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1. Increasing trend of type 1 diabetes incidence in the pediatric population of the Calabria region in 2019–2021

Author

Stefano Passanisi, Giuseppina Salzano, Monica Aloe, Bruno Bombaci, Felice Citriniti, Fiorella De Berardinis, Rosaria De Marco, Nicola Lazzaro, Maria C. Lia, Rosanna Lia, Francesco Mammì, Filomena A. Stamati, Rosanna M. R. Toscano, Claudia Ventrici, Dario Iafusco, and Fortunato Lombardo

Subjects
Children, Diabetic ketoacidosis, Epidemiology, SARS-CoV-2, Pediatrics, RJ1-570
Abstract

Abstract Background Although type 1 diabetes (T1D) represents one of the most common chronic diseases in pediatric age, few studies on the epidemiology of T1D exist globally and the exact prevalence and incidence rates of the disease are unknown. In many countries, including Italy, national registries are missing. Methods This study aims to assess T1D incidence in the pediatric population of the Calabria region (southern Italy) in the period 2019–2021. The secondary objective was to describe the main demographical, clinical and immunological features of incident cases. Case ascertainment and all clinical data were assessed by retrospectively reviewing the electronic medical records of children and adolescents diagnosed with diabetes at any Pediatric Diabetes Center belonging to the Rete Diabetologica Calabrese (Calabria Region Diabetes Network), from January 2019 to December 2021. The incidence of T1D was estimated for the entire region and was stratified according to age group (0–4 years, 5–9 years, and 10–14 years) and gender. Standardized incidence ratios for each province in the region were also calculated. Results The crude incidence of T1D was 20.6/100,000 person/years. Incidence rates were higher among females and children aged 5–9 years. The crude incidence of T1D was higher in the province of Reggio Calabria (26.5/100,000 person-years). The provinces of Crotone, Catanzaro, and Vibo Valentia showed significantly lower standardized incidence ratios. The annual incidence in the region progressively increased by 43% during the study period. Conclusions Our study revealed a relatively high incidence in the Calabria region. The marked increasing incidence trend over the past two years could be related to the global impact of the COVID-19 pandemic, but further long-scale population-based studies are needed to confirm these findings.

Published
2022
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2. Corrigendum: The silent epidemic of diabetic ketoacidosis at diagnosis of type 1 diabetes in children and adolescents in italy during the covid-19 pandemic in 2020

Author

Valentino Cherubini, Monica Marino, Andrea E. Scaramuzza, Valentina Tiberi, Adriana Bobbio, Maurizio Delvecchio, Elvira Piccinno, Federica Ortolani, Stefania Innaurato, Barbara Felappi, Francesco Gallo, Carlo Ripoli, Maria Rossella Ricciardi, Filomena Pascarella, Filomena A. Stamati, Felice Citriniti, Claudia Arnaldi, Sara Monti, Vanna Graziani, Fiorella De Berardinis, Cosimo Giannini, Francesco Chiarelli, Maria Zampolli, Rosaria De Marco, Giulia Patrizia Bracciolini, Caterina Grosso, Valeria De Donno, Barbara Piccini, Sonia Toni, Susanna Coccioli, Giuliana Cardinale, Marta Bassi, Nicola Minuto, Giuseppe D’Annunzio, Claudio Maffeis, Marco Marigliano, Angela Zanfardino, Dario Iafusco, Assunta S. Rollato, Alessia Piscopo, Stefano Curto, Fortunato Lombardo, Bruno Bombaci, Silvia Sordelli, Chiara Mameli, Maddalena Macedoni, Andrea Rigamonti, Riccardo Bonfanti, Giulio Frontino, Barbara Predieri, Patrizia Bruzzi, Enza Mozzillo, Francesco Rosanio, Adriana Franzese, Gavina Piredda, Francesca Cardella, Brunella Iovane, Valeria Calcaterra, Maria Giulia Berioli, Anna Lasagni, Valentina Pampanini, Patrizia Ippolita Patera, Riccardo Schiaffini, Irene Rutigliano, Gianfranco Meloni, Luisa De Sanctis, Davide Tinti, Michela Trada, Lucia Paola Guerraggio, Roberto Franceschi, Vittoria Cauvin, Gianluca Tornese, Francesca Franco, Gianluca Musolino, Giulio Maltoni, Valentina Talarico, Antonio Iannilli, Lorenzo Lenzi, Maria Cristina Matteoli, Erica Pozzi, Carlo Moretti, Stefano Zucchini, Ivana Rabbone, and Rosaria Gesuita

Subjects
DKA, COVID - 19, type 1 diabetes, socioeconomic status, diabetes onset, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Published
2022
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3. The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

Author

Valentino Cherubini, Monica Marino, Andrea E. Scaramuzza, Valentina Tiberi, Adriana Bobbio, Maurizio Delvecchio, Elvira Piccinno, Federica Ortolani, Stefania Innaurato, Barbara Felappi, Francesco Gallo, Carlo Ripoli, Maria Rossella Ricciardi, Filomena Pascarella, Filomena A. Stamati, Felice Citriniti, Claudia Arnaldi, Sara Monti, Vanna Graziani, Fiorella De Berardinis, Cosimo Giannini, Francesco Chiarelli, Maria Zampolli, Rosaria De Marco, Giulia Patrizia Bracciolini, Caterina Grosso, Valeria De Donno, Barbara Piccini, Sonia Toni, Susanna Coccioli, Giuliana Cardinale, Marta Bassi, Nicola Minuto, Giuseppe D’Annunzio, Claudio Maffeis, Marco Marigliano, Angela Zanfardino, Dario Iafusco, Assunta S. Rollato, Alessia Piscopo, Stefano Curto, Fortunato Lombardo, Bruno Bombaci, Silvia Sordelli, Chiara Mameli, Maddalena Macedoni, Andrea Rigamonti, Riccardo Bonfanti, Giulio Frontino, Barbara Predieri, Patrizia Bruzzi, Enza Mozzillo, Francesco Rosanio, Adriana Franzese, Gavina Piredda, Francesca Cardella, Brunella Iovane, Valeria Calcaterra, Maria Giulia Berioli, Anna Lasagni, Valentina Pampanini, Patrizia Ippolita Patera, Riccardo Schiaffini, Irene Rutigliano, Gianfranco Meloni, Luisa De Sanctis, Davide Tinti, Michela Trada, Lucia Paola Guerraggio, Roberto Franceschi, Vittoria Cauvin, Gianluca Tornese, Francesca Franco, Gianluca Musolino, Giulio Maltoni, Valentina Talarico, Antonio Iannilli, Lorenzo Lenzi, Maria Cristina Matteoli, Erica Pozzi, Carlo Moretti, Stefano Zucchini, Ivana Rabbone, and Rosaria Gesuita

Subjects
DKA, COVID - 19, type 1 diabetes, socioeconomic status, diabetes onset, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Aim/HypothesisTo compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019.MethodsForty-seven pediatric diabetes centers caring for >90% of young people with diabetes in Italy recruited 4,237 newly diagnosed children with type 1 diabetes between 2017 and 2020 in a longitudinal study. Four subperiods in 2020 were defined based on government-imposed containment measures for COVID-19, and the frequencies of DKA and severe DKA compared with the same periods in 2017-2019.ResultsOverall, the frequency of DKA increased from 35.7% (95%CI, 33.5-36.9) in 2017-2019 to 39.6% (95%CI, 36.7-42.4) in 2020 (p=0.008), while the frequency of severe DKA increased from 10.4% in 2017-2019 (95%CI, 9.4-11.5) to 14.2% in 2020 (95%CI, 12.3-16.4, p

Published
2022
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4. A nationwide survey of Italian pediatric diabetologists about COVID-19 vaccination in children and adolescents with type 1 diabetes

Author

E Scaramuzza Andrea, Cherubini, Valentino, Schiaffini, Riccardo, Rabbone, Ivana, The Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes, Francesco, Gallo, Graziella, Fichera, Claudia, Arnaldi, Riccardo, Bonfanti, Fortunato, Lombardo, Rosaria De Marco, Filomena, Pascarella, Gianluca, Tornese, Adriana, Bobbio, Tosca, Suprani, Nicola, Minuto, Roberto, Franceschi, Elvira, Piccinno, Enza, Mozzillo, Silvia, Savastio, Barbara, Piccini, Anna Paola Frongia, Chiara, Mameli, Gianluca, Musolino, Sonia, Toni, Emioli, Randazzo, Giulio, Frontino, Maurizio, Delvecchio, Paola Sogno Valin, Petra, Reinstadler, Valeria, Calcaterra, Luisa De Sanctis, Michela, Trada, Maria Susanna Coccioli, Lucia Paola Guerraggio, Felice, Citriniti, Anna, Lasagni, Irene, Rutigliano, Filomena Andreina Stamati, Fiorella De Berardinis, Maria, Zampolli, Giulio, Maltoni, Elena, Fornari, Carlo, Ripoli, Alberto, Gaiero, Silvia, Sordelli, Giuseppe, D’Annunzio, Predieri, Barbara, Giuliana, Cardinale, Francesca, Cardella, Dario, Iafusco, Anna, Corò, Stefano, Zucchini, Claudio, Maffeis, Elisa, Giani, Davide, Tinti, Claudio, Cavalli, Scaramuzza, Ae, Cherubini, V, Schiaffini, R, Rabbone, I, Iafusco, D, E Scaramuzza, Andrea, Cherubini, Valentino, Schiaffini, Riccardo, Rabbone, Ivana, Tornese, Gianluca, Scaramuzza, A. E., Cherubini, V., Schiaffini, R., Rabbone, I., Gallo, F., Fichera, G., Arnaldi, C., Bonfanti, R., Lombardo, F., De Marco, R., Pascarella, F., Tornese, G., Bobbio, A., Suprani, T., Minuto, N., Franceschi, R., Piccinno, E., Mozzillo, E., Savastio, S., Piccini, B., Frongia, A. P., Mameli, C., Musolino, G., Toni, S., Randazzo, E., Frontino, G., Delvecchio, M., Sogno Valin, P., Reinstadler, P., Calcaterra, V., De Sanctis, L., Trada, M., Coccioli, M. S., Guerraggio, L. P., Citriniti, F., Lasagni, A., Rutigliano, I., Stamati, F. A., De Berardinis, F., Zampolli, M., Maltoni, G., Fornari, E., Ripoli, C., Gaiero, A., Sordelli, S., D'Annunzio, G., Predieri, B., Cardinale, G., Cardella, F., Iafusco, D., Coro, A., Zucchini, S., Maffeis, C., Giani, E., Tinti, D., and Cavalli, C.

Subjects
COVID-19 Vaccines, Adolescent, Type 1 diabete, Endocrinology, Diabetes and Metabolism, Vaccination, COVID-19, General Medicine, Adolescents, Diabetes Mellitus, Type 1, Endocrinology, Type 1 diabetes, Italy, Children, Vaccine, Internal Medicine, Humans, Child
Abstract

N/A

Published
2022

5. Has COVID-19 Delayed the Diagnosis and Worsened the Presentation of Type 1 Diabetes in Children?

Author

Rabbone, Ivana, Schiaffini, Riccardo, Cherubini, Valentino, Maffeis, Claudio, Scaramuzza, Andrea, Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes (Enrica Bertelli, Lucia, Ferlito, Adriana, Bobbio, Eleonardo, Schieven, Maurizio, Delvecchio, Giulio, Maltoni, Petra, Reinstadler, Barbara, Felappi, Francesco, Gallo, Carlo, Ripoli, Filomena, Pascarella, Filomena, A Stamati, Donatella Lo Presti, Felice, Citriniti, Stefano, Tumini, Maria, Zampolli, Rosaria De Marco, Claudio, Cavalli, Valeria De Donno, Sonia, Toni, Maria Susanna Coccioli, Giuseppe, D'Annunzio, Paola Sogno Valin, Dante, Cirillo, Silvia, Sordelli, Fortunato, Lombardo, Riccardo, Bonfanti, Chiara, Mameli, Predieri, Barbara, Adriana, Franzese, Dario, Iafusco, Silvia, Savastio, Gavina, Piredda, Francesca, Cardella, Valeria, Calcaterra, Emioli, Randazzo, Anna, Favia, Tosca, Suprani, Alessandra, Lasagni, Novella, Rapini, Irene, Rutigliano, Alberto, Gaiero, Luisa De Sanctis, Vittoria, Cauvin, Marta, Minute, Gianluca, Tornese, Francesca, Franco, Gianluca, Musolino, Marco, Marigliano, Silvia, Innaturato, Claudia, Arnaldi), Rabbone, Ivana, Schiaffini, Riccardo, Cherubini, Valentino, Maffeis, Claudio, Scaramuzza, Andrea, Tornese, Gianluca, Rabbone, I., Schiaffini, R., Cherubini, V., Maffeis, C., Scaramuzza, A., Italian Study Group of Diabetes of, Isped, and Iafusco, D

Subjects
Research design, Male, Pediatrics, Delayed Diagnosis, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Clinical Laboratory Technique, 0302 clinical medicine, COVID-19 Testing, 030212 general & internal medicine, Viral, Child, Emergency Service, Delayed Diagnosi, COVID-19, diabetes mellitus type 1, Italy, Adolescent, Child, Preschool, Clinical Laboratory Techniques, Coronavirus Infections, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetic Ketoacidosis, Emergency Service, Hospital, Female, Humans, Infant, Pandemics, Pneumonia, Viral, SARS-CoV-2, Betacoronavirus, medicine.symptom, Human, Type 1, medicine.medical_specialty, Diabetic ketoacidosis, 030209 endocrinology & metabolism, Asymptomatic, Diabetic Ketoacidosi, 03 medical and health sciences, Hospital, Diabetes mellitus, Internal Medicine, medicine, Diabetes Mellitus, Preschool, Advanced and Specialized Nursing, Cross-Sectional Studie, Type 1 diabetes, Pandemic, business.industry, Coronavirus Infection, Emergency department, Pneumonia, medicine.disease, business
Abstract

OBJECTIVE To evaluate whether the diagnosis of pediatric type 1 diabetes or its acute complications changed during the early phase of the coronavirus disease 2019 (COVID-19) pandemic in Italy. RESEARCH DESIGN AND METHODS This was a cross-sectional, web-based survey of all Italian pediatric diabetes centers to collect diabetes, diabetic ketoacidosis (DKA), and COVID-19 data in patients presenting with new-onset or established type 1 diabetes between 20 February and 14 April in 2019 and 2020. RESULTS Fifty-three of 68 centers (77.9%) responded. There was a 23% reduction in new diabetes cases in 2020 compared with 2019. Among those newly diagnosed patients who presented in a state of DKA, the proportion with severe DKA was 44.3% in 2020 vs. 36.1% in 2019 (P = 0.03). There were no differences in acute complications. Eight patients with asymptomatic or mild COVID-19 had laboratory-confirmed severe acute respiratory syndrome coronavirus 2. CONCLUSIONS The COVID-19 pandemic might have altered diabetes presentation and DKA severity. Preparing for any “second wave” requires strategies to educate and reassure parents about timely emergency department attendance for non–COVID-19 symptoms.

Published
2020

6. Delayed puberty versus hypogonadism: a challenge for the pediatrician

Author

Mauro Bozzola, Pietro Ferrara, Filomena Andreina Stamati, Chiara Montalbano, Alberto Villani, and Elena Bozzola

Subjects
Delayed puberty, medicine.medical_specialty, Kallmann syndrome, Turner syndrome, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Review Article, Short stature, 03 medical and health sciences, 0302 clinical medicine, Hypergonadotropic hypogonadism, Hypogonadotropic hypogonadism, 030225 pediatrics, Internal medicine, medicine, business.industry, Hypogonadism, Puberty, lcsh:RJ1-570, lcsh:Pediatrics, Bone age, medicine.disease, Settore MED/38, Endocrinology, Pediatrics, Perinatology and Child Health, Delayed skeletal maturation, medicine.symptom, Klinefelter syndrome, business
Abstract

Constitutional delay of growth and puberty (CDGP) is the most common cause of delayed puberty (DP), is mainly found in males, and is characterized by short stature and delayed skeletal maturation. A family history of the subject comprising the timing of puberty in the parents and physical examination may provide clues regarding the cause of DP. Delayed onset of puberty is rarely considered a disease in either sex. In fact, DP usually represents a common normal variant in pubertal timing, with favorable outcomes for final height and future reproductive capacity. In adolescents with CDGP, a linear growth delay occurs until immediately before the start of puberty, then the growth rate rapidly increases. Bone age is often delayed. CDGP is a diagnosis of exclusion; therefore, alternative causes of DP should be considered. Functional hypogonadotropic hypogonadism may be observed in patients with transient delay in hypothalamic-pituitary-gonadal axis maturation due to associated conditions including celiac disease, inflammatory bowel diseases, kidney insufficiency, and anorexia nervosa. Permanent hypogonadotropic hypogonadism (pHH) showing low serum value of testosterone or estradiol and blunted follicle-stimulating hormones (FSH) and luteinizing hormones (LH) levels may be due to abnormalities in the central nervous system. Therefore, magnetic resonance imaging is necessary to exclude morphological abnormalities and neoplasia. Moreover, pHH may be isolated, as observed in Kallmann syndrome, or associated with other hormone deficiencies, as found in panhypopituitarism. Baseline or gonadotropin-releasing hormone pituitary stimulated gonadotropin level is not sufficient to easily differentiate CDGP from pHH. Low serum testosterone in male patients and low estradiol values in female patients, associated with high serum FSH and LH levels, suggest a diagnosis of hypergonadotropic hypogonadism. A genetic analysis can reveal a chromosomal abnormality (e.g., Turner syndrome or Klinefelter syndrome). In cases where the adolescent with CDGP is experiencing psychological difficulties, treatment should be recommended.

Published
2018

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