valerio, G, Iafusco, D, Zucchini, S, Maffeis, C, Study Group on Diabetes of Italian Society of Pediatric Endocrinology, Collaborators: Lera R, D. i. a. b. e. t. o. l. o. g. y., Cherubini, V, Biagioni, M, Rollo, A, Gallo, F, Toni, S, Guasti, M, Mammì, F, Bruzzese, M, Lombardo, F, Salzano, G, Scaramuzza, A, Zuccotti, Gv, Sacco, H, Iughetti, L, Predieri, B, Calcaterra, V, Federico, G, Marchi, B, Cerutti, Franco, Rabbone, I, Cardinale, G, De Berardinis, F, De Donno, V, Franzese, A, Mozzillo, E, Prisco, F, Zedda, Ma, Ripoli, C., Valerio, G., Iafusco, D., Zucchini, S., Maffeis, C., Lera, R., Cherubini, V., Biagioni, M., Rollo, A., Gallo, F., Toni, S., Guasti, M., Mammi, F., Bruzzese, M., Lombardo, F., Salzano, G., Scaramuzza, A., Zuccotti, G. V., Iughetti, L., Predieri, B., Calcaterra, V., Federico, G., Marchi, B., Cerutti, F., Rabbone, I., Cardinale, G., De Berardinis, F., De Donno, V., Franzese, A., Mozzillo, Enza., Prisco, F., Zedda, M. A., Ripoli, C., Valerio, G, Iafusco, Dario, Zucchini, S, Maffeis, C, The Study Group on Diabetes of the Italian Society of Pediatric, Endocrinology, and Diabetology
Subjects: cardiovascular risk factors, Blood Glucose, Male, obesity, Health Knowledge, Attitudes, Practice, Glycated Hemoglobin A, type 1 diabetes, Endocrinology, Diabetes and Metabolism, Overweight, chemistry.chemical_compound, Endocrinology, Risk Factors, Prevalence, Abdominal obesity, Body surface area, Metabolic Syndrome, General Medicine, childre, Italy, Obesity, Abdominal, Hypertension, Female, medicine.symptom, Cardiovascular risk, Metabolic syndrome, Type 1 diabetes, Human, medicine.medical_specialty, Type 1 diabete, Adolescent, abdominal fat, Diabetic Angiopathie, Diabetes mellitus, Internal medicine, Weight Loss, Internal Medicine, medicine, Humans, Risk factor, Sex Distribution, Glycated Hemoglobin, business.industry, Risk Factor, medicine.disease, Surgery, Diabetes Mellitus, Type 1, chemistry, Glycated hemoglobin, business, Diabetic Angiopathies
Abstract: Aim To analyze the prevalence of abdominal adiposity and other traditional risk factors for cardiovascular disease in a large sample of Italian adolescents with type 1 diabetes mellitus (T1DM). Methods T1DM adolescents ( n =412 age: 17.3±0.9years) were enrolled from 18 clinical centres. Anthropometric and laboratory parameters, blood pressure and data on insulin treatment were registered. Metabolic syndrome (MetSy) was defined according to the International Diabetes Federation criteria. Results Abdominal obesity was the most common risk factor (20.1%) in females, while hypertension in males (25.1%). MetSy was found in 9.5% patients, predominantly in females. Patients with MetSy exhibited higher insulin requirement per body surface area and higher glycated hemoglobin than patients without MetSy. Overweight/obese patients had a much higher prevalence of MetSy than normal weight patients. The logistic regression analysis showed that just waist-to-height ratio and insulin dose per body surface area contributed to discriminate subjects with the MetSy from those without. Conclusion Adolescence is a critical period in determining risk of future vascular complications in T1DM. Pediatric diabetologists need to be aware of the considerable occurrence of abdominal adiposity and MetSy in T1DM patients, particularly in females, and should make any effort to achieve normal weight and better health outcomes.
Published: 2011

5. Glucokinase deficit and birthweight: does maternal hyperglycemia always meet fetal needs?

Author: D. Iafusco, Fernanda Iafusco, Enza Mozzillo, Nadia Tinto, Angela Napoli, Adriana Franzese, Camilla Festa, Olimpia Bitterman, Bitterman, O, Tinto, N, Franzese, A, Iafusco, F, Festa, C, Mozzillo, E, Napoli, A, Iafusco, D, Bitterman, Olimpia, Tinto, N., Franzese, A., Iafusco, F., Festa, C., Mozzillo, E., Napoli, A., and Iafusco, D.
Subjects: Male, Pediatrics, Endocrinology, Diabetes and Metabolism, MODY 2, Pregnancy in Diabetics, Fetal growth, Monogenic diabete, Fetal Development, 0302 clinical medicine, Endocrinology, Retrospective Studie, Pregnancy, Glucokinase, Birth Weight, Fetu, Child, diabetes and metabolism, Mother, 030219 obstetrics & reproductive medicine, Gestational age, General Medicine, Gestational diabetes, Phenotype, Gestational diabete, Child, Preschool, Prenatal Exposure Delayed Effects, monogenic diabetes, MODY, Female, gestational diabetes, Human, Adult, medicine.medical_specialty, Mothers, 030209 endocrinology & metabolism, Gestational Age, Pregnancy in Diabetic, Prenatal Exposure Delayed Effect, 03 medical and health sciences, Fetus, Diabetes mellitus, medicine, Internal Medicine, Humans, Hypoglycemic Agents, Retrospective Studies, Hypoglycemic Agent, business.industry, fetal growth, mody, pregnancy, internal medicine, endocrinology, diabetes and metabolism, endocrinology, Infant, Newborn, medicine.disease, Diabetes Mellitus, Type 2, Hyperglycemia, Mutation, Small for gestational age, business
Abstract: Aims: Many authors do not recommend hypoglycemic treatment during pregnancy in women affected by monogenic diabetes due to heterozygous glucokinase (GCK) mutations (MODY 2) in case of affected fetus, because maternal hyperglycemia would be necessary to achieve a normal birthweight. We aimed to evaluate differences in birthweight between MODY 2 affected children according to the parent who carried the mutation. Methods: We retrospectively studied 48 MODY 2 affected children, whose mothers did not receive hypoglycemic treatment during pregnancy, divided into two groups according to the presence of the mutation in the mother (group A) or in the father (group B). Data were extracted from the database of the Regional Centre of Pediatric Diabetology of the University of Campania, Naples, collected from 1996 to 2016. We analyzed birthweight and centile birthweight. Results: Percentage of small for gestational age was significantly higher in group B than in group A. We found three large for gestational age in the group that inherited the deficit from the mother, all with the same novel GCK mutation (p.Lys458-Cys461del). Conclusions: We hypothesize that not all MODY 2 affected fetuses need the same levels of hyperglycemia to have an appropriate growth, maybe because different kinds of GCK mutations may result in different phenotypes. Consequently, a “tailored therapy” of maternal hyperglycemia, based on fetal growth frequently monitored through ultrasounds, is essential in MODY 2 pregnancies.
Published: 2018

6. Low prevalence of HNF1A mutations after molecular screening of multiple MODY genes in 58 Italian families recruited in the pediatric or adult diabetes clinic from a single Italian hospital

Author: Maurizio, Delvecchio, Ornella, Ludovico, Claudia, Menzaghi, Rosa, Di Paola, Leopoldo, Zelante, Antonella, Marucci, Valeria, Grasso, Vincenzo, Trischitta, Massimo, Carella, Fabrizio, Barbetti, Francesco, Gallo, Maria Susanna, Coccioli, Clara, Zecchino, Maria Felicia, Faienza, Giuliana, Cardinale, Adriana, Franzese, Enza, Mozzillo, Dario, Iafusco, Angela, Zanfardino, Delvecchio, M, Ludovico, O, Menzaghi, C, Di Paola, R, Zelante, L, Marucci, A, Grasso, V, Trischitta, V, Carella, M, Barbetti, F, Gallo, F, Coccioli, M, Zecchino, C, Faienza, Mf, Cardinale, G, Franzese, A, Mozzillo, E, Iafusco, Dario, Zanfardino, A., Delvecchio, M., Ludovico, O., Menzaghi, C., Di Paola, R., Zelante, L., Marucci, A., Grasso, V., Trischitta, V., Carella, M., Barbetti, F., Gallo, F., Coccioli, Ms., Zecchino, C., Faienza, Mf., Cardinale, G., Franzese, A., Mozzillo, E., and Iafusco, D.
Subjects: Adult, Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Basic Helix-Loop-Helix Transcription Factor, DNA Mutational Analysis, Polymorphism, Single Nucleotide, Settore MED/13 - Endocrinologia, DNA Mutational Analysi, Hospital, Gene Frequency, Polymorphism (computer science), Diabetes mellitus, Glucokinase, Internal Medicine, medicine, Basic Helix-Loop-Helix Transcription Factors, Prevalence, Humans, Hepatocyte Nuclear Factor 1-alpha, Child, Gene, Allele frequency, Hepatocyte Nuclear Factor 1-beta, Advanced and Specialized Nursing, Homeodomain Proteins, Type 1 diabetes, Molecular screening, business.industry, Medicine (all), Homeodomain Protein, medicine.disease, Hospitals, HNF1A, Pedigree, Diabetes Mellitus, Type 2, Hepatocyte Nuclear Factor 4, Italy, Trans-Activator, Mutation, Trans-Activators, business, Human
Abstract: Maturity-onset diabetes of the young (MODY; MIM# 606391) is a genetically and clinically heterogeneous form of diabetes, accounting for 1–2% of all diabetes cases (1). MODY is characterized by mild hyperglycemia or overt diabetes usually detected in three consecutive generations, with onset before the age of 25 years and absence of type 1 diabetes autoantibodies. Among the thirteen MODY genes identified, two subtypes, GCK -MODY and HNF1A -MODY, account for most of cases (1). The prevalence of GCK -MODY has been reported higher in Southern Europe (2), while HNF1A -MODY is the most common MODY subtype in Northern Europe (3). This difference might be attributable to the clinical setting in which genetic screening is performed, especially when pediatric and adult diabetes clinics are distinct entities. We addressed this issue by investigating MODY patients identified in the pediatric or in the adult diabetes clinics of the same research-based …
Published: 2014

7. One-year glargine treatment can improve the course of lung disease in children and adolescents with cystic fibrosis and early glucose derangements

Author: Pasqualina Ferri, Valeria Raia, Gianfranco Mazzarella, Enza Mozzillo, Giuliana Valerio, Angela Sepe, Ilaria De Simone, Adriana Franzese, Mozzillo, E, Franzese, Adriana, Valerio, G, Sepe, A, De Simone, I, Mazzarella, G, Ferri, P, Raia, Valeria, Mozzillo E, 1., Franzese, A, and Ferri, G
Subjects: Lung Diseases, Spirometry, medicine.medical_specialty, Adolescent, Cystic Fibrosis, Endocrinology, Diabetes and Metabolism, Cystic fibrosis-related diabetes, Population, Insulin Glargine, Growth, Cystic fibrosis, Gastroenterology, Body Mass Index, glargine, Forced Expiratory Volume, Internal medicine, Diabetes mellitus, Glucose Intolerance, Diabetes Mellitus, Internal Medicine, Humans, Hypoglycemic Agents, Insulin, Medicine, Child, education, cystic fibrosi, Glycated Hemoglobin, Glucose tolerance test, education.field_of_study, medicine.diagnostic_test, diabetes, business.industry, Insulin glargine, Glucose Tolerance Test, medicine.disease, Insulin, Long-Acting, Treatment Outcome, Endocrinology, Hyperglycemia, Pediatrics, Perinatology and Child Health, business, Body mass index, medicine.drug
Abstract: Background: Diabetes increases morbidity and mortality in cystic fibrosis (CF) patients, but several studies indicate that also prediabetic status may have a potential impact on both nutrition and lung function. Objective: To evaluate the effect of glargine on the clinical course in CF patients with early glucose derangements. Methods: CF population was screened for glucose tolerance. CF patients with age >10 yr were screened with fasting hyperglycemia (FH). CF patients with age >10 yr without FH and those with age
Published: 2009

8. Diagnosis of congenital Hyperinsulinism can occur not only in infancy but also in later age: a new flow chart from a single center experience

Author: Alberto Casertano, Valentina Fattorusso, Arianna De Matteis, Enza Mozzillo, Francesco Maria Rosanio, P Buono, Adriana Franzese, Casertano, A., De Matteis, A., Mozzillo, E., Rosanio, F. M., Buono, P., Fattorusso, V., and Franzese, A.
Subjects: 0301 basic medicine, Male, Pediatrics, medicine.medical_specialty, Adolescent, 030209 endocrinology & metabolism, Hypoglycemia, ABCC8, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Medicine, Humans, Child, biology, business.industry, Neonatal hypoglycemia, Research, Age Factors, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Gestational diabetes, 030104 developmental biology, Postprandial, Italy, biology.protein, Congenital hyperinsulinism, Female, Congenital Hyperinsulinism, Presentation (obstetrics), Diagnostic flow-chart, business, Algorithms
Abstract: Background Congenital Hyperinsulinism typically occurs with a neonatal hypoglycemia but can appear even in childhood or in adolescence with different types of glucose metabolism derangements. Current diagnostic algorithms don’t take into account cases with a late presentation. Patients and methods Clinical and laboratory data of twenty-two subjects diagnosed at Federico II University of Naples have been described: patients have been divided according to the molecular defect into channel defects, metabolic defects and unidentified molecular defects. A particular focus has been made on three cases with a late presentation. Results and conclusions Late presentation cases may not be identified by previous diagnostic algorithms. Consequently, it seems appropriate to design a new flow-chart starting from the age of presentation, also considering that late presentation cases can show glucose metabolism derangements other than hypoglycaemic crises such as diabetes, glucose intolerance, postprandial hypoglycaemia and gestational diabetes.
Published: 2020
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9. Editorial: New Insights in Diagnosing and Treatment of Glucose Disorders and Obesity in Children and Adolescents

Author: Enza Mozzillo, Giulio Maltoni, Valentina Chiavaroli, Klemen Dovc, Marco Marigliano, Mozzillo, E., Maltoni, G., Chiavaroli, V., Dovc, K., and Marigliano, M.
Subjects: Pediatrics, medicine.medical_specialty, obesity, diabetes, business.industry, medicine.disease, Obesity, RJ1-570, Editorial, diabete, Diabetes mellitus, Pediatrics, Perinatology and Child Health, technology, medicine, adolescence, business, childhood
Published: 2021
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10. Use of FOLFIRINOX or Nab-Paclitaxel Plus Gemcitabine for the Treatment of Locally Advanced Pancreatic Adenocarcinoma: A Single Institution Observational Study

Author: Fabiana Napolitano, Sabino De Placido, Lucia Maresca, Antonio Santaniello, R. Marciano, Roberto Bianco, Eleonora Mozzillo, Alberto Servetto, Francesca Foschini, Luigi Formisano, Priscilla Cascetta, Pietro De Placido, Anna Rita Amato, Maria Rosaria Augurio, Servetto, A., Santaniello, A., Napolitano, F., Foschini, F., Marciano, R., Mozzillo, E., Cascetta, P., Amato, A. R., Augurio, M. R., Maresca, L., De Placido, P., De Placido, S., Formisano, L., and Bianco, R.
Subjects: Cancer Research, medicine.medical_specialty, FOLFIRINOX, medicine.medical_treatment, Peripheral edema, Neutropenia, Gastroenterology, Article, Internal medicine, medicine, nab-paclitaxel plus gemcitabine, Neoadjuvant therapy, RC254-282, Chemotherapy, Thrombocytosis, business.industry, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, locally advanced pancreatic adenocarcinoma, medicine.disease, Gemcitabine, Oncology, Adenocarcinoma, medicine.symptom, business, Locally advanced pancreatic adenocar-cinoma, medicine.drug
Abstract: Patients with locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) do not present distant metastases but are not eligible for surgery upfront. Chemotherapy regimens, such as FOLFIRINOX (FFN) or nab-paclitaxel plus gemcitabine (GemNab) in combination with loco-regional treatments are generally used in this setting. However, the best treatment choice is unknown. We retrospectively analyzed the information of 225 patients with stage II–III PDAC treated at our institution between October 2011 and December 2020. A total of 94 patients with LA PDAC who are non-eligible for surgery upfront received neoadjuvant FFN or GemNab. Of the 67 patients receiving FFN, 28 (41.8%) underwent surgery after neoadjuvant therapy. Of the 27 patients treated with GemNab, 6 (22.2%) became eligible for resection. The median overall survival (OS) was 85.1 weeks and 54.3 weeks in the FFN and GemNab groups, respectively (HR = 0.54, p = 0.0109). The median OS was 189.7 weeks and 76.4 weeks in the resected and unresected cohorts, respectively (HR = 0.25, p &lt, 0.0001). Neutropenia (37.3%), anemia (6.0%), and diarrhea (6.0%) in the FFN group and neutropenia (22.2%) and thrombocytopenia (18.5%) in the GemNab groups were the most frequent grade 3–4 side effects. Higher rates of thrombocytosis (p &lt, 0.0001) and peripheral edema (p &lt, 0.0001) were observed in the GemNab group. Our results suggest that the use of FFN is associated with more favorable clinical outcomes than GemNab for patients with LA PDAC. Future randomized and controlled clinical trials are needed to further elucidate the role of these regimens and loco-regional treatments in this setting.
Published: 2021

11. Prader-Willi Syndrome: Role of Bariatric Surgery in Two Adolescents with Obesity

Author: Giovanna Berardi, Enza Mozzillo, Mario Musella, Alberto Casertano, Marina Tripodi, Adriana Franzese, Martina Peluso, Tripodi, M., Casertano, A., Peluso, M., Musella, M., Berardi, G., Mozzillo, E., and Franzese, A.
Subjects: Pediatrics, medicine.medical_specialty, Nutrition and Dietetics, business.industry, Endocrinology, Diabetes and Metabolism, medicine, MEDLINE, Surgery, medicine.disease, business, Obesity
Published: 2020
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12. The effect of the COVID-19 pandemic on telemedicine in pediatric diabetes centers in Italy: Results from a longitudinal survey

Author: Enza Mozzillo, Andrea Scaramuzza, Riccardo Schiaffini, Anna Paola Frongia, Gianluca Tornese, Roberto Franceschi, Tornese, G., Schiaffini, R., Mozzillo, E., Franceschi, R., Frongia, A. P., Scaramuzza, A., Tornese, Gianluca, Schiaffini, Riccardo, Mozzillo, Enza, Franceschi, Roberto, Paola Frongia, Anna, and Scaramuzza, Andrea
Subjects: Telemedicine, Coronavirus disease 2019 (COVID-19), Pediatric endocrinology, Endocrinology, Diabetes and Metabolism, Continuous subcutaneous insulin infusion, continuous glucose monitoring, insulin pump, continuous subcutaneous insulin infusion, pediatric diabetes, State Medicine, Article, Pediatric diabete, Endocrinology, Pandemic, Internal Medicine, medicine, Diabetes Mellitus, Humans, Longitudinal Studies, Insulin pump, Child, Pandemics, Continuous glucose monitoring, Reimbursement, Descriptive statistics, business.industry, Pediatric diabetes, SARS-CoV-2, COVID-19, General Medicine, medicine.disease, National health service, Italy, Medical emergency, business
Abstract: Aims: In March and April 2020, at the start of the COVID-19 pandemic, our previous survey of Italian pediatric diabetes centers showed that 75% of telemedicine use was voluntary. We hypothesized that the COVID-19 pandemic has acted as a picklock to overcome barriers to telemedicine regulation, use, and reimbursement. Methods: Between March 22nd and April 12th, 2021, the same survey administered in 2020 was sent to all 68 Italian pediatric diabetes centers belonging to the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) to collect data on the demographic variables of respondents; information about the center; the use, codification, and reimbursement of telemedicine; and used tools. Descriptive data were evaluated to establish how the COVID-19 pandemic has changed telemedicine practice. Results: Eighty-two percent of responder centers reported an increase in the use of telemedicine, with televisits by video calling implemented in over half of centers. There was a significant increase in the number of centers formally tracking telemedicine use and obtaining reimbursement from the national health service (42% vs. 29% and 62% vs. 32%; p < 0.001, respectively). No reimbursement was provided to centers not using televisits. Conclusions: From a voluntary procedure with a lack of traceability, telemedicine has become a new structured reality that may help our pediatric patients beyond this pandemic.
Published: 2021

13. Polycystic ovary syndrome in pediatric obesity and diabetes

Author: Enza Mozzillo, Maria Tufano, Maria Cristina Vigone, Laura Lucaccioni, Maurizio Delvecchio, Gabriella Pozzobon, Graziamaria Ubertini, Elena Dondi, Dondi, E., Tufano, M., Vigone, M. C., Lucaccioni, L., Pozzobon, G., Ubertini, G., Mozzillo, E., and Delvecchio, M.
Subjects: Adult, Pediatrics, medicine.medical_specialty, Diabetes mellitu, Hirsutism, Pediatric Obesity, Adolescent, Anovulation, Diabetes mellitus, medicine, Obesity, Polycystic ovary syndrome, Child, Female, Humans, Diabetes Mellitus, Type 2, Polycystic Ovary Syndrome, hirsutism, business.industry, Type 2 Diabetes Mellitus, medicine.disease, Polycystic ovary, Metformin, Pediatrics, Perinatology and Child Health, Amenorrhea, medicine.symptom, Metabolic syndrome, business, Type 2, medicine.drug
Abstract: Introduction Polycystic ovary syndrome is characterized by anovulation (amenorrhea, oligomenorrhea, irregular menstrual cycles) combined with symptoms of androgen excess (hirsutism, acne, alopecia). The clear definition and diagnosis in adolescents could be challenging considering that most of symptoms occur as part of the expected physiological hormonal imbalance of puberty. Therefore, different diagnostic criteria have been elaborated. Polycystic ovary syndrome could be associated to obesity, diabetes mellitus, and metabolic syndrome. In adolescents with polycystic ovary syndrome, adiposity is associated with higher androgen concentrations and greater menstrual irregularity. Polycystic ovary syndrome in youth is considered a risk factor for type 2 diabetes mellitus in adulthood. On the other hand, increased prevalence of polycystic ovary syndrome has been shown in type 1 diabetes mellitus. Evidence The treatment of polycystic ovary syndrome in adolescents is controversial considering that adequate trials are lacking. First line treatment comprises lifestyle modification (preferably multicomponent including diet, exercise and behavioural strategies) that should be recommended overall in the patients with polycystic ovary syndrome and overweight, central obesity and insulin resistance. Beyond non-pharmacological therapy, pharmacological agents include combined hormonal contraceptives, metformin and antiandrogens, used separately or in combination. The aim of therapy is to bring back ovulation, to normalize menses, to reduce hirsutism and acne, to reduce weight. Other important goal is the treatment of hyperlipidaemia and of hyperglycaemia. Conclusions This narrative review aims to review the most pertinent literature about polycystic ovary syndrome in adolescents with obesity or diabetes. We overviewed the diagnostic criteria, the pathophysiology and the possible treatment approaches.
Published: 2021

14. Intermittently Scanned and Continuous Glucose Monitor Systems: A Systematic Review on Psychological Outcomes in Pediatric Patients

Author: Massimo Soffiati, Roberto Franceschi, Elisa Giani, Enza Mozzillo, Francesca Micheli, Vittoria Cauvin, Alice Liguori, Franceschi, R., Micheli, F., Mozzillo, E., Cauvin, V., Liguori, A., Soffiati, M., and Giani, E.
Subjects: type 1 diabetes, 030209 endocrinology & metabolism, PsycINFO, CINAHL, Cochrane Library, Pediatrics, RJ1-570, law.invention, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Randomized controlled trial, law, Medicine, 030212 general & internal medicine, Grading (education), child, psychological outcome, CGM, business.industry, Evidence-based medicine, psychological outcomes, Pediatrics, Perinatology and Child Health, Anxiety, Systematic Review, medicine.symptom, business, isCGM, Clinical psychology
Abstract: Aim: To explore the impact of real-time continuous glucose monitoring (rtCGMs) or intermittently scanned/viewed CGM (isCGM) on psychological outcomes in children and caregivers, and to grade the level of evidence.Method: Systematic review of the literature from PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Nursing reference center, Up to date, Google Scholar, and PsycINFO databases. The studies selected used validated questionnaires for investigating the psychological outcomes. We applied GRADE (Grading of Recommendations Assessment, Development and Evaluation) to rank the quality of a body of evidence.Results: A total of 192 studies were identified in the initial search and after the process of evaluation 25 studies were selected as appropriate to be included in this systematic review. We found in moderate quality studies that isCGM in adolescents can improve diabetes related distress, family conflicts, fear of hypoglycemia, and quality of life, while depression, anxiety, and quality of sleep have not yet been evaluated by validated questionnaires. In moderate—high quality studies, rtCGM technology does not impact on diabetes burden, diabetes specific family conflict, and depressive symptoms. The effect on fear of hypoglycemia, sleep quality, and anxiety is still debated and RCT studies powered to find significant results in psychological outcomes are lacking. RtCGM increases satisfaction and quality of life in parents and patients wearing rtCGM.Conclusion: these data present an interesting point to consider when families are deciding whether or not to start CGM use, choosing between rtCGM to reach a tighter metabolic control, or isCGM which allows greater benefits on psychological outcomes.
Published: 2021
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15. Case Report: Ophthalmologic Evaluation Over a Long Follow-Up Time in a Patient With Wolfram Syndrome Type 2: Slowly Progressive Optic Neuropathy as a Possible Clinical Finding

Author: Francesco Maria Rosanio, Claudio Iovino, Valentina Di Iorio, Francesca Di Candia, Francesco Testa, Adriana Franzese, Enza Mozzillo, Francesca Simonelli, Rita Genesio, Di Iorio, V., Mozzillo, E., Rosanio, F. M., Di Candia, F., Genesio, R., Testa, F., Iovino, C., Franzese, A., and Simonelli, F.
Subjects: 0301 basic medicine, Pediatrics, medicine.medical_specialty, Wolfram syndrome, Peptic, 030209 endocrinology & metabolism, Case Report, Disease, 030105 genetics & heredity, Fundus (eye), non-autoimmune diabete, non-autoimmune diabetes, RJ1-570, Optic neuropathy, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Diabetes mellitus, medicine, optic atrophy, business.industry, CISD2 gene, neurodegeneration, medicine.disease, optic neuropathy, Diabetes insipidus, Pediatrics, Perinatology and Child Health, business
Abstract: Wolfram syndrome (WFS) is a rare autosomal recessive neurodegenerative disease whose diagnosis requires diabetes mellitus and optic atrophy (OA). WFS includes a wide spectrum of other possible complications such as diabetes insipidus, sensorineural deafness, urinary tract problems, neurological and psychiatric disorders. Most WFS patients show type 1 syndrome (WFS1) caused by mutations in the WFS1 gene, encoding Wolframin protein, while few patients are affected by WFS type 2 (WFS2) due to a pathogenetic variants in the CISD2 gene encoding an endoplasmic reticulum intermembrane small protein. WFS2 is considered a phenotypic and genotypic variant of WFS, from which differs only for the increased risk of bleeding and presence of peptic ulcers. OA and diabetes are considered cardinal features of WFS. We hereby report the ophthalmologic evaluation in a patient, previously described, with WFS2 after 8 years of follow-up. A 20-year-old white woman was referred to our retinal center for the first time in 2012 following a diagnosis of a novel intragenic exon 2 CISD2 homozygous deletion, for the suspicion of an associated bilateral OA. Fundus examination, spectral-domain optical coherence tomography, visual field, visual evoked potentials were performed and confirmed the presence of an optic neuropathy that remained stable over 8 years follow up. A slowly progressive optic neuropathy, rather than OA can characterize patients with WFS2 and CISD2 intragenic deletion.
Published: 2021
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16. Albuminuric and non-albuminuric reduced eGFR phenotypes in youth with type 1 diabetes: Factors associated with cardiometabolic risk

Author: Maurizio Delvecchio, C. Ripoli, Claudia Piona, Alberto Casertano, Roberto Franceschi, Riccardo Schiaffini, Maria R Ricciardi, Valentino Tiberi, Elvira Piccinno, T. Suprani, Giulio Maltoni, Enza Mozzillo, Procolo Di Bonito, Angela Zanfardino, Dario Iafusco, Gianluca Tornese, Silvia Savastio, C. Arnaldi, Valentino Cherubini, Francesco Maria Rosanio, Brunella Iovane, Claudio Maffeis, Adriana Franzese, Di Bonito, P., Mozzillo, E., Rosanio, F. M., Maltoni, G., Piona, C. A., Franceschi, R., Ripoli, C., Ricciardi, M. R., Tornese, G., Arnaldi, C., Iovane, B., Iafusco, D., Zanfardino, A., Suprani, T., Savastio, S., Cherubini, V., Tiberi, V., Piccinno, E., Schiaffini, R., Delvecchio, M., Casertano, A., Maffeis, C., Franzese, A., Di Bonito, Procolo, Mozzillo, Enza, Rosanio, Francesco Maria, Maltoni, Giulio, Piona, Claudia Anita, Franceschi, Roberto, Ripoli, Carlo, Ricciardi, Maria Rossella, Tornese, Gianluca, Arnaldi, Claudia, Iovane, Brunella, Iafusco, Dario, Zanfardino, Angela, Suprani, Tosca, Savastio, Silvia, Cherubini, Valentino, Tiberi, Valentina, Piccinno, Elvira, Schiaffini, Riccardo, Delvecchio, Maurizio, Casertano, Alberto, Maffeis, Claudio, and Franzese, Adriana
Subjects: Male, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), White, Diabetic nephropathy, 030204 cardiovascular system & hematology, Kidney, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, cardiovascular disease, Retrospective Studie, Prevalence, eGFR, Medicine, Age Factor, Diabetic Nephropathies, Child, Children, Nutrition and Dietetics, cardiometabolic risk factor, type 1 diabete, Age Factors, Cardiovascular disease, Phenotype, Type 1 diabetes, Italy, Child, Preschool, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Human, Glomerular Filtration Rate, Type 1, medicine.medical_specialty, microalbuminuria, Type 1 diabete, Adolescent, Renal function, 030209 endocrinology & metabolism, Risk Assessment, White People, Autoimmune thyroiditis, 03 medical and health sciences, children, Internal medicine, Diabetes Mellitus, Humans, Albuminuria, Diabetic kidney disease, diabetic nephropathy, diabetic kidney disease, cardiometabolic risk factors, type 1 diabetes, Retrospective Studies, Cross-Sectional Studie, Creatinine, Cardiometabolic risk factor, business.industry, Thyroiditis, Autoimmune, Biomarker, medicine.disease, Cardiometabolic risk factors, Cross-Sectional Studies, Diabetes Mellitus, Type 1, chemistry, Diabetic Nephropathie, Uric acid, Microalbuminuria, business, Biomarkers
Abstract: Background and aim: Albuminuria and reduced eGFR are hallmarks of Diabetic Kidney Disease in adults. Our aim was to analyze factors associated with albuminuric and non-albuminuric mildly reduced eGFR phenotypes in youths with type 1 diabetes. Methods and results: This multicenter cross-sectional study included 1549 youths (age 5–17 years) with type 1 diabetes enrolled at 14 Italian Pediatric Diabetes Centers. Albuminuria, creatinine, glycosylated hemoglobin (HbA1c), lipids, blood pressure (BP), neutrophils (N) and lymphocytes (L) count were analyzed. Uric acid (UA) was available in 848 individuals. Estimated GFR (eGFR) was calculated using bedside Schwartz's equation. The sample was divided in three phenotypes: 1) normoalbuminuria and eGFR ≥90 mL/min/1.73 m2 (reference category, n = 1204), 2) albuminuric and normal GFR phenotype (n = 106), 3) non-albuminuric mildly reduced GFR (MRGFR) phenotype (eGFR 60–89 mL/min/1.73 m2, n = 239). Albuminuric and non-albuminuric reduced eGFR phenotypes were significantly associated with autoimmune thyroiditis (P =0.028 and P=0.044, respectively). Albuminuric phenotype showed high risk of high HbA1c (P=0.029), high BP (P < 0.001), and low HDL-C (P =0.045) vs reference category. Non-albuminuric MRGFR phenotype showed high risk of high BP (P < 0.0001), low HDL-C (P =0.042), high Triglycerides/HDL-C ratio (P =0.019), and high UA (P < 0.0001) vs reference category. Conclusion: Non albuminuric MRGFR phenotype is more prevalent than albuminuric phenotype and shows a worst cardiometabolic risk (CMR) profile). Both phenotypes are associated with autoimmune thyroiditis. Our data suggest to evaluate both albuminuria and eGFR earlier in type 1 diabetes to timely identify young people with altered CMR profile.
Published: 2021

17. Telemedicine in the Time of the COVID-19 Pandemic: Results from the First Survey among Italian Pediatric Diabetes Centers

Author: Tornese, Gianluca, Schiaffini, Riccardo, Mozzillo, Enza, Franceschi, Roberto, Frongia, Anna, Scaramuzza, Andrea, Group, on behalf of HCL Expert Pathway Pediatric, Endocrinology, the Diabetes Study Group of the Italian Society for Pediatric, Tornese, Gianluca, Schiaffini, Riccardo, Mozzillo, Enza, Franceschi, Roberto, Frongia, Anna, Scaramuzza, Andrea, Tornese, G., Schiaffini, R., Mozzillo, E., Franceschi, R., Frongia, A. P., and Scaramuzza, A.
Subjects: Insulin pump, Telemedicine, Leadership and Management, Health Informatics, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, Pediatric diabete, 0302 clinical medicine, Health Information Management, Phone, Pandemic, medicine, 030212 general & internal medicine, pediatric diabetes, Reimbursement, Accreditation, Type 1 diabetes, continuous subcutaneous insulin infusion, telemedicine, continuous glucose monitoring, insulin pump, Pediatric diabetes, business.industry, Health Policy, medicine.disease, Medicine, Medical emergency, business
Abstract: Background: Use of telemedicine for children and adolescents with type 1 diabetes at the beginning of the COVID-19 pandemic was investigated. Method: 68 Italian pediatric diabetes centers were invited to complete a survey about telemedicine usage in their pediatric patients, allocated to the no-tech group (multiple daily injections and self-monitoring blood glucose) and the tech group (insulin pump and/or flash- or continuous-glucose monitoring). Results: 60.3% of the centers completed the survey. In both the no-tech and tech groups, the most used ways of communication were generic download portals, instant messaging with personal physicians’ mobiles, working emails, and phone calls to physicians’ mobiles, with no difference, except for the use of email being higher in the no-tech group (p = 0.03). Seventy-four percent of the centers did not have any systematization and/or reimbursement, with significant differences among regions (p = 0.03). Conclusions: Almost all Italian pediatric diabetes centers use telemedicine in a semi-volunteering manner, lacking proper codification, reimbursement system, legal traceability, and accreditation system.
Published: 2021

18. Type 2 diabetes in pediatrics

Author: Emanuele Miraglia del Giudice, Fabrizio Barbetti, Enza Mozzillo, Ivana Rabbone, Fortunato Lombardo, Elena Fornari, Dario Iafusco, Fornari, Elena, Barbetti, Fabrizio, Iafusco, Dario, Lombardo, Fortunato, MIRAGLIA DEL GIUDICE, Emanuele, Rabbone, Ivana, Mozzillo, Enza, Fornari, E., Barbetti, F., Iafusco, D., Lombardo, F., Giudice, E. M. D., Rabbone, I., and Mozzillo, E.
Subjects: Adult, medicine.medical_specialty, MEDLINE, Type 2 diabetes, Overweight, Pediatrics, Multidisciplinary approach, Physicians, Diabetes mellitus, Control, medicine, Humans, Family history, Intensive care medicine, Life Style, Pediatric, child, Type 1 diabetes, business.industry, Prevention, Diabetes Mellitu, medicine.disease, Obesity, Type 2 Diabetes Mellitus, Diabetes Mellitus, Type 2, adolescent, Pediatrics, Perinatology and Child Health, epidemiology, medicine.symptom, business, Type 2
Abstract: iNtrOdUctiON: type 2 diabetes (t2d) in adolescents has become an increasing health concern throughout the world and its prevention and screening should be implemented in pediatric care. as clinical features at presentation, in some cases can be similar to type 1 diabetes and family history can be in favor of a monogenic form of diabetes, it is pivotal for physicians to be aware of youth-onset T2D specificities to ensure an accurate diagnosis. EVIDENCE ACQUISITION: We conducted the first search in Medline, Embase, Web of Science, using different keywords and their compositions. The keywords used, also called “mesh” (MEdical Subject Headings) on PubMed, are the following: “type 2 diabetes” AND (“child*” OR “pediatr*” OR “adolesce*”) AND (“epidem*” OR “diagnos*” OR “treat*” OR “complication” OR “comorbidit*”). International review, systematic reviews and meta-analyses, randomized control trials and case reports published between May 2018 and February 2021 were considered, to identify publications that deal with the topic. No restrictions were applied regarding the published paper’s language. eVideNce sYNtHesis: the global increase of overweight and obesity can complicate the diagnostic process and makes it essential to apply a systematic approach to each new diagnosis. Microvascular complications may be present at the time of diagnosis and chronic complications are frequent and need to be screened regularly. regular screening of comorbidities should also be performed. childhood t2d should be followed up by pediatric diabetes units to avoid diagnostic errors and delay in care. cONcLUsiONs: a multidisciplinary approach, by an experienced team, is pivotal to provide treatment options targeting the unique needs of pediatric patients. treatment programs must include the whole family and address all the aspects of the care (lifestyle, pharmacological therapy, psychological aspects, complications and comorbidities). an organized process of transition to adult care is essential.
Published: 2021

19. Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED)

Author: Stefano Zucchini, Donatella Lo Presti, Riccardo Schiaffini, Valentino Cherubini, Dorina Pjetraj, Claudia Piona, Fortunato Lombardo, Valeria Calcaterra, Anna Paola Frongia, Sonia Toni, M. C. Matteoli, Giuseppe d'Annunzio, Vittoria Cauvin, Elvira Piccinno, Andrea Scaramuzza, Barbara Predieri, Claudio Maffeis, Giulio Maltoni, Enza Mozzillo, Alberto Casertano, Ivana Rabbone, Roberto Franceschi, Stefano Passanisi, Adriana Franzese, Mozzillo, E., Franceschi, R., Piona, C., Passanisi, S., Casertano, A., Pjetraj, D., Maltoni, G., Calcaterra, V., Cauvin, V., Cherubini, V., D'Annunzio, G., Franzese, A., Frongia, A. P., Lombardo, F., Lo Presti, D., Matteoli, M. C., Piccinno, E., Predieri, B., Rabbone, I., Scaramuzza, A. E., Toni, S., Zucchini, S., Maffeis, C., and Schiaffini, R.
Subjects: Blood Glucose, recommendation, Pediatrics, medicine.medical_specialty, Cystic Fibrosis, Pediatric endocrinology, Endocrinology, Diabetes and Metabolism, cystic fibrosis-related diabete, Cystic fibrosis-related diabetes, cystic fibrosis-related diabetes, 030209 endocrinology & metabolism, Review, prediabetes, Cystic fibrosis, Diseases of the endocrine glands. Clinical endocrinology, Prediabetic State, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, abnormal glucose tolerance, continuous glucose monitoring, glargine insulin, oral glucose tolerance test (OGTT), recommendations, systematic review, Diabetes mellitus, medicine, Diabetes Mellitus, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Prediabetes, Glycemic, Insulin glargine, business.industry, Glucose Tolerance Test, RC648-665, medicine.disease, Prognosis, Comorbidity, Disease Progression, prediabete, business, medicine.drug
Abstract: Cystic fibrosis related diabetes (CFRD) is a comorbidity of cystic fibrosis (CF) that negatively impacts on its clinical course. Prediabetes is an important predictor of either CFRD development and unfavorable prognosis of CF in both pediatric and adult patients. International guidelines recommend insulin only in case of CFRD diagnosis. Whether early detection and treatment of prediabetes may contribute to improve the clinical course of CF is still debated. A subgroup of pediatric diabetologists of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED) performed a systematic review of the literature based on predefined outcomes: impact of pre-diabetes on clinical outcomes and on the risk of developing CFRD; diagnosis of diabetes and pre-diabetes under 10 years of age; effectiveness of therapy on glycemic control, impact of therapy on pulmonary function and nutritional status. Thirty-one papers were selected for the analysis data presented in these papers were reported in tables sorted by outcomes, including comprehensive evidence grading according to the GRADE approach. Following the grading of the quality of the evidence, the entire ISPED diabetes study group achieved consensus for the Italian recommendations based on both evidence and clinical experience. We concluded that in patients with CF, prediabetes should be carefully considered as it can evolve into CFRD. In patients with CF and prediabetic conditions, after complete evaluation of the OGTT trend, glucometrics, glycemic values measured during pulmonary exacerbations and/or steroid therapy, early initiation of insulin therapy could have beneficial effects on clinical outcomes of patients with CF and prediabetes.
Published: 2021

20. An Overview of Hypoglycemia in Children Including a Comprehensive Practical Diagnostic Flowchart for Clinical Use

Author: Alberto Casertano, Alessandro Rossi, Simona Fecarotta, Francesco Maria Rosanio, Cristina Moracas, Francesca Di Candia, Giancarlo Parenti, Adriana Franzese, Enza Mozzillo, Casertano, A., Rossi, A., Fecarotta, S., Rosanio, F. M., Moracas, C., Di Candia, F., Parenti, G., Franzese, A., and Mozzillo, E.
Subjects: medicine.medical_specialty, PHOSPHOENOLPYRUVATE CARBOXYKINASE GTP, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, inborn errors of metabolism, Review, Neonatal age, Hypoglycemia, Diseases of the endocrine glands. Clinical endocrinology, childhood hypoglycemia, 03 medical and health sciences, congenital hyperinsulinism, Endocrinology, 0302 clinical medicine, 030225 pediatrics, PRIMARY ADRENAL INSUFFICIENCY, Humans, Medicine, Endocrine system, Glucose homeostasis, glucose homeostasis, Intensive care medicine, Child, business.industry, Neonatal hypoglycemia, DEXTROSE GEL, HYPERINSULINEMIC HYPOGLYCEMIA, High-Throughput Nucleotide Sequencing, GLYCOGEN-STORAGE-DISEASE, RC648-665, medicine.disease, Inborn error of metabolism, endocrine hypoglycemia, ENDOCRINE-SOCIETY, GH DEFICIENCY, Etiology, Congenital hyperinsulinism, GLUCOSE-HOMEOSTASIS, neonatal hypoglycemia, glucose homeostasi, business, Human
Abstract: Hypoglycemia is the result of defects/impairment in glucose homeostasis. The main etiological causes are metabolic and/or endocrine and/or other congenital disorders. Despite hypoglycemia is one of the most common emergencies in neonatal age and childhood, no consensus on the definition and diagnostic work-up exists yet. Aims of this review are to present the current age-related definitions of hypoglycemia in neonatal-pediatric age, to offer a concise and practical overview of its main causes and management and to discuss the current diagnostic-therapeutic approaches. Since a systematic and prompt approach to diagnosis and therapy is essential to prevent hypoglycemic brain injury and long-term neurological complications in children, a comprehensive diagnostic flowchart is also proposed.
Published: 2021

21. Effectiveness of a closed-loop control system and a virtual educational camp for children and adolescents with type 1 diabetes: A prospective, multicentre, real-life study

Author: Sara Giorda, C. Ripoli, Andrea Rigamonti, Francesco Maria Rosanio, D. Lo Presti, Maria Giulia Berioli, Francesca Redaelli, Barbara Predieri, Marta Bassi, C. Carducci, M. Calandretti, Enza Mozzillo, Davide Tinti, Valentino Cherubini, Marco Marigliano, Riccardo Bonfanti, Claudio Maffeis, Giuseppina Salzano, S. Savastio, Andrea Scaramuzza, Monica Marino, Giulio Maltoni, D. Iafusco, Ivana Rabbone, C. Pigniatiello, Barbara Piccini, Stefano Zucchini, Sonia Toni, M. Trada, V. Tiberi, Fortunato Lombardo, Maurizio Delvecchio, Angela Zanfardino, Rosaria Gesuita, Nicola Minuto, Chiara Mameli, Riccardo Schiaffini, Federico Abate Daga, Elvira Piccinno, M. R. Ricciardi, P. Buzzi, Cherubini, V., Rabbone, I., Berioli, M. G., Giorda, S., Lo Presti, D., Maltoni, G., Mameli, C., Marigliano, M., Marino, M., Minuto, N., Mozzillo, E., Piccinno, E., Predieri, B., Ripoli, C., Schiaffini, R., Rigamonti, A., Salzano, G., Tinti, D., Toni, S., Zanfardino, A., Scaramuzza, A. E., Gesuita, R., Tiberi, V., Savastio, S., Pigniatiello, C., Trada, M., Zucchini, S., Redaelli, F. C., Maffeis, C., Bassi, M., Rosanio, F. M., Delvecchio, M., Buzzi, P., Ricciardi, M. R., Carducci, C., Bonfanti, R., Lombardo, F., Piccini, B., Iafusco, D., Calandretti, M., and Daga, F. A.
Subjects: Blood Glucose, medicine.medical_specialty, Glucose control, Diabetic ketoacidosis, Adolescent, type 1 diabetes, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, continuous glucose monitoring, CSII, glycaemic control, insulin pump therapy, observational study, Target range, Endocrinology, Insulin Infusion Systems, Interquartile range, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Diabetes Mellitus, Humans, Hypoglycemic Agents, Insulin, Prospective Studies, Child, Type 1 diabetes, Hypoglycemic Agent, type 1 diabete, business.industry, Blood Glucose Self-Monitoring, medicine.disease, Prospective Studie, Diabetes Mellitus, Type 1, Insulin Infusion System, business, Life study, Human, Type 1
Abstract: Aim: To evaluate the impact of a virtual educational camp (vEC) on glucose control in children and adolescents with type 1 diabetes using a closed-loop control (CLC) system. Materials and Methods: This was a prospective multicentre study of children and adolescents with type 1 diabetes using the Tandem Basal-IQ system. Insulin pumps were upgraded to Control-IQ, and children and their parents participated in a 3-day multidisciplinary vEC. Clinical data, glucose metrics and HbA1c were evaluated over the 12 weeks prior to the Control-IQ update and over the 12 weeks after the vEC. Results: Forty-three children and adolescents (aged 7-16 years) with type 1 diabetes and their families participated in the vEC. The median percentage of time in target range (70-180 mg/dL; TIR) increased from 64% (interquartile range [IQR] 56%-73%) with Basal-IQ to 76% (IQR 71%-81%) with Control-IQ (P&nbsp
Published: 2021

22. Plasma dosage of ghrelin, IGF-1, GLP- 1 and leptin related to gastric emptying and esophageal pH-impedance in children with obesity

Author: Gerardo Nardone, Alba Rocco, Enza Mozzillo, Paolo Quitadamo, Annamaria Staiano, V. Giorgio, Adriana Franzese, Letizia Zenzeri, Quitadamo, P., Zenzeri, L., Mozzillo, E., Giorgio, V., Rocco, A., Franzese, A., Nardone, G., and Staiano, A.
Subjects: Leptin, Male, medicine.medical_specialty, Esophageal pH Monitoring, Gastrointestinal Diseases, Endocrinology, Diabetes and Metabolism, Gastric motility, 030209 endocrinology & metabolism, Gastric emptying, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Glucagon-Like Peptide 1, Internal medicine, medicine, Humans, pH-impedance monitoring, Obesity, Insulin-Like Growth Factor I, Child, Correlation of Data, Breath test, medicine.diagnostic_test, business.industry, digestive, oral, and skin physiology, medicine.disease, Hormone, digestive system diseases, Ghrelin, Gastroesophageal reflux, 030220 oncology & carcinogenesis, GERD, Quality of Life, Female, business
Abstract: Purpose: The main aim of the study was to assess the relationship between leptin, ghrelin, insulin-like growth factor 1 (IGF-1), and glucagon-like peptide 1 (GLP-1) blood levels and gastric motility in children with obesity compared to healthy children. Secondary aims were to assess the possible association between these hormones and obesity, reflux impedance parameters, reflux symptoms, other GI disorders, and quality-of-life scores within the same groups. Methods: Children with obesity plus GERD symptoms and 2 control groups of children with obesity without GERD and healthy lean children aged 4–17 years underwent an auxological evaluation, an assessment of gastro-intestinal symptoms and quality of life, hormonal dosages, and an evaluation of gastric emptying time (GET) through 13C-octanoic acid breath test. Results: No significant association was found between hormones and gastric motility. Leptin and ghrelin levels were significantly associated with obesity parameters. No significant differences were found between GET and hormones of the patients with obesity, either with or without GERD. Conclusion: Although we found an association between auxological parameters and both leptin and ghrelin levels, this association did not imply an effect on the upper GI motility. Therefore, our hypothesis that alterations of these hormones in children with obesity could affect gastric emptying, triggering GERD, was not supported by our data.
Published: 2021

23. Relationships between HbA1c and continuous glucose monitoring metrics of glycaemic control and glucose variability in a large cohort of children and adolescents with type 1 diabetes

Author: Dario Iafusco, Enza Mozzillo, Elvira Piccinno, Claudio Maffeis, Claudia Piona, Francesco Maria Rosanio, Maurizio Delvecchio, Marco Marigliano, Giulio Maltoni, Stefano Zucchini, Angela Zanfardino, Piona, C., Marigliano, M., Mozzillo, E., Rosanio, F., Zanfardino, A., Iafusco, D., Maltoni, G., Zucchini, S., Piccinno, E., Delvecchio, M., and Maffeis, C.
Subjects: Blood Glucose, Pediatrics, medicine.medical_specialty, Children and adolescents, Glycated Hemoglobin A, HbA1c, Adolescent, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Glycemic Control, Spearman's rank correlation coefficient, Metrics of glycaemic control, Endocrinology, Diabetes mellitus, Diabetes Mellitus, Internal Medicine, medicine, Humans, Child, Continuous glucose monitoring, Retrospective Studies, Glycated Hemoglobin, Type 1 diabetes, business.industry, Blood Glucose Self-Monitoring, nutritional and metabolic diseases, General Medicine, Glucose variability, medicine.disease, Children and adolescent, Large cohort, Benchmarking, Glucose, Diabetes Mellitus, Type 1, Cohort, Population study, Analysis of variance, business, Type 1
Abstract: Aims: To evaluate the relationships between HbA1c and Continuous Glucose Monitoring (CGM) metrics in children/adolescents with Type 1 Diabetes (T1D). Methods: HbA1c and real-life CGM data of the 12 weeks preceding its measurement were retrospectively collected from 654 children/adolescents with T1D. The relationships between HbA1c and CGM metrics were assessed by Spearman correlation coefficient. Participants were categorized into groups based on HbA1c and CGM metrics values. ANOVA was run across HbA1c and CGM metrics groups in the entire study population and in subjects stratified by CGM type, insulin therapy, age and puberty. Results: HbA1c was positively correlated with mean glucose, SD, %TAR > 180 mg/dL, %TAR > 250 mg/dL, HBGI and negatively with %TIR, %TBR and %time < 54 mg/dL. HbA1c-based groups were significantly associated with these metrics, but for each group their value widely ranged with a substantial overlap between them. HbA1c and HbA1c-based groups were not associated with %CV and LBGI, as well as %CV and LBGI-based groups had not significantly different HbA1c. Comparable results were found analysing subjects according to age, type of CGM, insulin therapy and puberty. Conclusions: The relationships between HbA1c and CGM metrics described in this cohort of paediatric subjects with T1D support the importance of the evaluation of these metrics, in particular %CV and LBGI, independently of HbA1c value.
Published: 2021

24. Glucose Tolerance Stages in Cystic Fibrosis Are Identified by a Unique Pattern of Defects of Beta-Cell Function

Author: Chiara Zusi, Enza Mozzillo, Maddalena Trombetta, Antonella Tosco, Adriana Franzese, Valeria Raia, Maria Linda Boselli, Sonia Volpi, Riccardo C. Bonadonna, Claudio Maffeis, Claudia Piona, Marco Cipolli, Piona, C, Volpi, S, Zusi, C, Mozzillo, E, Tosco, A, Franzese, A, Raia, V, Boselli, Ml, Trombetta, M, Cipolli, M, Bonadonna, Rc, and Maffeis, C.
Subjects: Adult, Blood Glucose, Male, medicine.medical_specialty, β-cell function, Adolescent, Cystic Fibrosis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, glucose metabolism, Clinical Biochemistry, Beta-cell Function, Carbohydrate metabolism, oral glucose tolerance test, Biochemistry, Cystic fibrosis, Severity of Illness Index, Impaired glucose tolerance, Young Adult, Endocrinology, Diabetes mellitus, Internal medicine, Insulin-Secreting Cells, Glucose Intolerance, Insulin Secretion, medicine, Humans, insulin sensitivity, Child, cystic fibrosi, business.industry, Insulin, Biochemistry (medical), Insulin sensitivity, Glucose Tolerance Test, medicine.disease, Cross-Sectional Studies, Glucose, Italy, Carbohydrate Metabolism, Blood sugar regulation, Female, Insulin Resistance, business
Abstract: Objective We aimed to assess the order of severity of the defects of 3 direct determinants of glucose regulation—beta-cell function, insulin clearance, and insulin sensitivity—in patients with cystic fibrosis (CF), categorized according their glucose tolerance status, including early elevation of mid-level oral glucose tolerance test (OGTT) glucose values (>140 and Methods A total of 232 CF patients aged 10 to 25 years underwent OGTT. Beta-cell function and insulin clearance were estimated by OGTT mathematical modeling and OGTT-derived biomarkers of insulin secretion and sensitivity were calculated. The association between glucometabolic variables and 5 glucose tolerance stages (normal glucose tolerance [NGT], AGT140, indeterminate glucose tolerance [INDET], impaired glucose tolerance [IGT], cystic fibrosis–related diabetes CFRD]) was assessed with a general linear model. Results Beta-cell function and insulin sensitivity progressively worsened across glucose tolerance stages (P Conclusions In CF patients, each of the 5 glucose tolerance stages shows a unique pattern of defects of the direct determinants of glucose regulation, with AGT140 patients significantly differing from NGT and being similar to IGT. These findings suggest that AGT140 should be recognized as a distinct glucose tolerance stage and that reconsideration of the grade of glucometabolic deterioration across glucose tolerance stages in CF is warranted.
Published: 2021

25. Diabetes outbreak during COVID19 lock-down in a prediabetic patient with cystic fibrosis long treated with glargine

Author: Antonella Tosco, Valeria Raia, Alberto Casertano, Chiara Cimbalo, Enza Mozzillo, Angela Sepe, Francesco Maria Rosanio, Adriana Franzese, Rosanio, Fm, Mozzillo, E, Cimbalo, C, Casertano, A, Sepe, A, Raia, V, Franzese, A, and Tosco, A
Subjects: Male, Cystic fibrosis related diabetes, Pediatrics, medicine.medical_specialty, Adolescent, Cystic Fibrosis, COVID19, Cystic fibrosis-related diabetes, Insulin Glargine, 030209 endocrinology & metabolism, Case Report, Oral glucose tolerance test, Cystic fibrosis, RJ1-570, Pulmonary function testing, Glucose derangements, Ivacaftor, Prediabetic State, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Diabetes mellitus, Lockdown, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Prediabetes, Glargine, Pandemics, Insulin glargine, business.industry, SARS-CoV-2, Lumacaftor, COVID-19, medicine.disease, Respiratory Function Tests, Diabetes Mellitus, Type 1, chemistry, Cystic fibrosis related diabetes, Prediabetes, Glucose derangements, Insulin, Glargine, Oral glucose tolerance test, COVID19, Lockdown, business, medicine.drug
Abstract: Background Cystic Fibrosis Related Diabetes (CFRD) is a frequent comorbidity of patients with Cystic Fibrosis (CF). A worsening of clinical conditions appears before CFRD. It has been demonstrated a decline in pulmonary function and nutritional status also in patients with prediabetes. Few trials show that insulin may be beneficial in prediabetic CF patients, to date guidelines do not recommend for this condition. Case presentation We report a case of a patient treated with insulin glargine at 13 years, due to glycemic intolerance, and with Lumacaftor/Ivacaftor at 15 years. A reduction of pulmonary exacerbations was observed after glargine therapy, also confirmed after the starting of Lumacaftor/ Ivacaftor in this patient. Pulmonary function improved only after the first year of glargine therapy, then a deterioration appeared due to the natural history of CF lung damage. During the COVID-19 lockdown, poor adherence to care contributed to diabetes mellitus onset needing high insulin requirements. After two weeks the patient returned to prediabetic condition and his previous dose of glargine. Conclusions our case highlights firstly that insulin glargine has contributed to preserve him from further clinical worsening due to prediabetes in the years before pandemic, secondly the negative impact of COVID-19 lockdown on the clinical course of a chronic disease as CF.
Published: 2020

26. Time in Range in Children with Type 1 Diabetes Using Treatment Strategies Based on Nonautomated Insulin Delivery Systems in the Real World

Author: N. Rapini, Luca Zagaroli, Giulio Maltoni, Fortunato Lombardo, Andrea Scaramuzza, Enza Mozzillo, Davide Tinti, Ivana Rabbone, Riccardo Bonfanti, Valentino Cherubini, Claudio Maffeis, Elena De Nitto, Andrea Rigamonti, Giuseppina Salzano, Marta Bassi, Sonia Toni, Alberto Casertano, Stefano Zucchini, Rosaria Gesuita, Marco Marigliano, Riccardo Schiaffini, Nicola Minuto, Antonio Iannilli, Cherubini, V., Bonfanti, R., Casertano, A., De Nitto, E., Iannilli, A., Lombardo, F., Maltoni, G., Marigliano, M., Bassi, M., Minuto, N., Mozzillo, E., Rabbone, I., Rapini, N., Rigamonti, A., Salzano, G., Scaramuzza, A., Schiaffini, R., Tinti, D., Toni, S., Zagaroli, L., Zucchini, S., Maffeis, C., and Gesuita, R.
Subjects: Blood Glucose, Male, Insulin glulisine, Insulin degludec, medicine.medical_specialty, Coefficient of variation, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Time above range, %, Time below range, Real-world evaluation, Time in range, 030209 endocrinology & metabolism, Insulin aspart, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Endocrinology, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Insulin, Insulin lispro, 030212 general & internal medicine, Child, Glycated Hemoglobin, Blood glucose monitoring, Type 1 diabetes, medicine.diagnostic_test, business.industry, Insulin glargine, Blood Glucose Self-Monitoring, medicine.disease, Medical Laboratory Technology, Cross-Sectional Studies, Diabetes Mellitus, Type 1, %, Emergency medicine, Time above range, Female, business, medicine.drug
Abstract: Background: Glucose sensors consist of real-time continuous glucose monitoring (rtCGM) and intermittently scanned CGM (isCGM). Their clinical use has been widely increasing during the past 5 years. The aim of this study is to evaluate percentage of time in range (TIR) in a large group of children with type 1 diabetes (T1D) using glucose sensors with nonautomated insulin delivery systems, in a real-world setting. Methods: An 11-center cross-sectional study was conducted during January-May 2019. Children with T1D 1 year, treated with multiple daily injections (MDI) or nonautomated insulin pump (IP), were recruited consecutively. Clinical data, HbA1c measurement, and CGM downloaded data were collected by each center and included in a centralized database for the analysis. Glucose metrics of four treatment strategies were analyzed: isCGM-MDI, rtCGM-MDI, isCGM-IP, and rtCGM-IP. Results: Data from 666 children with T1D (51% male and 49% female), median age 12 years, diabetes duration 5 years, were analyzed. An rtCGM was used by 51% of the participants, and a nonautomated IP by 46%. For isCGM-MDI, rtCGM-MDI, isCGM-IP, and rtCGM-IP, the median TIR 70-180 mg/dL values were 49%, 56%, 56%, and 61% (P < 0.001), respectively; HbA1c 7.6%, 7.5%, 7.3%, and 7.3% (P < 0.001), respectively. Use of rtCGM was associated with significant lower time below target range 180 mg/dL and lower HbA1c. If there are no barriers, an upgrade of the treatment strategy with a higher performing technology should be offered to all children who do not achieve blood glucose metrics within the suggested range.
Published: 2020

27. Long-term glycemic control and glucose variability assessed with continuous glucose monitoring in a pediatric population with type 1 diabetes: Determination of optimal sampling duration

Author: Claudio Maffeis, Giulio Maltoni, Claudia Piona, Dario Iafusco, Enza Mozzillo, Angela Zanfardino, Maurizio Delvecchio, Adriana Franzese, Stefano Zucchini, Marco Marigliano, Piona, C., Marigliano, M., Mozzillo, E., Franzese, A., Zanfardino, A., Iafusco, D., Maltoni, G., Zucchini, S., Delvecchio, M., and Maffeis, C.
Subjects: Blood Glucose, Male, Pediatrics, Glycated Hemoglobin A, Time Factors, endocrine system diseases, type 1 diabetes, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 0302 clinical medicine, Insulin, children and adolescent, 030212 general & internal medicine, Child, type 1 diabete, Continuous glucose monitoring, Sampling (statistics), long-term glycemic control and glucose variability, children and adolescents, Child, Preschool, Female, continuous glucose monitoring, Human, medicine.medical_specialty, Adolescent, Coefficient of variation, Injections, Subcutaneous, 030209 endocrinology & metabolism, Absolute difference, Injections, Subcutaneou, Follow-Up Studie, 03 medical and health sciences, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Glycemic, Glycated Hemoglobin, Type 1 diabetes, Hypoglycemic Agent, business.industry, Blood Glucose Self-Monitoring, medicine.disease, Term (time), Diabetes Mellitus, Type 1, data sampling, Pediatrics, Perinatology and Child Health, business, Follow-Up Studies
Abstract: Background: No studies have assessed if 2-week of continuous glucose monitoring (CGM) data provide good estimation of long-term glycemic control and glucose variability (GV) in pediatric patients with type 1 diabetes (T1D) as in adults. Methods: Six hundred fifty-four T1D pediatric patients were enrolled and 12-weeks of CGM data, before HbA1c measurement, were collected. Metrics of glycemic control and GV in incremental sampling periods were calculated. The agreement between metrics calculated in the sampling periods and the full 12-week period was assessed with correlation analysis (R2), median relative absolute difference (RAD) or absolute difference in the entire study populations and subjects stratified by age, pubertal status, insulin therapy (MDI,CSII), type of CGM (intermittently scanned [isCGM], real-time [rtCGM]), and HbA1c level. Results: Correlations with metrics of the full 12-week period improved by extending the sampling periods. R2 values close to 0.90 using 4-week period were significantly higher than 2-week period, particularly for coefficient of variation, mean glucose SD, percentage of time below the range
Published: 2020

28. Blood Co-Circulating Extracellular microRNAs and Immune Cell Subsets Associate with Type 1 Diabetes Severity

Author: Valentina Fattorusso, Paola de Candia, Antonio Ceriello, Elena Tagliabue, Enza Mozzillo, Annibale Alessandro Puca, Giuseppe Matarese, Sara Bruzzaniti, Pierluigi Mauri, Silvia Garavelli, Lucia La Sala, Francesco Perna, Francesco Prattichizzo, Dario Di Silvestre, Mario Galgani, Adriana Franzese, Garavelli, S., Bruzzaniti, S., Tagliabue, E., Prattichizzo, F., Silvestre, D. D., Perna, F., La Sala, L., Ceriello, A., Mozzillo, E., Fattorusso, V., Mauri, P., Puca, A. A., Franzese, A., Matarese, G., Galgani, M., and de Candia, P.
Subjects: 0301 basic medicine, Male, lymphocytes, Autoimmune, Biomarkers, Lymphocytes, MicroRNAs, medicine.disease_cause, lcsh:Chemistry, chemistry.chemical_compound, 0302 clinical medicine, Immunophenotyping, IL-2 receptor, Child, lcsh:QH301-705.5, Spectroscopy, MicroRNA, General Medicine, 3. Good health, Computer Science Applications, Lymphocyte, Female, Human, B-Lymphocyte Subsets, 030209 endocrinology & metabolism, Catalysis, Article, Inorganic Chemistry, 03 medical and health sciences, Immune system, medicine, Humans, Circulating MicroRNA, Physical and Theoretical Chemistry, micrornas, Molecular Biology, Type 1 diabetes, business.industry, Organic Chemistry, biomarkers, autoimmune, Biomarker, Immune dysregulation, medicine.disease, 030104 developmental biology, Diabetes Mellitus, Type 1, chemistry, lcsh:Biology (General), lcsh:QD1-999, Immunology, Glycated hemoglobin, business
Abstract: Immune cell subsets and microRNAs have been independently proposed as type 1 diabetes (T1D) diagnostic and/or prognostic biomarkers. Here, we aimed to analyze the relationships between peripheral blood circulating immune cell subsets, plasmatic microRNAs, and T1D. Blood samples were obtained from both children with T1D at diagnosis and age-sex matched healthy controls. Then, immunophenotype assessed by flow cytometry was coupled with the quantification of 60 plasmatic microRNAs by quantitative RT-PCR. The associations between immune cell frequency, plasmatic microRNAs, and the parameters of pancreatic loss, glycemic control, and diabetic ketoacidosis were assessed by logistic regression models and correlation analyses. We found that the increase in specific plasmatic microRNAs was associated with T1D disease onset (let-7c-5p, let-7d-5p, let-7f-5p, let-7i-5p, miR-146a-5p, miR-423-3p, and miR-423-5p), serum C-peptide concentration (miR-142-5p and miR-29c-3p), glycated hemoglobin (miR-26a-5p and miR-223-3p) and the presence of ketoacidosis (miR-29c-3p) more strongly than the evaluated immune cell subset frequency. Some of these plasmatic microRNAs were shown to positively correlate with numbers of blood circulating B lymphocytes (miR-142-5p) and CD4+CD45RO+ (miR-146a-5p and miR-223-3p) and CD4+CD25+ cells (miR-423-3p and miR-223-3p) in children with T1D but not in healthy controls, suggesting a disease-specific microRNA association with immune dysregulation in T1D. In conclusion, our results suggest that, while blood co-circulating extracellular microRNAs and immune cell subsets may be biologically linked, microRNAs may better provide powerful information about T1D onset and severity.
Published: 2020

29. Cardiovascular risk factors in children and adolescents with type 1 diabetes in Italy: a multicentric observational study

Author: F. Cardella, Claudia Piona, R Roppolo, T. Suprani, Enza Mozzillo, Claudio Maffeis, Barbara Predieri, Riccardo Bonfanti, Marco Marigliano, Ivana Rabbone, Nicola Minuto, Raffaele Buganza, Elisa Giani, Fortunato Lombardo, Elena Fornari, Vittoria Cauvin, Angela Zanfardino, Ippolita Patrizia Patera, Stefano Zucchini, Donatella Lo Presti, P. Reinstadler, Valentino Cherubini, Fornari, E., Piona, C., Rabbone, I., Cardella, F., Mozzillo, E., Predieri, B., Lo Presti, D., Cherubini, V., Patera, I. P., Suprani, T., Bonfanti, R., Cauvin, V., Lombardo, F., Zucchini, S., Zanfardino, A., Giani, E., Reinstadler, P., Minuto, N., Buganza, R., Roppolo, R., Marigliano, M., and Maffeis, C.
Subjects: Male, cardiovascular risk, cardiovascular risk factors, medicine.medical_specialty, Cross-sectional study, type 1 diabetes, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Logistic regression, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, children, Risk Factors, Internal medicine, Prevalence, Internal Medicine, medicine, Humans, cardiovascular risk factor, 030212 general & internal medicine, adolescents, Child, Type 1 diabetes, medicine.diagnostic_test, business.industry, adolescents, cardiovascular risk, cardiovascular risk factors, children, type 1 diabetes, Anthropometry, medicine.disease, Physical activity level, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Italy, Cardiovascular Diseases, Child, Preschool, adolescent, Pediatrics, Perinatology and Child Health, Cohort, Female, Lipid profile, business, Cohort study
Abstract: Aims to assess the prevalence of cardiovascular risk factors (CVRFs) and to identify the variables associated with CVRFs in a cohort of children and adolescents with Type 1 Diabetes. Methods 2,021 subjects, 2-18 year-old, were recruited in 17 Italian Pediatric Diabetes Centers. Anthropometric, blood pressure, biochemical (HbA1c, lipid profile, ACR), insulin therapy, physical activity level, smoking and family socio-economic status data were collected. CVRFs prevalence and their distribution were analyzed according to age and binary logistic regression was performed with positivity for at least one major CVRF (BMI-SDS>+2SD, blood pressure>90th percentile, LDL cholesterol>100 mg/dl) as dependent variable and age, duration of illness, gender, HbA1c and physical activity, as independent variables. Results The prevalence of CVFRs not at the recommended target was respectively: 32.5% one CVRF, 6.7% two CVRFs and 0.6% three CVRFs, with no significant differences across the 3 age groups (2-10, 10-15, 15-18 years). In the total sample, HbA1c and inadequate physical activity were associated with a higher probability of having at least one major CVRF. This probability was associated with physical activity in the 2-10-year-old group, with physical activity and HbA1c in the 10-15-year-old group and with HbA1c only in subjects older than 15 years. Conclusions More than 30% of subjects had at least a major CVRF. Early detection of CVRFs may be useful to enforce the therapeutic intervention in this subgroup, in order to reduce the risk to develop cardiovascular complications. This article is protected by copyright. All rights reserved.
Published: 2020

30. FOLFIRINOX after first-line gemcitabine-based chemotherapy in advanced pancreatic cancer: a retrospective comparison with FOLFOX and FOLFIRI schedules

Author: Giovanni Butturini, Roberta Marciano, Luigi Formisano, Cataldo Bianco, Eleonora Mozzillo, Anna Chiara Carratù, Sabino De Placido, Isabella Frigerio, Francesca Foschini, Priscilla Cascetta, Pietro De Placido, Roberto Bianco, Fabiana Napolitano, Antonio Santaniello, Sabina Delcuratolo, Nicola Silvestris, P. Regi, Enrico Vasile, Alberto Servetto, Caterina Vivaldi, Foschini, F., Napolitano, F., Servetto, A., Marciano, R., Mozzillo, E., Carratu, A. C., Santaniello, A., De Placido, P., Cascetta, P., Butturini, G., Frigerio, I., Regi, P., Silvestris, N., Delcuratolo, S., Vasile, E., Vivaldi, C., Bianco, C., De Placido, S., Formisano, L., and Bianco, R.
Subjects: Oncology, safety, medicine.medical_specialty, FOLFIRINOX, lcsh:RC254-282, Metastasis, gemcitabine, pancreatic adenocarcinoma, second line, 03 medical and health sciences, 0302 clinical medicine, FOLFOX, Internal medicine, Pancreatic cancer, Medicine, 030212 general & internal medicine, Original Research, business.industry, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Gemcitabine, Oxaliplatin, Irinotecan, 030220 oncology & carcinogenesis, FOLFIRI, business, FOLFIRINOX, gemcitabine, pancreatic adenocarcinoma, safety, second line, medicine.drug
Abstract: Background: Pancreatic adenocarcinoma is the fourth leading cause of cancer-related death. In cases with metastasis, the combination of 5-fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) or gemcitabine-based chemotherapy regimens are considered the standard of care. However, the optimal sequence of these regimens is unclear. Methods: This retrospective study initially evaluated 186 patients with locally advanced/metastatic pancreatic cancer at three Italian institutions between February 2013 and October 2019. All patients had progressed after receiving gemcitabine-based first-line chemotherapy and were subsequently offered second-line FOLFIRINOX, FOLFOX-6, or FOLFIRI treatment. This study evaluated progression-free survival (PFS), overall survival from the start of second-line treatment (OS2), overall survival from the start of first-line treatment (OS1), and safety outcomes. Results: A total of 77 patients received ⩾4 cycles of second-line chemotherapy and were considered eligible: 15 patients received FOLFIRINOX, 32 patients received FOLFOX-6, and 30 patients received FOLFIRI. The FOLFIRINOX group had median PFS of 26.29 weeks and median OS2 of 47.86 weeks, while the FOLFIRI group had median PFS of 10.57 weeks and median OS2 of 25.00 weeks ( p = 0.038). No significant differences were observed between the FOLFIRINOX and FOLFOX-6 groups in terms of PFS (26.29 weeks versus 23.07 weeks) or OS2 (47.86 weeks versus 42.00 weeks). The most common grade 3–4 toxicities were anemia, neutropenia, and thrombocytopenia, which occurred more frequently in the FOLFIRINOX and FOLFOX-6 groups. Conclusion: Relative to the FOLFIRI regimen, the FOLFIRINOX regimen had a favorable toxicity profile and better survival outcomes. No significant differences were observed relative to the FOLFOX-6 regimen.
Published: 2020

31. Plasma circulating miR-23~27~24 clusters correlate with the immunometabolic derangement and predict C-peptide loss in children with type 1 diabetes

Author: Paola de Candia, Lucia La Sala, Pierluigi Mauri, Valentina Fattorusso, Antonio Ceriello, Dario Di Silvestre, Adriana Franzese, Silvia Garavelli, Marco Marigliano, Mario Galgani, Claudio Maffeis, Enza Mozzillo, Francesco Prattichizzo, Rocky Strollo, Alessandra Petrelli, Giuseppe Matarese, Annibale Alessandro Puca, Elena Tagliabue, Sara Bruzzaniti, Emanuele Bosi, Garavelli, S., Bruzzaniti, S., Tagliabue, E., Di Silvestre, D., Prattichizzo, F., Mozzillo, E., Fattorusso, V., La Sala, L., Ceriello, A., Puca, A. A., Mauri, P., Strollo, R., Marigliano, M., Maffeis, C., Petrelli, A., Bosi, E., Franzese, A., Galgani, M., Matarese, G., and de Candia, P.
Subjects: 0301 basic medicine, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Diabetic complication, Gastroenterology, Diabetic complications, Diabetes Complications, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Immunopathology, Internal medicine, Internal Medicine, medicine, Humans, Biomarkers, Cardiovascular risk, Immunometabolism, Insulin secretion, microRNA, Osteoprotegerin, Type 1 diabetes, C-Peptide, C-peptide, business.industry, Insulin, Leptin, Metabolic disorder, Biomarker, medicine.disease, Circulating MicroRNA, MicroRNAs, 030104 developmental biology, Diabetes Mellitus, Type 1, chemistry, Resistin, business
Abstract: Aims/hypothesis: We aimed to analyse the association between plasma circulating microRNAs (miRNAs) and the immunometabolic profile in children with type 1 diabetes and to identify a composite signature of miRNAs/immunometabolic factors able to predict type 1 diabetes progression. Methods: Plasma samples were obtained from children at diagnosis of type 1 diabetes (n = 88) and at 12 (n = 32) and 24 (n = 30) months after disease onset and from healthy control children with similar sex and age distribution (n = 47). We quantified 60 robustly expressed plasma circulating miRNAs by quantitative RT-PCR and nine plasma immunometabolic factors with a recognised role at the interface of metabolic and immune alterations in type 1 diabetes. Based on fasting C-peptide loss over time, children with type 1 diabetes were stratified into the following groups: those who had lost >90% of C-peptide compared with diagnosis level; those who had lost
Published: 2020

32. HLA-DQA1 and HLA-DQB1 Alleles, Conferring Susceptibility to Celiac Disease and Type 1 Diabetes, are More Expressed Than Non-Predisposing Alleles and are Coordinately Regulated

Author: Giovanna Del Pozzo G, Laura Pisapia, Stefania Picascia, Pasquale Barba, Carmen Gianfrani, Enza Mozzillo, Serena Vitale, Adriana Franzese, Federica Farina, Farina, Federica, Piaccia, S, Pisapia, L, Barba, P, Vitale, S, Franzese, A, Mozzillo, E, Gianfrani, C, and Del Pozzo, G
Subjects: 0301 basic medicine, endocrine system, endocrine system diseases, Adolescent, Human leukocyte antigen, Biology, medicine.disease_cause, HLA-DQ alpha-Chains, Article, Autoimmunity, 03 medical and health sciences, 0302 clinical medicine, Antigen, Genotype, expression, medicine, HLA-DQ beta-Chains, Humans, Genetic Predisposition to Disease, Allele, Child, lcsh:QH301-705.5, Gene, Alleles, Genetics, Antigen Presentation, HLA-DQB1, autoimmunity, nutritional and metabolic diseases, regulation, General Medicine, risk genes, Celiac Disease, 030104 developmental biology, Diabetes Mellitus, Type 1, lcsh:Biology (General), Gene Expression Regulation, Ectopic expression, 030217 neurology & neurosurgery
Abstract: HLA DQA1(star)05 and DQB1(star)02 alleles encoding the DQ2.5 molecule and HLA DQA1(star)03 and DQB1(star)03 alleles encoding DQ8 molecules are strongly associated with celiac disease (CD) and type 1 diabetes (T1D), two common autoimmune diseases (AD). We previously demonstrated that DQ2.5 genes showed a higher expression with respect to non-CD associated alleles in heterozygous DQ2.5 positive (HLA DR1/DR3) antigen presenting cells (APC) of CD patients. This differential expression affected the level of the encoded DQ2.5 molecules on the APC surface and established the strength of gluten-specific CD4(+) T cells response. Here, we expanded the expression analysis of risk alleles in patients affected by T1D or by T1D and CD comorbidity. In agreement with previous findings, we found that DQ2.5 and DQ8 risk alleles are more expressed than non-associated alleles also in T1D patients and favor the self-antigen presentation. To investigate the mechanism causing the high expression of risk alleles, we focused on HLA DQA1(star)05 and DQB1(star)02 alleles and, by ectopic expression of a single mRNA, we modified the quantitative equilibrium among the two transcripts. After transfection of DR7/DR14 B-LCL with HLA-DQA1(star)05 cDNA, we observed an overexpression of the endogenous DQB1(star)02 allele. The DQ2.5 heterodimer synthesized was functional and able to present gluten antigens to cognate CD4(+) T cells. Our results indicated that the high expression of alpha and beta transcripts, encoding for the DQ2.5 heterodimeric molecules, was strictly coordinated by a mechanism acting at a transcriptional level. These findings suggested that, in addition to the predisposing HLA-DQ genotype, also the expression of risk alleles contributed to the establishment of autoimmunity.
Published: 2019
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33. Total metabolic tumor volume by 18F-FDG PET/CT for the prediction of outcome in patients with non-small cell lung cancer

Author: Luisa Piccin, Silvana Del Vecchio, Eleonora Mozzillo, Sara Pellegrino, Sabino De Placido, Rosa Fonti, Vincenzo Damiano, Elide Matano, Emanuela Mazziotti, Pellegrino, S, Fonti, R, Mazziotti, E, Piccin, Luisa, Mozzillo, E, Damiano, V, Matano, E, De Placido, S, and Del Vecchio, S
Subjects: Adult, Male, medicine.medical_specialty, Lung Neoplasms, Multivariate analysis, Total lesion glycolysis, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Non-small cell lung cancer, Fluorodeoxyglucose F18, Carcinoma, Non-Small-Cell Lung, Positron Emission Tomography Computed Tomography, 80 and over, medicine, Humans, Radiology, Nuclear Medicine and imaging, Stage (cooking), Non-Small-Cell Lung, Lung cancer, Survival analysis, Aged, Retrospective Studies, Aged, 80 and over, Univariate analysis, 18F-FDG PET/CT, Metabolic tumor volume, Prognosis, Female, Middle Aged, Tumor Burden, business.industry, Carcinoma, Cancer, General Medicine, medicine.disease, Primary tumor, 030220 oncology & carcinogenesis, Radiology, business, 18F-FDG PET, CT
Abstract: Objective Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are imaging parameters derived from 18F-FDG PET/CT that have been proposed for risk stratification of cancer patients. The aim of our study was to test whether these whole-body volumetric imaging parameters may predict outcome in patients with non-small cell lung cancer (NSCLC). Methods Sixty-five patients (45 men, 20 women; mean age +/- SD, 65 +/- 12 years), with histologically proven NSCLC who had undergone 18F-FDG PET/CT scan before any therapy, were included in the study. Imaging parameters including SUVmax, SUVmean, total MTV (MTVTOT) and whole-body TLG (TLG(WB)) were determined. Univariate and multivariate analyses of clinical and imaging variables were performed using Cox proportional hazards regression. Survival analysis was performed using Kaplan-Meier method and log-rank tests. Results A total of 298 lesions were analyzed including 65 primary tumors, 114 metastatic lymph nodes and 119 distant metastases. MTVTOT and TLG(WB) could be determined in 276 lesions. Mean value of MTVTOT was 81.83 ml +/- 14.63 ml (SE) whereas mean value of TLG(WB) was 459.88 g +/- 77.02 g (SE). Univariate analysis showed that, among the variables tested, primary tumor diameter (p = 0.0470), MTV of primary tumor (p = 0.0299), stage (p < 0.0001), treatment (p < 0.0001), MTVTOT (p = 0.0003) and TLG(WB) (p = 0.0002) predicted progression-free survival in NSCLC patients, while age (p = 0.0550), MTV of primary tumor (p = 0.0375), stage (p < 0.0001), treatment (p < 0.0001), MTVTOT (p = 0.0001) and TLG(WB) (p = 0.0008) predicted overall survival. At multivariate analysis age, TLG(WB) and stage were retained in the model for prediction of progression-free survival (p < 0.0001), while age, MTVTOT and stage were retained in the model for prediction of overall survival (p < 0.0001). Survival analysis showed that patients with TLG(WB) 54.7 g (p < 0.0001). Moreover, overall survival was significantly better in patients showing a MTVTOT 9.5 ml (p < 0.0001). Similar results were obtained in a subgroup of 43 patients with advanced disease (stages III and IV). Conclusions Whole-body PET-based volumetric imaging parameters are able to predict outcome in NSCLC patients.
Published: 2019
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34. Neoadjuvant Treatment in Locally Advanced Pancreatic Cancer (LAPC) Patients with FOLFIRINOX or Gemcitabine NabPaclitaxel: A Single-Center Experience and a Literature Review

Author: Francesca Foschini, Roberta Marciano, Luigi Formisano, Roberto Bianco, Alberto Servetto, Roberto Girelli, Alessandro Giardino, Anna Chiara Carratù, Fabiana Napolitano, Priscilla Cascetta, Antonio Santaniello, Pietro De Placido, Eleonora Mozzillo, Sabino De Placido, Napolitano, F, Formisano, L, Giardino, A, Girelli, R, Servetto, A, Santaniello, A, Foschini, F, Marciano, R, Mozzillo, E, Carratù, Ac, Cascetta, P, De Placido, P, De Placido, S, and Bianco, R.
Subjects: Oncology, Cancer Research, medicine.medical_specialty, FOLFIRINOX, LAPC, Population, Single Center, lcsh:RC254-282, Article, 03 medical and health sciences, 0302 clinical medicine, Unresected, Pancreatic cancer, Internal medicine, medicine, NACT, education, education.field_of_study, business.industry, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, locally advanced pancreatic cancer, conversion therapy, Gemcitabine, Locally advanced pancreatic cancer, 030220 oncology & carcinogenesis, Gemcitabine Nab-Paclitaxel, 030211 gastroenterology & hepatology, Folfirinox Regimen, business, medicine.drug, neoadjuvant chemotherapy
Abstract: The optimal therapeutic strategy for locally advanced pancreatic cancer patients (LAPC) has not yet been established. Our aim is to evaluate how surgery after neoadjuvant treatment with either FOLFIRINOX (FFN) or Gemcitabine-NabPaclitaxel (GemNab) affects the clinical outcome in these patients. LAPC patients treated at our institution were retrospectively analysed to reach this goal. The group characteristics were similar: 35 patients were treated with the FOLFIRINOX regimen and 21 patients with Gemcitabine Nab-Paclitaxel. The number of patients undergoing surgery was 14 in the FFN group (40%) and six in the GemNab group (28.6%). The median Disease-Free Survival (DFS) was 77.10 weeks in the FFN group and 58.65 weeks in the Gem Nab group (p = 0.625), while the median PFS in the unresected group was 49.4 weeks in the FFN group and 30.9 in the GemNab group (p = 0.0029, 95% CI 0.138&ndash, 0.862, HR 0.345). The overall survival (OS) in the resected population needs a longer follow up to be completely assessed, while the median overall survival (mOS) in the FFN group was 72.10 weeks and 53.30 weeks for the GemNab group (p = 0.06) in the unresected population. Surgery is a valuable option for LAPC patients and it is able to induce a relevant survival advantage. FOLFIRINOX and Gem-NabPaclitaxel should be offered as first options to pancreatic cancer patients in the locally advanced setting.
Published: 2019

35. Screening of glucose metabolism derangements in pediatric cystic fibrosis patients: how, when, why

Author: Valentina Fattorusso, Adriana Franzese, Giuliana Valerio, Enza Mozzillo, Valeria Raia, Franzese, Adriana, Mozzillo, E., Fattorusso, V., Raia, V., and Valerio, G.
Subjects: medicine.medical_specialty, Adolescent, Cystic Fibrosis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Oral glucose tolerance test, Comorbidity, Carbohydrate metabolism, Cystic fibrosis, Glucose derangement, Pulmonary function testing, Diabetes Complications, Endocrinology, Internal medicine, Diabetes mellitus, Glucose Intolerance, Diabetes Mellitus, Internal Medicine, Humans, Mass Screening, Medicine, Child, Glucose tolerance test, medicine.diagnostic_test, business.industry, Insulin, General Medicine, Glucose Tolerance Test, medicine.disease, Child, Preschool, Cystic fibrosi, Insulin therapy, General health, business
Abstract: Diabetes mellitus is the most common comorbidity in cystic fibrosis (CF), occurring in a variable number of children and adolescents. Glucose metabolism derangements (GMDs) are responsible for a negative impact on the general health status of CF patients. Screening of GMDs is important since the youngest age and should be performed by means of OGTT, including its intermediate times, that could detect other non-traditional GMDs. Insulin treatment, administered before overt diabetes, could be beneficial in reducing the number of pulmonary infections, in improving both pulmonary function and nutritional status. Early screening of GMDs in pediatric age can exert an important preventing role regarding all aspects of health status of patients with CF.
Published: 2015
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36. 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

37. Can glargine reduce the number of lung infections in patients with cystic fibrosis-related diabetes?

Author: Valeria Raia, Enza Mozzillo, Angela Sepe, Giuliana Valerio, Maria Immacolata Spagnuolo, Adriana Franzese, Franzese, Adriana, Spagnuolo, MARIA IMMACOLATA, Sepe, A, Valerio, G, Mozzillo, E, and Raia, Valeria
Subjects: Adult, medicine.medical_specialty, Pediatrics, Adolescent, Cystic Fibrosis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Cystic fibrosis-related diabetes, Cystic Fibrosis Transmembrane Conductance Regulator, Insulin Glargine, Insulin analog, Cystic fibrosis, Forced Expiratory Volume, Diabetes mellitus, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Child, Intensive care medicine, Adverse effect, Lung, Sequence Deletion, Advanced and Specialized Nursing, biology, business.industry, medicine.disease, Cystic fibrosis transmembrane conductance regulator, Insulin, Long-Acting, medicine.anatomical_structure, Diabetes Mellitus, Type 2, biology.protein, business
Abstract: Incidence and prevalence of cystic fibrosis–related diabetes (CFRD) are rapidly increasing in recent years, according to the gradual increase in median survival age, which is now around 30 years (1). CFRD, with or without fasting hyperglycemia, may be chronic or intermittent, the latter in physically stressed patients. It is possible that the prediabetic state may have adverse effects on clinical status, nutrition, and lung function in patients with cystic fibrosis (2). As a matter of fact, impairment of lung function seems to appear up to 2–4 years before the clinical onset of diabetes. Insulin therapy was able to improve lung function in CFRD patients (3). Glargine is a recent long-acting insulin analog, which is …
Published: 2005

38. Quantitative ultrasound of proximal phalanxes in patients with type 1 diabetes mellitus

Author: Manuela Zanatta, P Buono, Giuliana Valerio, Erika Moretto, Enza Mozzillo, Loredana Mastidoro, Antonio Del Puente, Adriana Franzese, Antonella Esposito, Valerio, G, DEL PUENTE, Antonio, Buono, P, Esposito, A, Zanatta, M, Mozzillo, E, Moretto, E, Mastidoro, L, and Franzese, Adriana
Subjects: Male, medicine.medical_specialty, Time Factors, Adolescent, Endocrinology, Diabetes and Metabolism, Osteoporosis, Fingers, chemistry.chemical_compound, Endocrinology, Bone Density, Internal medicine, Diabetes mellitus, Surveys and Questionnaires, Internal Medicine, Medicine, Humans, Insulin, In patient, Child, Ultrasonography, Glycated Hemoglobin, Type 1 diabetes, business.industry, General Medicine, Phalanx, medicine.disease, Quantitative ultrasound, Calcium, Dietary, Bone Diseases, Metabolic, Diabetes Mellitus, Type 1, chemistry, Italy, Metabolic control analysis, Data Interpretation, Statistical, Female, Glycated hemoglobin, business
Abstract: The influence of duration of diabetes and metabolic control on phalangeal quantitative ultrasound (QUS) was evaluated in a group of children and adolescents with type 1 diabetes. Eighty-six patients (mean age 11.9 years; mean duration 4.3 years) were studied. Daily calcium intake was assessed by means of a questionnaire. Amplitude-dependent speed of sound (AD-SoS) was measured at the phalanxes of the non-dominant hand and expressed as a z-score. Linear and multivariate correlations with duration of diabetes and, short term and long term metabolic control were sought. AD-SoS z-score was −0.43±1.4 (95% CI, −0.73; −0.13). Nine subjects had values below −2S.D. Daily calcium intake was 1042±456 mg/day; 47 subjects (54.6%) were below the recommended levels. A negative correlation was found between AD-SoS z-score and duration (r, −0.33, P=0.002) or metabolic control (HbA1c-last year r, −0.32, P=0.002; HbA1c-whole duration, r, −0.40; P=0.003). Negative AD-SoS z-scores depended significantly and directly on duration and quality of metabolic control, even when controlled for calcium intake. In conclusion, the architectural organization of bone was impaired in 10.5% patients. Duration of diabetes and poor metabolic control were the main determinants affecting AD-SoS. QUS may be a useful tool in the screening of bone disturbance in young patients with diabetes. Optimization of metabolic control is required to prevent osteoporosis.
Published: 2003

39. The Lumbar Bone Mineral Density Is Affected by Long-Term Poor Metabolic Control in Adolescents with Type 1 Diabetes mellitus

Author: Enza Mozzillo, Antonio del Puente, Giuliana Valerio, P Buono, Antonella Esposito-del Puente, Adriana Franzese, Valerio, G, DEL PUENTE, Antonio, Esposito del Puente, A, Buono, P, Mozzillo, E, and Franzese, Adriana
Subjects: Blood Glucose, Male, Deoxypyridinoline, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, Pyridinium Compounds, Disease, Bone resorption, chemistry.chemical_compound, Endocrinology, Lumbar, Absorptiometry, Photon, Bone Density, Internal medicine, medicine, Humans, Bone Resorption, Child, Dual-energy X-ray absorptiometry, Bone mineral, Glycated Hemoglobin, Type 1 diabetes, medicine.diagnostic_test, business.industry, Body Weight, medicine.disease, Body Height, Spine, Diabetes Mellitus, Type 1, chemistry, Metabolic control analysis, Pediatrics, Perinatology and Child Health, Female, business, Biomarkers
Abstract: Aim: To analyze whether bone mineral density (BMD) and bone resorption status are influenced by long-term metabolic control and duration of disease in adolescents with long-standing type 1 diabetes mellitus. Methods: Twenty-seven adolescents (age 13.1 ± 1.7 years, duration of diabetes 6.9 ± 3.0 years) were studied. The BMD, expressed as z score, was measured at the lumbar spine (L1–L4) using dual-energy X-ray absorptiometry, while the urinary excretion of total deoxypiridinoline (Dpyd), a marker of bone resorption, was measured by immunoassay and was corrected by creatinine (Cr). Linear and multivariate correlations between lumbar BMD z score or Dpyd/Cr excretion and age and disease variables [short-term (Hb A1clatest) or long-term (Hb A1cwholeduration) metabolic control, duration, ‘diabetes impact index’ (mean Hb A1cwholeduration x duration of disease in months)] were sought. Results: In diabetic subjects the mean BMD z score was –0.44 ± (SD) 1.02 (95% CI: –0.03; –0.84), and the Dpyd/Cr excretion was not increased. A negative correlation was found between lumbar BMD z score and age (r –0.59; p = 0.001), duration (r –0.39; p = 0.04), and the diabetes impact index (r –0.4; p = 0.04). The Dpyd/Cr ratio correlated negatively with age (r –0.40; p = 0.04) and positively with height velocity (r 0.42; p = 0.04). By using multiple linear regression, age showed a significant inverse correlation with lumbar BMD z score (β = –0.39; p = 0.0005). A negative correlation was found between lumbar BMD z score and Hb A1cwholeduration (β = –0.40; p = 0.02) or diabetes impact index (β = –0.001; p = 0.01). Conclusions: Poor metabolic control may expose adolescents with long-standing type 1 diabetes to the risk of developing osteopenia in adult age. Optimization of metabolic control in growing diabetic children may prevent osteoporosis in later life.
Published: 2002

40. Mauriac syndrome still exists

Author: P Buono, Enza Mozzillo, M Mascolo, Adriana Franzese, R Iorio, Giuliana Valerio, Franzese, Adriana, Iorio, Raffaele, Buono, P, Mascolo, M, Mozzillo, E, and Valerio, G.
Subjects: Glycated Hemoglobin, Pediatrics, medicine.medical_specialty, Adolescent, business.industry, Liver Diseases, Endocrinology, Diabetes and Metabolism, Dwarfism, Syndrome, General Medicine, medicine.disease, Treatment Refusal, Diabetes Mellitus, Type 1, Endocrinology, Diabetes mellitus, Internal Medicine, Mauriac syndrome, Humans, Insulin, Medicine, Female, business
Published: 2001

41. Glucose Derangements in Very Young Children With Cystic Fibrosis and Pancreatic Insufficiency

Author: Valentina Fattorusso, Mariateresa Falco, Rosa Nugnes, Angela Sepe, Valeria Raia, Adriana Franzese, Enza Mozzillo, Giuliana Valerio, Fabiola De Gregorio, Mozzillo, E, Raia, Valeria, Fattorusso, V, Falco, M, Sepe, A, De Gregorio, F, Nugnes, R, Valerio, G, and Franzese, Adriana
Subjects: Blood Glucose, Male, medicine.medical_specialty, Pediatrics, Cystic Fibrosis, Endocrinology, Diabetes and Metabolism, Cystic fibrosis, children, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Endocrine system, Humans, In patient, Online Letters: Observations, Prediabetes, Exocrine pancreatic insufficiency, Child, cystic fibrosi, Advanced and Specialized Nursing, Glucose tolerance test, medicine.diagnostic_test, diabetes, business.industry, Glucose Tolerance Test, medicine.disease, Comorbidity, Endocrinology, Glucose, Child, Preschool, Exocrine Pancreatic Insufficiency, Female, business
Abstract: Cystic fibrosis–related diabetes (CFRD) is considered the most common comorbidity in patients affected by cystic fibrosis (CF), with a prevalence increasing with age (1). Recently, more attention has been turned to other less severe glucose metabolism derangements (GMD), since prediabetes may be related to increased morbidity (1), and early treatment may improve the clinical course in patients with CF (2). According to recent guidelines released by the Cystic Fibrosis Foundation, the American Diabetes Association, and the Pediatric Endocrine Society, the oral glucose tolerance test (OGTT) is recommended yearly in patients with CF over 10 years of age (3). Some authors recommend annual OGTT after the age of 6 years in CF patients with pancreatic insufficiency (4). In …
Published: 2012

42. Continuous glucose monitoring system in the screening of early glucose derangements in children and adolescents with cystic fibrosis

Author: Valeria Raia, Ilaria De Simone, Angela Sepe, Enza Mozzillo, Maria Immacolata Spagnuolo, Adriana Franzese, Giuliana Valerio, P Buono, Franzese, Adriana, Valerio, G, Buono, P, Spagnuolo, MARIA IMMACOLATA, Sepe, A, Mozzillo, E, De Simone, I, and Raia, Valeria
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Cystic Fibrosis, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Cystic fibrosis-related diabetes, Carbohydrate metabolism, Cystic fibrosis, Gastroenterology, Impaired glucose tolerance, Endocrinology, Internal medicine, Blood Glucose Self-Monitoring, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Respiratory system, Child, Glycated Hemoglobin, Glucose tolerance test, medicine.diagnostic_test, business.industry, nutritional and metabolic diseases, Glucose Tolerance Test, medicine.disease, Glucose, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, business, human activities, hormones, hormone substitutes, and hormone antagonists
Abstract: Background In cystic fibrosis (CF), diabetes mellitus (DM) is associated with progression of pulmonary disease and nutritional impairment. Aim To compare oral glucose tolerance test (OGTT) and continuous glucose monitoring system (CGMS) in patients with CF with early glucose derangements. Patients and methods Thirty-two patients with CF (5-20 years) with intermediate glucose values > 7.7 mmol/l during OGTT received a CGMS registration. Patients were classified into those with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and DM, according to glucose values at 120 min of OGTT and during CGMS. Furthermore BMI z-scores, forced expiratory volume in 1 second (FEV1%), number of respiratory infections/year, enzyme supplementation, and HbA1c were evaluated. Results OGTT and CGMS derangements were in agreement in 43.7% of the patients. BMI z-scores, FEV1%, number of respiratory infections/ year, enzyme supplementation, and HbA1c did not differ among the three groups. HbA1c, correlated positively with 120 min OGTT (r = 0.34; p = 0.059), CGMS area (r = 0.35; p = 0.048) and the number of respiratory infections, and negatively with FEV1%. Conclusions Intermediate glucose values during OGTT should be considered as a screening test in patients with CF. CGMS can be useful in studying the early occurrence of glucose derangements in selected patients.

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