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4. Adolescent gender dysphoria management: position paper from the Italian Academy of Pediatrics, the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, the Italian Society of Adolescent Medicine and the Italian Society of Child and Adolescent Neuropsychiatry

Author

Calcaterra, V, Tornese, G, Zuccotti, G, Staiano, A, Cherubini, V, Gaudino, R, Fazzi, E, Barbi, E, Chiarelli, F, Corsello, G, Esposito, S, Ferrara, P, Iughetti, L, Laforgia, N, Maghnie, M, Marseglia, G, Perilongo, G, Pettoello-Mantovani, M, Ruggieri, M, Russo, G, Salerno, M, Striano, P, Valerio, G, Wasniewska, M, Agosti, M, Agostoni, C, Aiuti, A, Azzari, C, Badolato, R, Balduzzi, A, Baraldi, E, Canani, R, Biffi, A, Biondi, A, Bisogno, G, Pierri, N, Carnielli, V, Cianfarani, S, Cogo, P, Corvaglia, L, Dani, C, Di Salvo, G, Fagioli, F, Fanos, V, Ferrero, G, Francavilla, R, Galli, L, Gazzolo, D, Giaquinto, C, Giordano, P, Gitto, E, Grosso, S, Guarino, A, Indrio, F, Lanari, M, Lionetti, P, Locatelli, F, Lombardo, F, Maffeis, C, Marino, B, Midulla, F, Del Giudice, E, Del Giudice, M, Montini, G, Parenti, G, Parisi, P, Peroni, D, Perrotta, S, Piacentini, G, Pietrobelli, A, Raimondi, F, Ramenghi, U, Ravelli, A, Romano, C, Rossi, F, Rossi, P, Damiano, V, Spalice, A, Suppiej, A, Troncone, R, Verrotti, A, Null, N, Calcaterra, Valeria, Tornese, Gianluca, Zuccotti, Gianvincenzo, Staiano, Annamaria, Cherubini, Valentino, Gaudino, Rossella, Fazzi, Elisa Maria, Barbi, Egidio, Chiarelli, Francesco, Corsello, Giovanni, Esposito, Susanna Maria Roberta, Ferrara, Pietro, Iughetti, Lorenzo, Laforgia, Nicola, Maghnie, Mohamad, Marseglia, Gianluigi, Perilongo, Giorgio, Pettoello-Mantovani, Massimo, Ruggieri, Martino, Russo, Giovanna, Salerno, Mariacarolina, Striano, Pasquale, Valerio, Giuliana, Wasniewska, Malgorzata, Agosti, Massimo, Agostoni, Carlo Virginio, Aiuti, Alessandro, Azzari, Chiara, Badolato, Raffaele, Balduzzi, Adriana, Baraldi, Eugenio, Canani, Roberto Berni, Biffi, Alessandra, Biondi, Andrea, Bisogno, Gianni, Pierri, Nicola Brunetti, Carnielli, Virginio, Cianfarani, Stefano, Cogo, Paola, Corvaglia, Luigi, Dani, Carlo, Di Salvo, Giovanni, Fagioli, Franca, Fanos, Vassilios, Ferrero, Giovanni Battista, Francavilla, Ruggiero, Galli, Luisa, Gazzolo, Diego, Giaquinto, Carlo, Giordano, Paola, Gitto, Eloisa, Grosso, Salvatore, Guarino, Alfredo, Indrio, Flavia, Lanari, Marcello, Lionetti, Paolo, Locatelli, Franco, Lombardo, Fortunato, Maffeis, Claudio, Marino, Bruno, Midulla, Fabio, Del Giudice, Emanuele Miraglia, Del Giudice, Michele Miraglia, Montini, Giovanni, Parenti, Giancarlo, Parisi, Pasquale, Peroni, Diego, Perrotta, Silverio, Piacentini, Giorgio, Pietrobelli, Angelo, Raimondi, Francesco, Ramenghi, Ugo, Ravelli, Angelo, Romano, Claudio, Rossi, Francesca, Rossi, Paolo, Damiano, Vincenzo Salpietro, Spalice, Alberto, Suppiej, Agnese, Troncone, Riccardo, Verrotti, Alberto, null, null, Calcaterra, V, Tornese, G, Zuccotti, G, Staiano, A, Cherubini, V, Gaudino, R, Fazzi, E, Barbi, E, Chiarelli, F, Corsello, G, Esposito, S, Ferrara, P, Iughetti, L, Laforgia, N, Maghnie, M, Marseglia, G, Perilongo, G, Pettoello-Mantovani, M, Ruggieri, M, Russo, G, Salerno, M, Striano, P, Valerio, G, Wasniewska, M, Agosti, M, Agostoni, C, Aiuti, A, Azzari, C, Badolato, R, Balduzzi, A, Baraldi, E, Canani, R, Biffi, A, Biondi, A, Bisogno, G, Pierri, N, Carnielli, V, Cianfarani, S, Cogo, P, Corvaglia, L, Dani, C, Di Salvo, G, Fagioli, F, Fanos, V, Ferrero, G, Francavilla, R, Galli, L, Gazzolo, D, Giaquinto, C, Giordano, P, Gitto, E, Grosso, S, Guarino, A, Indrio, F, Lanari, M, Lionetti, P, Locatelli, F, Lombardo, F, Maffeis, C, Marino, B, Midulla, F, Del Giudice, E, Del Giudice, M, Montini, G, Parenti, G, Parisi, P, Peroni, D, Perrotta, S, Piacentini, G, Pietrobelli, A, Raimondi, F, Ramenghi, U, Ravelli, A, Romano, C, Rossi, F, Rossi, P, Damiano, V, Spalice, A, Suppiej, A, Troncone, R, Verrotti, A, Null, N, Calcaterra, Valeria, Tornese, Gianluca, Zuccotti, Gianvincenzo, Staiano, Annamaria, Cherubini, Valentino, Gaudino, Rossella, Fazzi, Elisa Maria, Barbi, Egidio, Chiarelli, Francesco, Corsello, Giovanni, Esposito, Susanna Maria Roberta, Ferrara, Pietro, Iughetti, Lorenzo, Laforgia, Nicola, Maghnie, Mohamad, Marseglia, Gianluigi, Perilongo, Giorgio, Pettoello-Mantovani, Massimo, Ruggieri, Martino, Russo, Giovanna, Salerno, Mariacarolina, Striano, Pasquale, Valerio, Giuliana, Wasniewska, Malgorzata, Agosti, Massimo, Agostoni, Carlo Virginio, Aiuti, Alessandro, Azzari, Chiara, Badolato, Raffaele, Balduzzi, Adriana, Baraldi, Eugenio, Canani, Roberto Berni, Biffi, Alessandra, Biondi, Andrea, Bisogno, Gianni, Pierri, Nicola Brunetti, Carnielli, Virginio, Cianfarani, Stefano, Cogo, Paola, Corvaglia, Luigi, Dani, Carlo, Di Salvo, Giovanni, Fagioli, Franca, Fanos, Vassilios, Ferrero, Giovanni Battista, Francavilla, Ruggiero, Galli, Luisa, Gazzolo, Diego, Giaquinto, Carlo, Giordano, Paola, Gitto, Eloisa, Grosso, Salvatore, Guarino, Alfredo, Indrio, Flavia, Lanari, Marcello, Lionetti, Paolo, Locatelli, Franco, Lombardo, Fortunato, Maffeis, Claudio, Marino, Bruno, Midulla, Fabio, Del Giudice, Emanuele Miraglia, Del Giudice, Michele Miraglia, Montini, Giovanni, Parenti, Giancarlo, Parisi, Pasquale, Peroni, Diego, Perrotta, Silverio, Piacentini, Giorgio, Pietrobelli, Angelo, Raimondi, Francesco, Ramenghi, Ugo, Ravelli, Angelo, Romano, Claudio, Rossi, Francesca, Rossi, Paolo, Damiano, Vincenzo Salpietro, Spalice, Alberto, Suppiej, Agnese, Troncone, Riccardo, Verrotti, Alberto, and null, null

Abstract

Background In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, Italian Society of Adolescent Medicine and Italian Society of Child and Adolescent Neuropsychiatry is drafting a position paper. The purpose of this paper is to convey the author's opinion on the topic, offering foundational information on potential aspects of gender-affirming care and emphasizing the care and protection of children and adolescents with GD.Main body Recognizing that adolescents may choose interventions based on their unique needs and goals and understanding that every individual within this group has a distinct trajectory, it is crucial to ensure that each one is welcomed and supported. The approach to managing individuals with GD is a multi-stage process involving a multidisciplinary team throughout all phases. Decisions regarding treatment should be reached collaboratively by healthcare professionals and the family, while considering the unique needs and circumstances of the individual and be guided by scientific evidence rather than biases or ideologies. Politicians and high court judges should address discrimination based on gender identity in legislation and support service development that aligns with the needs of young people. It is essential to establish accredited multidisciplinary centers equipped with the requisite skills and experience to effectively manage adolescents with GD, thereby ensuring the delivery of high-quality care.Conclusion Maintaining an evidence-based approach is essential to safeguard the well-being of transgender and gender diverse adolescents.

Published
2024

10. SGLT2 inhibitors improve hepatic fibrosis assessed by Fibroscan in NAFLD patients with type 2 diabetes: A five-year follow-up study

Author

Lombardi, R., primary, Cespiati, A., additional, Mantovani, A., additional, Maffi, G., additional, Del Zanna, E., additional, Francione, P., additional, Cinque, F., additional, Villani, R., additional, Maffeis, C., additional, Passigato, N., additional, Orsi, E., additional, Grancini, V., additional, Pisano, G., additional, Airaghi, L., additional, Targher, G., additional, Serviddio, G., additional, Fargion, S., additional, and Fracanzani, A.L., additional

Published
2023
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11. Eligibility criteria for pediatric patients who may benefit from anti SARS-CoV-2 monoclonal antibody therapy administration: an Italian inter-society consensus statement

Author

Lanari, M., Venturini, E., Pierantoni, L., Stera, G., Castelli Gattinara, G., Esposito, S. M. R., Favilli, S., Franzoni, E., Fusco, E., Lionetti, P., Maffeis, C., Marseglia, G., Massella, L., Midulla, F., Zanobini, A., Zecca, M., Villani, A., Staiano, A., Galli, L., Blasi, F., Di Giorgio, A., Dona, D., Licari, A., Martinelli, M., Mastrangelo, A., Miraglia del Giudice, M., Nicolini, G., Pugliese, F., Striano, P., Valerio, G., Lanari, M., Venturini, E., Pierantoni, L., Stera, G., Castelli Gattinara, G., Esposito, S. M. R., Favilli, S., Franzoni, E., Fusco, E., Lionetti, P., Maffeis, C., Marseglia, G., Massella, L., Midulla, F., Zanobini, A., Zecca, M., Villani, A., Staiano, A., Galli, L., Blasi, F., Di Giorgio, A., Dona, D., Licari, A., Martinelli, M., Mastrangelo, A., Miraglia del Giudice, M., Nicolini, G., Pugliese, F., Striano, P., Valerio, G., Lanari M., Venturini E., Pierantoni L., Stera G., Castelli Gattinara G., Esposito S.M.R., Favilli S., Franzoni E., Fusco E., Lionetti P., Maffeis C., Marseglia G., Massella L., Midulla F., Zanobini A., Zecca M., Villani A., Staiano A., Galli L., Blasi F., Di Giorgio A., Dona D., Licari A., Martinelli M., Mastrangelo A., Miraglia del Giudice M., Nicolini G., Pugliese F., Striano P., Valerio G., Lanari, M, Venturini, E, Pierantoni, L, Castelli Gattinara, G. Esposito S. M. R., Favilli, S, Franzoni, E, Marseglia, G, Massella, L, Zecca, M, Villani, A, Staiano, A, Galli, L, Blasi, F, and Donà, D.

Subjects
Monoclonal antibody, Consensus, Adolescent, COVID19, Consensu, Review, Antibodies, Monoclonal, Humanized, Adolescents, Pediatrics, Antiviral Agents, RJ1-570, Drug Combination, Humans, Age Factor, Child, Societies, Medical, Antiviral Agent, Risk Factor, Patient Selection, Age Factors, Antibodies, Monoclonal, COVID-19, Settore MED/38, Antibodies, Neutralizing, COVID-19 Drug Treatment, Drug Combinations, Italy, Risk factors, Risk Factors, Human
Abstract

The fast diffusion of the SARS-CoV-2 pandemic have called for an equally rapid evolution of the therapeutic options.The Human recombinant monoclonal antibodies (mAbs) have recently been approved by the Food and Drug Administration (FDA) and by the Italian Medicines Agency (AIFA) in subjects aged ≥12 with SARS-CoV-2 infection and specific risk factors.Currently the indications are specific for the use of two different mAbs combination: Bamlanivimab+Etesevimab (produced by Eli Lilly) and Casirivimab+Imdevimab (produced by Regeneron).These drugs have shown favorable effects in adult patients in the initial phase of infection, whereas to date few data are available on their use in children.AIFA criteria derived from the existing literature which reports an increased risk of severe COVID-19 in children with comorbidities. However, the studies analyzing the determinants for progression to severe disease are mainly monocentric, with limited numbers and reporting mostly generic risk categories.Thus, the Italian Society of Pediatrics invited its affiliated Scientific Societies to produce a Consensus document based on the revision of the criteria proposed by AIFA in light of the most recent literature and experts’ agreement.This Consensus tries to detail which patients actually have the risk to develop severe disease, analyzing the most common comorbidities in children, in order to detail the indications for mAbs administration and to guide the clinicians in identifying eligible patients.

Published
2022

15. Impaired fasting glucose and impaired glucose tolerance in children and adolescents with overweight/obesity

Author

Di Bonito, P., Pacifico, L., Chiesa, C., Valerio, G., Miraglia del Giudice, E., Maffeis, C., Morandi, A., Invitti, C., Licenziati, M. R., Loche, S., Tornese, G., Franco, F., Manco, M., Baroni, M. G., Driul, D., Grandone, A., Incani, M., Pani, M. G., Tomat, Michela, Sanguigno, E., Gilardini, L., Pellegrin, M. C., and for the “CARdiometabolic risk factors in overweight and obese children in ITALY” (CARITALY) Study Group

Published
2017
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16. Left atrial function may mitigate the effect of mitral regurgitation on right chambers in patients with severe aortic valve stenosis

Author

Urbani, G, primary, Springhetti, P, additional, Quer, L, additional, Dotto, A, additional, Ciceri, L, additional, Fanti, D, additional, Maffeis, C, additional, Tafciu, E, additional, Bergamini, C, additional, Nistri, S, additional, Inciardi, R M, additional, Ribichini, F L, additional, and Benfari, G, additional

Published
2022
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18. 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(Front. Endocrinol., (2022), 13, (878634), 10.3389/fendo.2022.878634)

Author

Cherubini, V., Marino, M., Scaramuzza, A. E., Tiberi, V., Bobbio, A., Delvecchio, M., Piccinno, E., Ortolani, F., Innaurato, S., Felappi, B., Gallo, F., Ripoli, C., Ricciardi, M. R., Pascarella, F., Stamati, F. A., Citriniti, F., Arnaldi, C., Monti, S., Graziani, V., De Berardinis, F., Giannini, C., Chiarelli, F., Zampolli, M., De Marco, R., Bracciolini, G. P., Grosso, C., De Donno, V., Piccini, B., Toni, S., Coccioli, S., Cardinale, G., Bassi, M., Minuto, N., D?annunzio, G., Maffeis, C., Marigliano, M., Zanfardino, A., Iafusco, D., Rollato, A. S., Piscopo, A., Curto, S., Lombardo, F., Bombaci, B., Sordelli, S., Mameli, C., Macedoni, M., Rigamonti, A., Bonfanti, R., Frontino, G., Predieri, B., Bruzzi, P., Mozzillo, E., Rosanio, F., Franzese, A., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, M. G., Lasagni, A., Pampanini, V., Patera, P. I., Schiaffini, R., Rutigliano, I., Meloni, G., De Sanctis, L., Tinti, D., Trada, M., Guerraggio, L. P., Franceschi, R., Cauvin, V., Tornese, G., Franco, F., Musolino, G., Maltoni, G., Talarico, V., Iannilli, A., Lenzi, L., Matteoli, M. C., Pozzi, E., Moretti, C., Zucchini, S., Rabbone, I., Gesuita, R., Cherubini, V., Marino, M., Scaramuzza, A. E., Tiberi, V., Bobbio, A., Delvecchio, M., Piccinno, E., Ortolani, F., Innaurato, S., Felappi, B., Gallo, F., Ripoli, C., Ricciardi, M. R., Pascarella, F., Stamati, F. A., Citriniti, F., Arnaldi, C., Monti, S., Graziani, V., De Berardinis, F., Giannini, C., Chiarelli, F., Zampolli, M., De Marco, R., Bracciolini, G. P., Grosso, C., De Donno, V., Piccini, B., Toni, S., Coccioli, S., Cardinale, G., Bassi, M., Minuto, N., D'Annunzio, G., Maffeis, C., Marigliano, M., Zanfardino, A., Iafusco, D., Rollato, A. S., Piscopo, A., Curto, S., Lombardo, F., Bombaci, B., Sordelli, S., Mameli, C., Macedoni, M., Rigamonti, A., Bonfanti, R., Frontino, G., Predieri, B., Bruzzi, P., Mozzillo, E., Rosanio, F., Franzese, A., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, M. G., Lasagni, A., Pampanini, V., Patera, P. I., Schiaffini, R., Rutigliano, I., Meloni, G., De Sanctis, L., Tinti, D., Trada, M., Guerraggio, L. P., Franceschi, R., Cauvin, V., Tornese, G., Franco, F., Musolino, G., Maltoni, G., Talarico, V., Iannilli, A., Lenzi, L., Matteoli, M. C., Pozzi, E., Moretti, C., Zucchini, S., Rabbone, I., and Gesuita, R.

Subjects
socioeconomic status, COVID - 19, type 1 diabetes, DKA, socioeconomic statu, diabetes onset
Abstract

In the published article, there was an error in affiliation(s) 29. Instead of “Departement of Pediatrics, Diabetes Research Institute, IRCCS San Raffaele, Milano, Italy”, it should be “Diabetes Research Institute, IRCCS San Raffaele Hospital, Milan, Italy”. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.

Published
2022

21. Fluid intake and hydration status in obese vs normal weight children

Author

Maffeis, C., Tommasi, M., Tomasselli, F., Spinelli, J., Fornari, E., Scattolo, N., Marigliano, M., and Morandi, A.

Subjects
Drinking (Physiology) -- Comparative analysis, Body weight -- Health aspects, Obesity in children -- Physiological aspects, Food/cooking/nutrition, Health
Abstract

BACKGROUND/OBJECTIVES: Little is known on the relationship between obesity and hydration levels in children. This study assessed whether and by which mechanisms hydration status differs between obese and non-obese children. SUBJECTS/METHODS: Hydration levels of 86 obese and 89 normal weight children (age: 7-11 years) were compared. Hydration was measured as the average free water reserve (FWR = urine output/24 h minus the obligatory urine output [total 24 h excreted solutes/97th percentile of urine osmolality of children with adequate water intake, that is, 830 mOsm/kg]) over 2 days. Three days of weighed dietary and fluid intakes were recorded. Non-parametric tests were used to compare variables that were skewed and to assess which variables correlated with hydration. Variables mediating the different hydration levels of obese and normal weight children were assessed by co-variance analysis. RESULTS: Obese children were less hydrated than normal weight peers [FWR= median (IQR): 0.80 (-0.80-2.80) hg/day vs 2.10 (0.10-4.45) hg/day, P < 0.02;32% of obese children vs 20% of non-obese peers had negative FWR, P < 0.001]. Body mass index (BMI) z-score (z-BMI) and water intake from fluids correlated with FWR (ρ = - 0.18 and 0.45, respectively, both P < 0.05). Water intake from fluids completely explained the different hydration between obese and normal weight children [FWR adjusted for water from fluids and z-BMI = 2.44 (0.44) hg vs 2.10 (0.50) hg, P = NS;B coefficient of co-variation between FWR (hg/day) and water intake from fluids (hg/day) = 0.47, P < 0.001]. CONCLUSIONS: Obese children were less hydrated than normal weight ones because, taking into account their z-BMI, they drank less. Future prospective studies are needed to explore possible causal relationships between hydration and obesity. European Journal of Clinical Nutrition (2016) 70, 560-565; doi: 10.1038/ejcn.2015.170; published online 14 October 2015, INTRODUCTION Obesity is the most common nutritional disorder in children from western or westernized countries, with a relevant impact on public health. Obese children have a high chance (40-80%) of [...]

Published
2016
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24. How to Apply European and American Guidelines on High Blood Pressure in Children and Adolescents. A Position Paper Endorsed by the Italian Society of Hypertension and the Italian Society of Pediatrics

Author

Genovesi, S, Parati, G, Giussani, M, Bona, G, Fava, C, Maffeis, C, Ferri, C, Giordano, U, Genovesi S., Parati G., Giussani M., Bona G., Fava C., Maffeis C., Ferri C., Giordano U., Genovesi, S, Parati, G, Giussani, M, Bona, G, Fava, C, Maffeis, C, Ferri, C, Giordano, U, Genovesi S., Parati G., Giussani M., Bona G., Fava C., Maffeis C., Ferri C., and Giordano U.

Abstract

Children are defined as hypertensive when their blood pressure values equal or exceed the 95th percentile of the blood pressure value distribution in a pediatric population, according to gender, age and height. The population on which reference tables are based is of fundamental importance to establish the threshold values for the diagnosis of hypertension in pediatric age. Before 2017, both American and European guidelines used nomograms created in the same reference population which included children of all weight classes. Given the close and well-known association between hypertension and excess weight in childhood, the 2017 American guidelines proposed new reference nomograms excluding subjects with overweight and obesity from the “historical” reference population. Furthermore, the new American guidelines suggested a fixed cut-off of 130/80 mmHg, starting from 13 years and regardless of gender and height, to make the diagnosis of hypertension. In this document, the Italian Hypertension Society (SIIA) and the Italian Pediatric Society (SIP) jointly discuss a number of issues raised by the new American guidelines that involve the entire medical community, and also address the definition of arterial hypertension in the transition phase between childhood and adulthood.

Published
2020

25. Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity

Author

Hunter, KE, Johnson, BJ, Askie, L, Golley, RK, Baur, LA, Marschner, IC, Taylor, RW, Wolfenden, L, Wood, CT, Mihrshahi, S, Hayes, AJ, Rissel, C, Robledo, KP, O'Connor, DA, Espinoza, D, Staub, LP, Chadwick, P, Taki, S, Barba, A, Libesman, S, Aberoumand, M, Smith, WA, Sue-See, M, Hesketh, Kylie, Thomson, JL, Bryant, M, Paul, IM, Verbestel, V, Stough, CO, Wen, LM, Larsen, JK, O'Reilly, Sharleen, Wasser, HM, Savage, JS, Ong, KK, Salvy, SJ, Messito, MJ, Gross, RS, Karssen, LT, Rasmussen, FE, Campbell, Karen, Linares, AM, Øverby, NC, Palacios, C, Joshipura, KJ, González Acero, C, Lakshman, R, Thompson, AL, Maffeis, C, Oken, E, Ghaderi, A, Campos Rivera, M, Pérez-Expósito, AB, Banna, JC, de la Haye, K, Goran, M, Røed, M, Anzman-Frasca, S, Taylor, BJ, Seidler, AL, Hunter, KE, Johnson, BJ, Askie, L, Golley, RK, Baur, LA, Marschner, IC, Taylor, RW, Wolfenden, L, Wood, CT, Mihrshahi, S, Hayes, AJ, Rissel, C, Robledo, KP, O'Connor, DA, Espinoza, D, Staub, LP, Chadwick, P, Taki, S, Barba, A, Libesman, S, Aberoumand, M, Smith, WA, Sue-See, M, Hesketh, Kylie, Thomson, JL, Bryant, M, Paul, IM, Verbestel, V, Stough, CO, Wen, LM, Larsen, JK, O'Reilly, Sharleen, Wasser, HM, Savage, JS, Ong, KK, Salvy, SJ, Messito, MJ, Gross, RS, Karssen, LT, Rasmussen, FE, Campbell, Karen, Linares, AM, Øverby, NC, Palacios, C, Joshipura, KJ, González Acero, C, Lakshman, R, Thompson, AL, Maffeis, C, Oken, E, Ghaderi, A, Campos Rivera, M, Pérez-Expósito, AB, Banna, JC, de la Haye, K, Goran, M, Røed, M, Anzman-Frasca, S, Taylor, BJ, and Seidler, AL

Published
2022

26. Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol

Author

Johnson, BJ, Hunter, KE, Golley, RK, Chadwick, P, Barba, A, Aberoumand, M, Libesman, S, Askie, L, Taylor, RW, Robledo, KP, Mihrshahi, S, O'Connor, DA, Hayes, AJ, Wolfenden, L, Wood, CT, Baur, LA, Rissel, C, Staub, LP, Taki, S, Smith, W, Sue-See, M, Marschner, IC, Espinoza, D, Thomson, JL, Larsen, JK, Verbestel, V, Odar Stough, C, Salvy, SJ, O'Reilly, SL, Karssen, LT, Rasmussen, FE, Messito, MJ, Gross, RS, Bryant, M, Paul, IM, Wen, LM, Hesketh, Kylie, González Acero, C, Campbell, Karen, Øverby, NC, Linares, AM, Wasser, HM, Joshipura, KJ, Palacios, C, Maffeis, C, Thompson, AL, Ghaderi, A, Lakshman, R, Banna, JC, Oken, E, Campos Rivera, M, Pérez-Expósito, AB, Taylor, BJ, Savage, JS, Røed, M, Goran, M, de la Haye, K, Anzman-Frasca, S, Seidler, AL, Johnson, BJ, Hunter, KE, Golley, RK, Chadwick, P, Barba, A, Aberoumand, M, Libesman, S, Askie, L, Taylor, RW, Robledo, KP, Mihrshahi, S, O'Connor, DA, Hayes, AJ, Wolfenden, L, Wood, CT, Baur, LA, Rissel, C, Staub, LP, Taki, S, Smith, W, Sue-See, M, Marschner, IC, Espinoza, D, Thomson, JL, Larsen, JK, Verbestel, V, Odar Stough, C, Salvy, SJ, O'Reilly, SL, Karssen, LT, Rasmussen, FE, Messito, MJ, Gross, RS, Bryant, M, Paul, IM, Wen, LM, Hesketh, Kylie, González Acero, C, Campbell, Karen, Øverby, NC, Linares, AM, Wasser, HM, Joshipura, KJ, Palacios, C, Maffeis, C, Thompson, AL, Ghaderi, A, Lakshman, R, Banna, JC, Oken, E, Campos Rivera, M, Pérez-Expósito, AB, Taylor, BJ, Savage, JS, Røed, M, Goran, M, de la Haye, K, Anzman-Frasca, S, and Seidler, AL

Published
2022

27. Health care organization and use of technological devices in people with diabetes in Italy: Results from a survey of the Working Group on Diabetes and Technology

Author

Pitocco, Dario, Laurenzi, A., Tomaselli, L., Assaloni, R., Consoli, A., Di Bartolo, P., Guardasole, V., Lombardo, F., Maffeis, C., Rossi, A., Gesuita, R., Di Molfetta, S., Rigamonti, Alain, Scaramuzza, A., Irace, C., Cherubini, V., Pitocco D. (ORCID:0000-0002-6220-686X), Rigamonti A., Pitocco, Dario, Laurenzi, A., Tomaselli, L., Assaloni, R., Consoli, A., Di Bartolo, P., Guardasole, V., Lombardo, F., Maffeis, C., Rossi, A., Gesuita, R., Di Molfetta, S., Rigamonti, Alain, Scaramuzza, A., Irace, C., Cherubini, V., Pitocco D. (ORCID:0000-0002-6220-686X), and Rigamonti A.

Abstract

Background and aim: The use of technology offers recognized benefits to persons with diabetes. The aim of this study was to evaluate the organization of healthcare facilities, the composition of the diabetes team, and the use of Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring (CGM) in Italy. Methods and results: Diabetes care centers were asked to complete a web survey based on information collected in 2018. Sixty-one pediatric and 243 adult centers participated in the survey, accounting for 507,386 patients, mostly with type 2 diabetes (86.4%). Fifty-three percent of pediatric centers and 11% of adult centers reported a team composed of diabetologists, nurses, and psychologists. Overall, 13,204 patients (2.6%) were using CSII (95% with type 1 diabetes), and 28,936 (5.7%), were using CGM (74% with type 1 diabetes). When stratifying for the type of diabetes, 24% and 40.8% of patients with type 1 were using CSII and CGM, respectively, whereas low use of technology was reported for patients with type 2 and women with gestational diabetes. The percentage of adult and pediatric patients with type 1 diabetes on CSII and CGM was respectively 21% and 32%, and 35% and 57%. Conclusions: The spread of CGM and CSII increased in Italy between 2013 and 2018. However, the percentage of users is still lower than what is expected based on clinical indications for use of technology. The inadequate number of professionals in the diabetes care team and insufficient economic resources are relevant barriers to disseminating technology for diabetes management.

Published
2022

32. Dietary factors associated with subclinical inflammation among girls

Author

del Mar Bibiloni, M., Maffeis, C., Llompart, I., Pons, A., and Tur, J.A.

Subjects
Inflammation -- Physiological aspects -- Demographic aspects, Prevalence studies (Epidemiology) -- Research, Diet -- Health aspects -- Demographic aspects, Food/cooking/nutrition, Health
Abstract

BACKGROUND/OBJECTIVES: Dietary patterns and biomarkers of inflammation have been scarcely associated. The aim was to assess dietary factors associated with subclinical inflammation among girls. SUBJECTS/METHODS: Fasting blood samples were collected from 12- to 17-year old girls (n = 219) to measure adiponectin, leptin, tumor necrosis factor-alpha, plasminogen activator inhibitor 1 (PAI-1), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) levels. Body mass index (BMI) and waist-to-height ratio (WHtR), and food intake were also measured. Western (WDP) and Mediterranean (MDP) dietary patterns were identified. RESULTS: BMI and WHtR were associated with adiponectin, leptin and hs-CRP (the last, only associated with BMI). Intakes of β-carotene equivalents and vitamin C were associated with adiponectin; saturated fatty acids (SFA), vitamin A, manganese and selenium with leptin; linoleic acid with PAI-1;and oleic acid and vitamin E with IL-6. Selenium was inversely associated with adiponectin, whereas magnesium was positively associated with IL-6. MDP was associated with higher plasma concentrations of adiponectin (β = 0.174, P < 0.05); after adjustment for BMI, associations were not significant (β = 0.144, P = 0.076). WDP was negatively associated with adiponectin (β = -0.177, P < 0.05) and positively with IL-6 (β = 0.183, P < 0.05). CONCLUSIONS: Subclinical inflammation is detectable with increasing BMI and also WHtR. Measures of adiposity (BMI and WHtR) are significant predictors of adiponectin, leptin and hs-CRP. Dietary patterns per se have a small role in affecting inflammatory markers among adolescents. European Journal of Clinical Nutrition (2013) 67, 1264-1270; doi: 10.1038/ejcn.2013.196; published online 23 October 2013 Keywords: inflammation; adiponectin; leptin; PAI-1; IL-6; hs-CRP, INTRODUCTION The alarming increase in obesity worldwide is of concern, because of the associations of obesity with metabolic syndrome, insulin resistance, type 2 diabetes, dyslipidaemia and cardiovascular diseases. (1) Adipose [...]

Published
2013
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33. A Multicenter Italian Study on Prader-Willi Syndrome

Author

Pozzan, G. B., Cerutti, F., Corrias, A., Maffeis, C., Tonini, G., De Simone, M., Crino, A., Sposito, M., Balsamo, A., Balestrazzi, P., De Toni, T., Brambilla, P., Livieri, C., Salvatoni, A., Vido, L., Pinelli, L., Lungarotti, M. S., Mazzanti, L., Iughetti, L., Gastaldi, R., Lorini, R., Seminara, S., Borrelli, P., Chiumello, G., and Cassidy, Suzanne B., editor

Published
1992
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34. Diabetic ketoacidosis at the onset of disease during a national awareness campaign: A 2-year observational study in children aged 0-18 years

Author

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

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

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

Published
2020

39. Metabolic and hormonal consequences of two different meals after a moderate intensity exercise bout in obese prepubertal children

Author

Maffeis, C., Bonadonna, R., Maschio, M., Aiello, G., Tommasi, M., Marigliano, M., Fornari, E., and Morandi, A.

Subjects
Obesity in children -- Research, Physical fitness -- Influence, Food/cooking/nutrition, Health
Abstract

BACKGROUND/OBJECTIVES: To investigate the relationship between postprandial nutrient balance, satiety and hormone changes induced by two different meals taken after a moderate intensity exercise bout. SUBJECTS/METHODS: Ten prepubertal obese children participated in the study. The experiment was designed as a cross-over study for repeated measures. Each test period lasted five consecutive hours during which the children were under medical supervision. The effects of two isocaloric meals were compared after a moderate intensity exercise (4 multiples of resting metabolic rate, 30 min, cycling): a low-fat/high-carbohydrate meal (meal A) and a high-fat/low-carbohydrate meal (meal B). Pre and postprandial (3 h) substrate oxidation, biochemical parameters, gastrointestinal hormone concentrations and appetite were measured. RESULTS: The main results were: (i) higher fat balance (5.1 [+ or -] 5.0 vs -5.0 ± 6.6g, P = 0.001) and lower carbohydrate balance after meal B than A (-9.7 ± 13.3 vs 11.3 ± 18.3 g, P < 0.01); (ii) higher energy balance after meal B than after meal A (5.9 ± 21.5 vs -13.9 ± 20.2 kcal, P < 0.05); (iii) higher plasma triglyceride concentrations (area under the curve) after meal B than after meal A (2962.5 ± 2095.8 mg * 180 min/dl vs -169.5 ± 1633.7 mg * 180 min/dl, P < 0.01); (iv) higher serum glucagon-like peptide-1 concentrations after meal B than after meal A (1101.5 ± 873.0 pmol * 180 min/l vs 478.8 [+ or -] 638.3 pmol * 180 min/l, P < 0.05). CONCLUSIONS: After a bout of moderate intensity exercise, a meal with a high-fat/low-carbohydrate ratio had a less favorable metabolic impact than an isoenergetic, isoproteic low-fat/high-carbohydrate meal. European Journal of Clinical Nutrition (2013) 67, 725-731; doi: 10.1038/ejcn.2013.86; published online 1 May 2013 Keywords: obesity; children; GLP-1; fat oxidation; insulin resistance, INTRODUCTION Physical activity has a central role in weight control and in improving the quality of life and well being, with effects on long-term health and life expectancy, by inducing [...]

Published
2013
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40. Recommendations for recognizing, risk stratifying, treating, and managing children and adolescents with hypoglycemia

Author

Stefano Zucchini, Stefano Tumini, Andrea Enzo Scaramuzza, Riccardo Bonfanti, Maurizio Delvecchio, Roberto Franceschi, Dario Iafusco, Lorenzo Lenzi, Enza Mozzillo, Stefano Passanisi, Claudia Piona, Ivana Rabbone, Novella Rapini, Andrea Rigamonti, Carlo Ripoli, Giuseppina Salzano, Silvia Savastio, Riccardo Schiaffini, Angela Zanfardino, Valentino Cherubini, Diabetes Study Group of the Italian Society for Pediatric Endocrinology Diabetes, Albino Claudia Accursia, Aloe Monica, Anzelotti Maria Teresa, Arnaldi Claudia, Barbetti Fabrizio, Bassi Marta, Berioli Maria Giulia, Bernardini Luca, Bertelli Enrica, Biagioni Martina, Bobbio Adriana, Bombaci Bruno, Bonfanti Riccardo, Bonura Clara, Bracciolini Giulia Patrizia, Bruzzese Mariella, Bruzzi Patrizia, Buono Pietro, Buscarino Piera, Cadario Francesco, Calcaterra Valeria, Calzi Elena, Cappa Marco, Cardani Roberta, Cardella Francesca, Cardinale Giuliana Marcella, Casertano Alberto, Castorani Valeria, Cauvin Vittoria, Cenciarelli Valentina, Ceruti Franco, Cherubini Valentino, Chiarelli Francesco, Chiari Giovanni, Cianfarani Stefano, Cicchetti Mario, Cipriano Paola, Cirillo Dante, Citriniti Felice, Coccioli Maria Susanna, Confetto Santino, Contreas Giovanna, Coro Anna, Correddu Antonella, Corsini Elisa, Crino’ Antonino, d’Annunzio Giuseppe, De Berardinis Fiorella, De Donno Valeria, De Filippo Gianpaolo, De Marco Rosaria, De Sanctis Luisa, Del Duca Elisabetta, Delvecchio Maurizio, Deodati Annalisa, Di Bonito Procolo, Di Candia Francesca, Faleschini Elena, Fattorusso Valentina, Favia Anna, Federico Giovanni, Felappi Barbara, Ferrari Mara, Ferrito Lucia, Fichera Graziella, Fontana Franco, Fornari Elena, Franceschi Roberto, Franco Francesca, Franzese Adriana, Frongia Anna Paola, Frontino Giulio, Gaiero Alberto, Galassi Sabrina Maria, Gallo Francesco, Gargantini Luigi, Giani Elisa, Gortan Anna Jolanda, Graziani Vanna, Grosso Caterina, Gualtieri Antonella, Guasti Monica, Guerraggio Lucia Paola, Guzzetti Chiara, Iafusco Dario, Iannicelli Gennaro, Iezzi Maria Laura, Ignaccolo Maria Giovanna, Innaurato Stefania, Inzaghi Elena, Iovane Brunella, Iughetti Lorenzo, Kaufmann Peter, La Loggia Alfonso, Lambertini Anna Giulia, Lapolla Rosa, Lasagni Anna, Lazzaro Nicola, Lazzeroni Pietro, Lenzi Lorenzo, Lera Riccardo, Levantini Gabriella, Lezzi Marilea, Lia Rosanna, Liguori Alice, Lo Presti Donatella, Lombardo Fortunato, Lonero Antonella, Longhi Silvia, Lorubbio Antonella, Lucchesi Sonia, Maccioni Rosella, Macedoni Maddalena, Macellaro Patrizia Cristiana, Madeo Simona Filomena, Maffeis Claudio, Mainetti Benedetta, Maltoni Giulio, Mameli Chiara, Mammì Francesco, Manca Bitti Maria Luisa, Mancioppi Valentina, Manco Melania, Marigliano Marco, Marino Monica, Marsciani Alberto, Matteoli Maria Cristina, Mazzali Elena, Minute Marta, Minuto Nicola, Monti Sara, Morandi Anita,, Morganti Gianfranco, Morotti Elisa, Mozzillo Enza, Musolino Gianluca, Olivieri Francesca, Ortolani Federica, Pampanini Valentina, Pardi Daniela, Pascarella Filomena, Pasquino Bruno, Passanisi Stefano, Patera Ippolita Patrizia, Pedini Annalisa, Pennati Maria Cristina, Peruzzi Sonia, Peverelli Paola, Pezzino Giulia, Piccini Barbara, Piccinno Elvira Eugenia Rosaria, Piona Claudia, Piredda Gavina, Piscopo Alessia, Pistone Carmelo, Pozzi Erica, Prandi Elena, Predieri Barbara, Prudente Sabrina, Pulcina Anna, Rabbone Ivana, Randazzo Emioli, Rapini Novella, Reinstadler Petra, Riboni Sara, Ricciardi Maria Rossella, Rigamonti Andrea, Ripoli Carlo, Rossi Virginia, Rossi Paolo, Rutigliano Irene, Sabbion Alberto, Salvatoni Alessandro, Salvo Caterina, Salzano Giuseppina, Sanseviero Mariateresa, Savastio Silvia, Savini Rosanna, Scanu Mariapiera, Scaramuzza Andrea Enzo, Schiaffini Riccardo, Schiavone Maurizio, Schieven Eleonardo, Scipione Mirella, Secco Andrea, Silvestri Francesca, Siri Giulia, Sogno Valin Paola, Sordelli Silvia, Spiri Daniele, Stagi Stefano, Stamati Filomena Andreina, Suprani Tosca, Talarico Valentina, Tiberi Valentina, Timpanaro Tiziana Antonia Lucia, Tinti Davide, Tirendi Antonina, Tomaselli Letizia Grazia, Toni Sonia, Torelli Cataldo, Tornese Gianluca, Trada Michela,, Trettene Adolfo Andrea, Tumini Stefano, Tumminelli Marilena, Valerio Giuliana, Vandelli Sara, Ventrici Claudia, Zampolli Maria, Zanatta Manuela, Zanfardino Angela, Zecchino Clara, Zonca Silvia, and Zucchini Stefano

Subjects
adolescents, automated insulin delivery, children, hypoglycemia, glucagon, oral glucose, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

There has been continuous progress in diabetes management over the last few decades, not least due to the widespread dissemination of continuous glucose monitoring (CGM) and automated insulin delivery systems. These technological advances have radically changed the daily lives of people living with diabetes, improving the quality of life of both children and their families. Despite this, hypoglycemia remains the primary side-effect of insulin therapy. Based on a systematic review of the available scientific evidence, this paper aims to provide evidence-based recommendations for recognizing, risk stratifying, treating, and managing patients with hypoglycemia. The objective of these recommendations is to unify the behavior of pediatric diabetologists with respect to the timely recognition and prevention of hypoglycemic episodes and the correct treatment of hypoglycemia, especially in patients using CGM or advanced hybrid closed-loop systems. All authors have long experience in the specialty and are members of the Italian Society of Pediatric Endocrinology and Diabetology. The goal of treating hypoglycemia is to raise blood glucose above 70 mg/dL (3.9 mmol/L) and to prevent further decreases. Oral glucose at a dose of 0.3 g/kg (0.1 g/kg for children using “smart pumps” or hybrid closed loop systems in automated mode) is the preferred treatment for the conscious individual with blood glucose

Published
2024
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41. Impaired fasting glucose and impaired glucose tolerance in children and adolescents with overweight/obesity

Author

Di Bonito, P., Pacifico, L., Chiesa, C., Valerio, G., Miraglia Del Giudice, E., Maffeis, C., Morandi, A., Invitti, C., Licenziati, M. R., Loche, S., Tornese, G., Franco, F., Manco, M., Baroni, M. G., Driul, D., Grandone, A., Incani, M., Pani, M. G., Tomat, Michela, Sanguigno, E., Gilardini, L., Pellegrin, M. C., Di Bonito, P., Pacifico, L., Chiesa, C., Valerio, G., Miraglia Del Giudice, E., Maffeis, C., Morandi, A., Invitti, C., Licenziati, M. R., Loche, S., Tornese, G., Franco, F., Manco, M., Baroni, M. G., Driul, D., Grandone, A., Incani, M., Pani, M. G., Tomat, Michela, Sanguigno, E., Gilardini, L., Pellegrin, M. C., Di Bonito, P, Pacifico, L, Chiesa, C, Valerio, G, Miraglia Del Giudice, E, Maffeis, C, Morandi, A, Invitti, C, Licenziati, M R, Loche, S, Tornese, G, Franco, F, Manco, M, and Baroni, M G

Subjects
Blood Glucose, Male, endocrine system diseases, Endocrinology, Diabetes and Metabolism, prediabetes, Overweight, Impaired glucose tolerance, 0302 clinical medicine, Endocrinology, impaired fasting glucose, Prevalence, Insulin, 030212 general & internal medicine, Prediabetes, Child, Glucose tolerance test, medicine.diagnostic_test, Cardiometabolic risk factors, Impaired fasting glucose, Pediatric obesity, Fasting, Diabetes and Metabolism, Italy, Prediabete, Adolescent, Case-Control Studies, Female, Glucose Intolerance, Glucose Tolerance Test, Humans, Insulin Resistance, Obesity, Prediabetic State, medicine.symptom, Case-Control Studie, hormones, hormone substitutes, and hormone antagonists, Human, medicine.medical_specialty, pediatric obesity, 030209 endocrinology & metabolism, 03 medical and health sciences, Insulin resistance, Internal medicine, medicine, Cardiometabolic risk factor, business.industry, Case-control study, nutritional and metabolic diseases, medicine.disease, cardiometabolic risk factors, impaired glucose tolerance, business
Abstract

OBJECTIVE: To investigate in a large sample of overweight/obese (OW/OB) children and adolescents the prevalence of prediabetic phenotypes such as impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), and to assess their association with cardiometabolic risk (CMR) factors including hepatic steatosis (HS). METHODS: Population data were obtained from the CARdiometabolic risk factors in children and adolescents in ITALY study. Between 2003 and 2013, 3088 youths (972 children and 2116 adolescents) received oral glucose tolerance test (OGTT) and were included in the study. In 798 individuals, abdominal ultrasound for identification of HS was available. RESULTS: The prevalence of IFG (3.2 vs. 3.3%) and IGT (4.6 vs. 5.0%) was similar between children and adolescents. Children with isolated IGT had a 2-11 fold increased risk of high LDL-C, non-HDL-C, Tg/HDL-C ratio, and low insulin sensitivity, when compared to those with normal glucose tolerance (NGT). No significant association of IFG with any CMR factor was found in children. Among adolescents, IGT subjects, and to a lesser extent those with IFG, showed a worse CMR profile compared to NGT subgroup. In the overall sample, IGT phenotype showed a twofold increased risk of HS compared to NGT subgroup. CONCLUSIONS: Our study shows an unexpected similar prevalence of IFG and IGT between children and adolescents with overweight/obesity. The IGT phenotype was associated with a worse CMR profile in both children and adolescents. Phenotyping prediabetes conditions by OGTT should be done as part of prediction and prevention of cardiometabolic diseases in OW/OB youth since early childhood.

Published
2016

43. The role and requirements of digestible dietary carbohydrates in infants and toddlers

Author

Stephen, A., Alles, M., de Graaf, C., Fleith, M., Hadjilucas, E., Isaacs, E., Maffeis, C., Zeinstra, G., Matthys, C., and Gil, A.

Subjects
Carbohydrates -- Research, Food/cooking/nutrition, Health
Abstract

Digestible carbohydrates are one of the main sources of dietary energy in infancy and childhood and are essential for growth and development. The aim of this narrative review is to outline the intakes of digestible carbohydrates and their role in health and disease, including the development of food preferences, as well the consequences of excess carbohydrate. Key experts in these fields provided up-to-date reviews of the literature. A search of available information on dietary intakes of children below the age of 4 years was conducted from 1985 up to 2010. Articles and reports including information about sugars and/or starch intakes were selected. A number of factors limit the ability to obtain an overall picture of carbohydrate intakes and food sources in this age group. These include small numbers of intake studies, differing approaches to analysing carbohydrate, a variety of terms used to describe sugars intakes and a dearth of information about starch intakes. Data suggest that sweet taste is preferred in infancy and later food choices. There are few established adverse consequences of high intakes of digestible carbohydrate for young children. The greatest evidence is for dental caries, although this is influenced by high intake frequency and poor oral hygiene. Evidence for detrimental effects on nutrient dilution, obesity, diabetes or cognition is limited. In infants, minimum carbohydrate (mainly lactose) intake should be 40% of total energy, gradually increasing to 55% energy by the age of 2 years. European Journal of Clinical Nutrition (2012) 66, 765-779; doi: 10.1038/ejcn.2012.27; published online 4 April 2012 Keywords: young children; dietary carbohydrates; dietary intake; obesity; dental caries; cognition, INTRODUCTION The early years of life are a period of very rapid growth. Appropriate nutrition is essential during this period: children who do not receive sufficient energy and nutrients will [...]

Published
2012
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45. Pros and cons of Minimed 670G hybrid closed-loop system: first 6-month experience in Italy

Author

Scaramuzza A, Minuto N, Marigliano M, Tornese G, Gallo F, De Donno V, Iovane B, De Berardinis F, Zanfardino A, Franceschi R, Delvecchio M, Iafusco D, Maffeis C, Bonfanti R., Scaramuzza, A, Minuto, N, Marigliano, M, Tornese, G, Gallo, F, De Donno, V, Iovane, B, De Berardinis, F, Zanfardino, A, Franceschi, R, Delvecchio, M, Iafusco, D, Maffeis, C, and Bonfanti, R.

Subjects
CSII, diabetes
Published
2019

46. Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion

Author

Lepore, G, Bonfanti, R, Bozzetto, L, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Laviola, L, Rabbone, I, Schiaffini, R, Bruttomesso, D, Mammi, F, Bruzzese, M, Schettino, M, Nuzzo, M, Fresa, R, Lambiase, C, Zanfardino, A, Confetto, S, Annuzzi, G, Alderisio, A, Riccardi, G, Gentile, S, Marino, G, Guarino, G, Zucchini, S, Maltoni, G, Suprani, T, Graziani, V, Nizzoli, M, Acquati, S, Cavani, R, Romano, S, Michelini, M, Manicardi, E, Bonadonna, R, Dei Cas, A, Dall'Aglio, E, Papi, M, Riboni, S, Manicardi, V, Pugni, V, Lasagni, A, Street, M, Pagliani, U, Rossi, C, Assaloni, R, Brunato, B, Tortul, C, Zanette, G, Li Volsi, P, Zanatta, M, Tonutti, L, Agus, S, Pellegrini, M, Ceccano, P, Pozzilli, G, Anguissola, B, Buzzetti, R, Moretti C, C, Leto, G, Pozzilli, P, Manfrini, S, Maurizi, A, Leotta, S, Altomare, M, Abbruzzese, S, Carletti, S, Suraci, C, Filetti, S, Manca Bitti, M, Arcano, S, Cavallo, M, De Bernardinis, M, Pitocco, D, Caputo, S, Rizzi, A, Manto, A, Cappa, M, Benevento, D, Frontoni, S, Malandrucco, I, Morano, S, Filardi, T, Lauro, D, Marini, M, Castaldo, E, Sabato, D, Tuccinardi, F, Forte, E, Viterbori, P, Arnaldi, C, Minuto, N, D'Annunzio, G, Corsi, A, Rota, R, Scaranna, C, Trevisan, R, Valentini, U, Bonfadini, S, Zarra, E, Plebani, A, Prandi, E, Felappi, B, Rocca, A, Meneghini, E, Galli, P, Ruggeri, P, Carrai, E, Fugazza, L, Baggi, V, Conti, D, Bosi, E, Laurenzi, A, Caretto, A, Molinari, C, Orsi, E, Grancini, V, Resi, V, Favalli, V, Bonura, C, Rigamonti, A, Bonomo, M, Bertuzzi, F, Pintaudi, B, Disoteo, O, Perseghin, G, Perra, S, Chiovato, L, De Cata, P, Zerbini, F, Lovati, E, Laneri, M, Guerraggio, L, Bossi, A, De Mori, V, Galetta, M, Meloncelli, I, Aiello A, A, Di Vincenzo, S, Nuzzi, A, Fraticelli, E, Ansaldi, E, Battezzati, M, Lombardi, M, Balbo, M, Lera, R, Secco, A, De Donno, V, Cadario, F, Savastio, S, Ponzani, C, Aimaretti, G, Ignaccolo, G, Tinti, D, Cerutti, F, Bari, F, Giorgino, F, Piccinno, E, Zecchino, O, Cignarelli, M, Lamacchia, O, Picca, G, De Cosmo, S, Rauseo, A, Tomaselli, L, Tumminia, A, Egiziano, C, Scarpitta, A, Maggio, F, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Scorsone, A, Scatena, A, Gregori, G, Lucchesi, S, Gadducci, F, Di Cianni, S, Pancani, S, Del Prato, S, Aragona, M, Crisci, I, Calianno, A, Fattor, B, Crazzolara, D, Reinstadler, P, Longhi, S, Incelli, G, Rauch, S, Romanelli, T, Orrasch, M, Cauvin, V, Franceschi, R, Lalli, C, Pianta, A, Marangoni, A, Arico, C, Marin, N, Nogara, N, Simioni, N, Filippi, A, Gidoni Guarneri, G, Contin, M, Decata, A, Bondesan, L, Confortin, L, Coracina, A, Lombardi, S, Costa Padova, S, Cipponeri, E, Scotton, R, Galasso, S, Boscari, F, Zanon, M, Vinci, C, Lisato, G, Gottardo, L, Bonora, E, Trombetta, M, Negri, C, Brangani, C, Maffeis, C, Sabbion, A, Marigliano, M, Lepore G., Bonfanti R., Bozzetto L., Di Blasi V., Girelli A., Grassi G., Iafusco D., Laviola L., Rabbone I., Schiaffini R., Bruttomesso D., Mammi F., Bruzzese M., Schettino M., Nuzzo M. G., Fresa R., Lambiase C., Zanfardino A., Confetto S., Annuzzi G., Alderisio A., Riccardi G., Gentile S., Marino G., Guarino G., Zucchini S., Maltoni G., Suprani T., Graziani V., Nizzoli M., Acquati S., Cavani R., Romano S., Michelini M., Manicardi E., Bonadonna R., Dei Cas A., Dall'aglio E., Papi M., Riboni S., Manicardi V., Pugni V., Lasagni A., Street M. E., Pagliani U., Rossi C., Assaloni R., Brunato B., Tortul C., Zanette G., Li Volsi P., Zanatta M., Tonutti L., Agus S., Pellegrini M. A., Ceccano P., Pozzilli G., Anguissola B., Buzzetti R., Moretti C C., Leto G., Pozzilli P., Manfrini S., Maurizi A. R., Leotta S., Altomare M., Abbruzzese S., Carletti S., Suraci C., Filetti S., Manca Bitti M. L., Arcano S., Cavallo M. G., De Bernardinis M., Pitocco D., Caputo S., Rizzi A., Manto A., Cappa M., Benevento D., Frontoni S., Malandrucco I., Morano S., Filardi T., Lauro D., Marini M. A., Castaldo E., Sabato D., Tuccinardi F., Forte E., Viterbori P., Arnaldi C., Minuto N., d'Annunzio G., Corsi A., Rota R., Scaranna C., Trevisan R., Valentini U., Bonfadini S., Zarra E., Plebani A., Prandi E., Felappi B., Rocca A., Meneghini E., Galli P., Ruggeri P., Carrai E., Fugazza L., Baggi V., Conti D., Bosi E., Laurenzi A., Caretto A., Molinari C., Orsi E., Grancini V., Resi V., Favalli V., Bonura C., Rigamonti A., Bonomo M., Bertuzzi F., Pintaudi B., Disoteo O., Perseghin G., Perra S., Chiovato L., De Cata P., Zerbini F., Lovati E., Laneri M., Guerraggio L., Bossi A. C., De Mori V., Galetta M., Meloncelli I., Aiello A A., Di Vincenzo S., Nuzzi A., Fraticelli E., Ansaldi E., Battezzati M., Lombardi M., Balbo M., Lera R., Secco A., De Donno V., Cadario F., Savastio S., Ponzani C., Aimaretti G., Ignaccolo G., Tinti D., Cerutti F., Bari F., Giorgino F., Piccinno E., Zecchino O., Cignarelli M., Lamacchia O., Picca G., De Cosmo S., Rauseo A., Tomaselli L., Tumminia A., Egiziano C., Scarpitta A. M., Maggio F., Cardella F., Roppolo R., Provenzano V., Fleres M., Scorsone A., Scatena A., Gregori G., Lucchesi S., Gadducci F., Di Cianni S., Pancani S., Del Prato S., Aragona M., Crisci I., Calianno A., Fattor B., Crazzolara D., Reinstadler P., Longhi S., Incelli G., Rauch S., Romanelli T., Orrasch M., Cauvin V., Franceschi R., Lalli C., Pianta A., Marangoni A., Arico C. N., Marin N., Nogara N., Simioni N., Filippi A., Gidoni Guarneri G. L., Contin M. L M. L., Decata A. P., Bondesan L., Confortin L., Coracina A., Lombardi S., Costa Padova S., Cipponeri E., Scotton R., Galasso S., Boscari F., Zanon M. S., Vinci C., Lisato G., Gottardo L., Bonora E., Trombetta M., Negri C., Brangani C., Maffeis C., Sabbion A., Marigliano M., Lepore, G, Bonfanti, R, Bozzetto, L, Di Blasi, V, Girelli, A, Grassi, G, Iafusco, D, Laviola, L, Rabbone, I, Schiaffini, R, Bruttomesso, D, Mammi, F, Bruzzese, M, Schettino, M, Nuzzo, M, Fresa, R, Lambiase, C, Zanfardino, A, Confetto, S, Annuzzi, G, Alderisio, A, Riccardi, G, Gentile, S, Marino, G, Guarino, G, Zucchini, S, Maltoni, G, Suprani, T, Graziani, V, Nizzoli, M, Acquati, S, Cavani, R, Romano, S, Michelini, M, Manicardi, E, Bonadonna, R, Dei Cas, A, Dall'Aglio, E, Papi, M, Riboni, S, Manicardi, V, Pugni, V, Lasagni, A, Street, M, Pagliani, U, Rossi, C, Assaloni, R, Brunato, B, Tortul, C, Zanette, G, Li Volsi, P, Zanatta, M, Tonutti, L, Agus, S, Pellegrini, M, Ceccano, P, Pozzilli, G, Anguissola, B, Buzzetti, R, Moretti C, C, Leto, G, Pozzilli, P, Manfrini, S, Maurizi, A, Leotta, S, Altomare, M, Abbruzzese, S, Carletti, S, Suraci, C, Filetti, S, Manca Bitti, M, Arcano, S, Cavallo, M, De Bernardinis, M, Pitocco, D, Caputo, S, Rizzi, A, Manto, A, Cappa, M, Benevento, D, Frontoni, S, Malandrucco, I, Morano, S, Filardi, T, Lauro, D, Marini, M, Castaldo, E, Sabato, D, Tuccinardi, F, Forte, E, Viterbori, P, Arnaldi, C, Minuto, N, D'Annunzio, G, Corsi, A, Rota, R, Scaranna, C, Trevisan, R, Valentini, U, Bonfadini, S, Zarra, E, Plebani, A, Prandi, E, Felappi, B, Rocca, A, Meneghini, E, Galli, P, Ruggeri, P, Carrai, E, Fugazza, L, Baggi, V, Conti, D, Bosi, E, Laurenzi, A, Caretto, A, Molinari, C, Orsi, E, Grancini, V, Resi, V, Favalli, V, Bonura, C, Rigamonti, A, Bonomo, M, Bertuzzi, F, Pintaudi, B, Disoteo, O, Perseghin, G, Perra, S, Chiovato, L, De Cata, P, Zerbini, F, Lovati, E, Laneri, M, Guerraggio, L, Bossi, A, De Mori, V, Galetta, M, Meloncelli, I, Aiello A, A, Di Vincenzo, S, Nuzzi, A, Fraticelli, E, Ansaldi, E, Battezzati, M, Lombardi, M, Balbo, M, Lera, R, Secco, A, De Donno, V, Cadario, F, Savastio, S, Ponzani, C, Aimaretti, G, Ignaccolo, G, Tinti, D, Cerutti, F, Bari, F, Giorgino, F, Piccinno, E, Zecchino, O, Cignarelli, M, Lamacchia, O, Picca, G, De Cosmo, S, Rauseo, A, Tomaselli, L, Tumminia, A, Egiziano, C, Scarpitta, A, Maggio, F, Cardella, F, Roppolo, R, Provenzano, V, Fleres, M, Scorsone, A, Scatena, A, Gregori, G, Lucchesi, S, Gadducci, F, Di Cianni, S, Pancani, S, Del Prato, S, Aragona, M, Crisci, I, Calianno, A, Fattor, B, Crazzolara, D, Reinstadler, P, Longhi, S, Incelli, G, Rauch, S, Romanelli, T, Orrasch, M, Cauvin, V, Franceschi, R, Lalli, C, Pianta, A, Marangoni, A, Arico, C, Marin, N, Nogara, N, Simioni, N, Filippi, A, Gidoni Guarneri, G, Contin, M, Decata, A, Bondesan, L, Confortin, L, Coracina, A, Lombardi, S, Costa Padova, S, Cipponeri, E, Scotton, R, Galasso, S, Boscari, F, Zanon, M, Vinci, C, Lisato, G, Gottardo, L, Bonora, E, Trombetta, M, Negri, C, Brangani, C, Maffeis, C, Sabbion, A, Marigliano, M, Lepore G., Bonfanti R., Bozzetto L., Di Blasi V., Girelli A., Grassi G., Iafusco D., Laviola L., Rabbone I., Schiaffini R., Bruttomesso D., Mammi F., Bruzzese M., Schettino M., Nuzzo M. G., Fresa R., Lambiase C., Zanfardino A., Confetto S., Annuzzi G., Alderisio A., Riccardi G., Gentile S., Marino G., Guarino G., Zucchini S., Maltoni G., Suprani T., Graziani V., Nizzoli M., Acquati S., Cavani R., Romano S., Michelini M., Manicardi E., Bonadonna R., Dei Cas A., Dall'aglio E., Papi M., Riboni S., Manicardi V., Pugni V., Lasagni A., Street M. E., Pagliani U., Rossi C., Assaloni R., Brunato B., Tortul C., Zanette G., Li Volsi P., Zanatta M., Tonutti L., Agus S., Pellegrini M. A., Ceccano P., Pozzilli G., Anguissola B., Buzzetti R., Moretti C C., Leto G., Pozzilli P., Manfrini S., Maurizi A. R., Leotta S., Altomare M., Abbruzzese S., Carletti S., Suraci C., Filetti S., Manca Bitti M. L., Arcano S., Cavallo M. G., De Bernardinis M., Pitocco D., Caputo S., Rizzi A., Manto A., Cappa M., Benevento D., Frontoni S., Malandrucco I., Morano S., Filardi T., Lauro D., Marini M. A., Castaldo E., Sabato D., Tuccinardi F., Forte E., Viterbori P., Arnaldi C., Minuto N., d'Annunzio G., Corsi A., Rota R., Scaranna C., Trevisan R., Valentini U., Bonfadini S., Zarra E., Plebani A., Prandi E., Felappi B., Rocca A., Meneghini E., Galli P., Ruggeri P., Carrai E., Fugazza L., Baggi V., Conti D., Bosi E., Laurenzi A., Caretto A., Molinari C., Orsi E., Grancini V., Resi V., Favalli V., Bonura C., Rigamonti A., Bonomo M., Bertuzzi F., Pintaudi B., Disoteo O., Perseghin G., Perra S., Chiovato L., De Cata P., Zerbini F., Lovati E., Laneri M., Guerraggio L., Bossi A. C., De Mori V., Galetta M., Meloncelli I., Aiello A A., Di Vincenzo S., Nuzzi A., Fraticelli E., Ansaldi E., Battezzati M., Lombardi M., Balbo M., Lera R., Secco A., De Donno V., Cadario F., Savastio S., Ponzani C., Aimaretti G., Ignaccolo G., Tinti D., Cerutti F., Bari F., Giorgino F., Piccinno E., Zecchino O., Cignarelli M., Lamacchia O., Picca G., De Cosmo S., Rauseo A., Tomaselli L., Tumminia A., Egiziano C., Scarpitta A. M., Maggio F., Cardella F., Roppolo R., Provenzano V., Fleres M., Scorsone A., Scatena A., Gregori G., Lucchesi S., Gadducci F., Di Cianni S., Pancani S., Del Prato S., Aragona M., Crisci I., Calianno A., Fattor B., Crazzolara D., Reinstadler P., Longhi S., Incelli G., Rauch S., Romanelli T., Orrasch M., Cauvin V., Franceschi R., Lalli C., Pianta A., Marangoni A., Arico C. N., Marin N., Nogara N., Simioni N., Filippi A., Gidoni Guarneri G. L., Contin M. L M. L., Decata A. P., Bondesan L., Confortin L., Coracina A., Lombardi S., Costa Padova S., Cipponeri E., Scotton R., Galasso S., Boscari F., Zanon M. S., Vinci C., Lisato G., Gottardo L., Bonora E., Trombetta M., Negri C., Brangani C., Maffeis C., Sabbion A., and Marigliano M.

Abstract

Background and aim: The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). Methods and results: Questionnaires investigating the organisation of diabetes care centres, individuals’ clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. The sample consisted of 6623 people with diabetes, which was obtained from 93 centres. Of them, 98.8% had type 1 diabetes mellitus, 57.2% were female, 64% used a conventional insulin pump and 36% used a sensor-augmented insulin pump. The median glycated haemoglobin (HbA1c) level was 60 mmol/mol (7.6%). The HbA1c target (i.e. <58 mmol/mol for age <18 years and [removed]18 years) was achieved in 43.4% of paediatric and 23% of adult participants. Factors such as advanced pump functions, higher rate of sensor use, pregnancy in the year before the study and longer duration of diabetes were associated with lower HbA1c levels. The most common chronic complications occurring in diabetes were retinopathy, microalbuminuria and hypertension. In the year before the study, 5% of participants reported ≥1 episode of severe hypoglycaemic (SH) episodes (SH) and 2.6% reported ≥1 episode of ketoacidosis. Conclusions: Advanced personal skills and use of sensor-based pump are associated with better metabolic control outcomes in Italian people with diabetes who were treated with CSII. The reduction in SH episodes confirms the positive effect of CSII on hypoglycaemia. Clinical trial registration number: NCT 02620917 (ClinicalTrials.gov).

Published
2018

47. Blood pressure measurement methodology and technology in the SWEET diabetes centers: An international SWEET database survey

Author

Gerasimidi-Vazeou, A. Birkebæk, N.H. Iotova, V. Cherubini, V. Piccini, B. Biester, T. Stipancic, G. Jefferies, C. Maffeis, C. Stergiou, G.S. SWEET study group

Abstract

Introduction: The accuracy of blood pressure (BP) measurement is a prerequisite for the reliable diagnosis and management of hypertension. Objectives: This survey evaluated the use of office and out-of-office BP measurements and the antihypertensive pharmacological treatment in expert pediatric diabetes centers. Methods: A questionnaire was distributed in 78 reference pediatric diabetes centers of the SWEET international consortium. The methodology, devices, indications, and interpretation of office BP measurements (OBPM), 24-hour ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM), and the preference for antihypertensive drug treatment was assessed. A grading score was developed to evaluate centers for overall BP measurement performance. Results: Fifty-two centers responded. The average score for OBPM methodology was 72.5%, for technology 77.5% and the overall center score was 74.75%.The majority of the centers used appropriate methodology and technology, however, there was heterogeneity among them. Manual auscultatory or automated devices specifically validated for children were used by 26/52 centers. ABPM was recommended by 35/52 centers (27/35 had health insurance coverage) and HBPM by 18/52 centers. The BP measurement methodology and devices used for ABPM and HBPM were frequently inadequate. Angiotensin converting enzyme inhibitors were the most frequently prescribed drugs for treating hypertension. Conclusions: The majority of SWEET pediatric diabetes centers use adequate methodology and devices for BP measurement. ABPM is recommended by two thirds of the centers, whereas HBPM is less widely used. Further improvement in the quality of office and out-of-office BP measurements and harmonization among centers is necessary according to current guidelines. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Published
2020

48. 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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