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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(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

3. The Importance of Office Blood Pressure Measurement Frequency and Methodology in Evaluating the Prevalence of Hypertension in Children and Adolescents With Type 1 Diabetes: The SWEET International Database

Author

Vazeou, A. Tittel, S.R. Birkebaek, N.H. Kordonouri, O. Iotova, V. Piccini, B. Saboo, B. Pundziute Lyckå, A. Seget, S. Maahs, D.M. Stergiou, G.

Abstract

OBJECTIVE: The prevalence of hypertension is higher in children and adolescents with type 1 diabetes (T1D) compared with those without. This retrospective analysis of a large cohort of children and adolescents with T1D from the SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) international consortium of pediatric diabetes centers aimed to 1) estimate the prevalence of elevated office blood pressure (BP) and hypertension and 2) investigate the influence of BP measurement methodology on the prevalence of hypertension. RESEARCH DESIGN AND METHODS: A total of 27,120 individuals with T1D, aged 5-18 years, were analyzed. Participants were grouped into those with BP measurements at three or more visits (n = 10,440) and fewer than 3 visits (n = 16,680) per year and stratified by age and sex. A subgroup analysis was performed on 15,742 individuals from centers providing a score indicating BP measurement accuracy. RESULTS: Among participants with BP measurement at three or more visits, the prevalence of hypertension was lower compared with those with fewer than three visits (10.8% vs. 17.5% P < 0.001), whereas elevated BP and normotension were higher (17.5% and 71.7% vs. 15.3% and 67.1%, respectively; both P < 0.001). The prevalence of hypertension and elevated BP was higher in individuals aged ≥13 years than in younger ones (P < 0.001) and in male than female participants (P < 0.001). In linear regression models, systolic and diastolic BP was independently determined by the BP measurement methodology. CONCLUSIONS: The estimated prevalence of elevated BP and hypertension in children and adolescents with T1D is ∼30% and depends on the BP measurement methodology. Less frequent BP evaluation may overestimate the prevalence of hypertension. © 2022 by the American Diabetes Association.

Published
2022

4. 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

7. 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

8. Association of diabetic ketoacidosis and HbA1c at onset with year-three HbA1c in children and adolescents with type 1 diabetes: Data from the International SWEET Registry

Author

Piccini B, Schwandt A, Jefferies C, Kordonouri O, Limbert C, Arslanoglu I, Cardona-Hernandez R, Coutant R, Kim JH, Preiksa RT, Pundziute Lyckå A, Rami-Merhar B, Richmond E, Savova R, Todorovic S, Veeze HJ, Toni S, and SWEET registry

Subjects
endocrine system diseases, nutritional and metabolic diseases, children, type 1 diabetes, diabetic ketoacidosis, metabolic control
Abstract

OBJECTIVE: To establish whether diabetic ketoacidosis (DKA) or HbA1c at onset is associated with year-three HbA1c in children with type 1 diabetes (T1D). METHODS: Children with T1D from the SWEET registry, diagnosed

Published
2020

9. Association of celiac disease in patients with multiple sclerosis in Tuscany

Author

Piccini, B., Ulivelli, M., Amato, M. P., Bartalini, S., Falcini, M., Giannini, M., Magnani, E., Massacesi, L., Repice, A. M., Vascotto, M., and Grosso, S.

Subjects
Adult, Male, medicine.medical_specialty, Epidemiology, Tissue transglutaminase, Population, Comorbidity, Disease, Gastroenterology, Cohort Studies, Multiple sclerosis, Internal medicine, medicine, Humans, Celiac disease, In patient, Villous atrophy, education, Retrospective Studies, education.field_of_study, Transglutaminases, biology, business.industry, General Medicine, medicine.disease, biology.protein, Female, business
Abstract

Background and study purpose: to describe the comorbidity of celiac disease among a large cohort of multiple sclerosis patients in Tuscany. Methods: the association of celiac disease among multiple sclerosis adult patients (n=2050) was retrospectively evaluated. Results: 13 patients were diagnosed with celiac disease, the female:male ratio was 3.3:1 and the median age at diagnosis was 34.2 years (SD 13). Seventy-seven per cent of subjects complained about gastrointestinal symptoms. IgA anti- transglutaminase was positive in 85 % of cases and there was 70 % of villous atrophy. Conclusions: the frequency of celiac disease among multiple sclerosis patients examined was lower than in the general population, 0.6 % vs 1 %)(p = 0.65).

Published
2020
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12. Insulin pump failures in Italian children with Type 1 diabetes: retrospective 1-year cohort study

Author

Rabbone, I., Minuto, N., Bonfanti, R., Marigliano, M., Cerutti, F., Cherubini, V., d(')Annunzio, G., Frongia, A. P., Iafusco, D., Ignaccolo, G., Lombardo, F., Schiaffini, R., Toni, S., Tumini, S., Zucchini, S., Pistorio, A., Scaramuzza, A. E., Scaramuuzza, A. E., Lera, R., Secco, A., Bobbio, A., Bechaz, M., Piccinno, E., Natale, M. P., Ortolani, F., Zecchino, C., Lonero, A., Maltoni, G., Pasquino, B., Gallo, F., Frongia, P., Ripoli, C., Lo Presti, D., Timpanaro, T., Citriniti, F., Suprani, T., Carinci, S., Cipriano, P., Lazzaro, N., De Donno, V., Gallarotti, F., Lenzi, L., Piccini, B., Vittorio, L., Russo, C., Borea, R., Mamm(`i), F., Bruzzese, M., Ventrici, C., Salzano, G., Frontino, G., Bonura, C., Favalli, V., Scaramuzza, A., Zuccotti, G. V., Ferrari, M., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, E., Buono, P., Confetto, S., Zanfardino, A., Cadario, F., Savastio, S., Fiorito, C., Barbieri, P., Piredda, G., Cardella, F., Ropolo, R., Federico, G., Marchi, B., Benevento, D., Carducci, C., Mancabitti, M. L., Delvecchio, M., Lapolla, R., Gaiero, A., Fichera, G., Ignaccolo, M. G., Tinti, D., Cauvin, V., Franceschi, R., Biagioni, M., Salvatoni, A., Scolari, A., Maffeis, C., Sabbion, A., Arnaldi, C., Tosini, D., Rabbone, I, Minuto, N., Bonfanti, R., Marigliano, M., Cerutti, F., Cherubini, V., D'Annunzio, G., Frongia, A. P., Iafusco, Dario, Ignaccolo, G., Lombardo, F., Schiaffini, R., Toni, S., Tumini, S., Zucchini, S., Pistorio, A., Scaramuzza, A. E., Rabbone, I., Iafusco, D., Lera, R., Secco, A., Bobbio, A., Bechaz, M., Piccinno, E., Natale, M. P., Ortolani, F., Zecchino, C., Lonero, A., Maltoni, G., Pasquino, B., Gallo, F., Frongia, P., Ripoli, C., Lo Presti, D., Timpanaro, T., Citriniti, F., Suprani, T., Carinci, S., Cipriano, P., Lazzaro, N., De Donno, V., Gallarotti, F., Lenzi, L., Piccini, B., Vittorio, L., Russo, C., Borea, R., Mammi, F., Bruzzese, M., Ventrici, C., Salzano, G., Frontino, G., Bonura, C., Favalli, V., Scaramuzza, A., Zuccotti, G. V., Ferrari, M., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, E., Buono, P., Confetto, S., Zanfardino, A., Cadario, F., Savastio, S., Fiorito, C., Barbieri, P., Piredda, G., Cardella, F., Ropolo, R., Federico, G., Marchi, B., Benevento, D., Carducci, C., Mancabitti, M. L., Del Vecchio, M., Lapolla, R., Gaiero, A., Fichera, G., Ignaccolo, M. G., Tinti, D., Cauvin, V., Franceschi, R., Biagioni, M., Salvatoni, A., Scolari, A., Maffeis, C., Sabbion, A., Arnaldi, C., Tosini, D., Rabbone, Minuto, Mammì, F., and Mozzillo, Enza.

Subjects
Blood Glucose, Male, Pediatrics, Adolescent, Blood Glucose Self-Monitoring, Child, Child, Preschool, Diabetes Mellitus, Type 1, Equipment Failure, Female, Humans, Infant, Insulin, Italy, Retrospective Studies, Insulin Infusion Systems, type 1 diabetes, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Internal Medicine, Endocrinology, 0302 clinical medicine, Retrospective Studie, Medicine, 030212 general & internal medicine, Diabetes, Diabetology, failure, Diabetes and Metabolism, children and adolescents, insulin pump, Cohort study, Type 1, Human, Insulin pump, medicine.medical_specialty, Disease duration, 030209 endocrinology & metabolism, 03 medical and health sciences, Diabetes mellitus, Diabetes Mellitus, Preschool, Type 1 diabetes, business.industry, Diabetes, Type1, Pump, Insulin, Type1, Retrospective cohort study, Pump, medicine.disease, Surgery, Insulin Infusion System, business
Abstract

Aims Insulin pump failure and/or malfunction requiring replacement have not been thoroughly investigated. This study evaluated pump replacement in children and adolescents with Type 1 diabetes using insulin pump therapy. Methods Data were collected for all participants younger than 19 years, starting insulin pump therapy before 31 December 2013. For each child, age, disease duration, date of insulin pump therapy initiation, insulin pump model, failure/malfunction/replacement yes/no and reason were considered for the year 2013. Results Data were returned by 40 of 43 paediatric centres belonging to the Diabetes Study Group of the Italian Society of Paediatric Endocrinology and Diabetology. In total, 1574 of 11 311 (13.9%) children and adolescents with Type 1 diabetes were using an insulin pump: 29.2% Animas VIBE™, 9.4% Medtronic MiniMed 715/515™, 34.3% Medtronic MiniMed VEO™, 24.3% Accu-Check Spirit Combo™ and 2.8% other models. In 2013, 0.165 insulin pump replacements per patient-year (11.8% due to pump failure/malfunction and 4.7% due to accidental damage) were recorded. Animas VIBE™ (22.1%) and Medtronic MiniMed VEO™ (17.7%) were the most replaced. Conclusions In a large cohort of Italian children and adolescents with Type 1 diabetes, insulin pump failure/malfunction and consequent replacement are aligned with rates previously reported and higher in more sophisticated pump models. This article is protected by copyright. All rights reserved.

Published
2017

13. The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes—A SWEET collaborative study

Author

Svensson, J. Schwandt, A. Pacaud, D. Beltrand, J. Birkebæk, N.H. Cardona-Hernandez, R. Casteels, K. Castro, S. Cherubini, V. Cody, D. Fisch, N. Hasnani, D. Kordonouri, O. Kosteria, I. Luczay, A. Pundziute-Lyckå, A. Maffeis, C. Piccini, B. Luxmi, P. Sumnik, Z. de Beaufort, C.

Abstract

Objective: To describe the association between height, demographics, and treatment in youths with type 1 diabetes participating in an international network for pediatric diabetes centers (SWEET). Methods: Data were collected from 55 centers with documented patients' height. All subjects below 20 years of age, diabetes duration >1 year, and without celiac disease were included. World Health Organization growth charts were used to calculate height and body mass index z-scores. Multiple hierarchic regression models adjusting for known confounders were applied. Results: Data on 22 941 subjects (51.8% male) were analyzed with a median and interquartile range for age 14.8 years (11.2, 17.6), diabetes duration 5.6 years (3.1, 8.9), and height z-score 0.34 (−0.37, 1.03). Children were taller in the youngest age groups: adjusted height z-scores of 0.31 (±0.06) and 0.39 (±0.06), respectively; with shorter diabetes duration (three injections/day and 0.19 ± 0.06 [0-3 injections daily]), respectively. High hemoglobin A1c (HbA1c) and low to normal weight were associated with a lower height z-score. Trends were identical in all models except for gender. No gender differences were found except in the final height model where females exhibited higher z-score than males. Conclusion: For youths treated at centers offering modern diabetes management, major growth disturbances are virtually eliminated. For children with a young age at onset, high HbA1c, injections, and/or non-intensive diabetes, treatment still requires attention in order to attain normal growth. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Published
2018

14. Epidemiologia della chetoacidosi diabetica in Italia

Author

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

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

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

Published
2014

15. Dynamic and differential expression of the gonadal aromatase during the process of sexual differentiation in a novel transgenic cyp19a1a-GFP zebrafish line

Author

Hinfray, Nathalie, Chadili, Edith, Piccini, B., Caulier, Morgane, Porcher, Jean Marc, Guiguen, Yann, Brion, François, Institut National de l'Environnement Industriel et des Risques, Laboratoire de Physiologie et Génomique des Poissons (LPGP), Institut National de la Recherche Agronomique (INRA)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut National de l'Environnement Industriel et des Risques (INERIS), Stress Environnementaux et BIOsurveillance des milieux aquatiques (SEBIO), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Reims Champagne-Ardenne (URCA)-SFR Condorcet, Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS)-Institut National de l'Environnement Industriel et des Risques (INERIS), and Society of Environmental Toxicology and Chemistry (SETAC). BEL.

Subjects
fish, endocrine disruptor, perturbateur endocrinien, endocrine system, fungi, poisson zèbre, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, reproduction, poisson, danio rerio, cyprinidae, poisson transgenique, [SDV.TOX.ECO]Life Sciences [q-bio]/Toxicology/Ecotoxicology, cyp19a1a, danio devario, cyp19a1b, expression des gènes
Abstract

In most gonochoristic fish species, aromatase, the enzyme responsible for the synthesis of estrogens, has been shown to play a critical role in the process of sexual differentiation (SD). In zebrafish, that undergoes a juvenile intersex stage, there is still a lack of knowledge regarding the precise localization and pattern of expression of gonadal aromatase (Cyp19a1a) impeding the formal characterization of the role of cyp19a1a in this process. To fulfill this gap, the spatio-temporal expression of cyp19a1a was analyzed in a novel transgenic zebrafish model expressing Green Fluorescent Protein (GFP) under the control of the zebrafish cyp19a1a gene promoter. First, we showed a perfect co-expression of GFP and endogenous Cyp19a1a protein in adult gonads that was localized in the cytoplasm of oogonia, young oocytes and peri-follicular cells of the ovary and in the cytoplasm of Leydig and germ cells in the testis. Then, the spatio-temporal expression pattern of cyp19a1a was studied during SD using GFP fluorescence imaging in gonads at 20, 30, 35 and 40 day post-fertilisation (dpf). Our data showed that GFP was expressed in all undifferentiated gonads of 20 dpf-old zebrafish. At later stages of development, GFP expression increased in early differentiated female at 30 and 35 dpf to reach high GFP intensity in well-differentiated ovaries at 40 dpf. This pattern of gonadal GFP expression markedly differed from that of males which consistently displayed low GFP expression as compared to female whatever their stage of development, resulting in a clear dimorphic expression between males and females. Interestingly, fish that undergoes ovary-to-testis transition (35 and 40 dpf) presented an intermediary GFP level as compared to those measured in males and females. Our results suggest that (1) cyp19a1a is expressed early during gonadal development before the histological process of SD, (2) the down-regulation of cyp19a1a expression is critical for the testicular differentiation, (3) although cyp19a1a expression exhibit a clear dimorphic expression in gonads during SD, its expression persists whatever the sex suggesting that estradiol synthesis is important for gonadal development in both male and female. Monitoring the expression of the GFP in control and exposed-fish will help to identify the interest of this model to study the mechanisms of action of endocrine disrupting chemicals on critical physiological processes such as SD.

Published
2015

16. Both aromatase isoforms are expressed in all gonads during sexual differentiation in zebrafish

Author

Caulier, Morgane, Brion, F., Chadili, E., Piccini, B., Porcher, J.M., Guiguen, Yann, Hinfray, N., Laboratoire de Physiologie et Génomique des Poissons (LPGP), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Recherche Agronomique (INRA), Institut National de l'Environnement Industriel et des Risques (INERIS), and Center of Marine Sciences (CCMAR). PRT.

Subjects
[SDV.BA]Life Sciences [q-bio]/Animal biology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2014

17. Increasing burden, younger age at onset and worst metabolic control in migrant than in Italian children with type 1 diabetes: An emerging problem in pediatric clinics

Author

Cadario, F1, Cerutti, F, Savastio, S, Rabbone, I, Tumini, S, Bruno, G, Lera, R, Cherubini, V, Bechaz, M, Zucchini, S, Prandi, E, Zattoni, V, Coccioli, S, Frongia, A, La Loggia, A, Lo Presti, D, Citrini, F, Suprani, T, Dedonno, V, Vergerio, A, Banin, P, Toni, S, Piccini, B, Barni, F, Pescamona, M, Cardinale, G, Lombardo, F, Bonfanti, R, Scaramuzza, A, Iughetti, Lorenzo, Franzese, A, Iafusco, D, Guercio Nuzio, S, Abiuso, C, Monciotti, C, Cardella, F, Vanelli, M, Chiari, G, Calcaterra, V, De Giorgi, G, Zanette, G, Marsciani, A, Patera, P, Manca Bitti, M, Delvecchio, M, Trada, M, Aimar, A, Gaiero, A, Tinti, D, Fontana, F, Guerraggio, L, Cauvin, V, Gargantini, L, Salvatoni, A, Trivellin, V, Maffeis, C, Marigliano, M, Arnaldi, C., Cadario, F, Cerutti, F, Savastio, S, Rabbone, I, Tumini, S, Bruno, G, Italian Society of Pediatric, Endocrinology, Diabetology Study, Group, Iafusco, Dario, Italian Society of pediatric Endocrinology and Diabetology Study group, (SIEDP), and Bonfanti, R

Subjects
Male, Age of onset, Children immigration, Environment factors, Type 1 diabetes, Pediatrics, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, TYPE I (INSULIN-DEPENDENT) DIABETES MELLITUS, Disease, Statistics, Nonparametric, Endocrinology, HLA Antigens, Weight loss, Interquartile range, Diabetes mellitus, Prevalence, Internal Medicine, medicine, Humans, Insulin, Genetic Predisposition to Disease, Child, Alleles, Glycemic, Transients and Migrants, Settore MED/38 - Pediatria Generale e Specialistica, business.industry, Case-control study, Infant, General Medicine, medicine.disease, Diabetes Mellitus, Type 1, Italy, Case-Control Studies, Child, Preschool, Female, medicine.symptom, business, Type 1 diabetes Children immigration Age of onset Environment factors
Abstract

To assess burden and clinical features of type 1 diabetes in migrant with respect to Italian children. Prevalent children with type 1 diabetes were identified through a multicenter study, including 46 pediatric outpatients diabetic clinics. A nested case–control study was also performed, comparing features at diabetes onset and after 1 year of insulin treatment in 84 migrants and 75 Italian children with onset in 2011, matched for age and sex. Out of 7,812 children cared for by pediatric diabetologists, 761 (10 %) were migrant and 548 of them were born in Italy. Age at diagnosis was lower in migrants born in Italy (5.1 years, interquartile range (IQR) 2.2–7.7) than in those born in their original countries (7.8 years, IQR 5.3–10.3) and in Italians (9.8 years, IQR 5.9–13.0, p\0.001). At diabetes onset, migrants had lower frequencies of positivities of markers of b-cell autoimmunity (96 vs. 99.5 %, p\0.01), higher values of weight loss (11 vs. 7 %, p\0.01), HbA1c (70 vs. 58 mmol/mol, p\0.001), and insulin requirement (0.70 ± 0.03 vs. 0.63 ± 0.10 UI/kg/die, p = 0.05) and lower levels of 25-OH vitamin D3 (15.0 ± 2.8 vs. 20.8 ± 1.3, p = 0.03). Moreover, they experienced higher frequencies of hospitalizations during the first year of disease (19.2 vs. 2.7 %, p\0.001). Burden of type 1 diabetes in migrant children is increasing in Italy, with younger age at onset and different clinical features than in Italian children. Higher hospitalization rates and poorer glycemic control over the first year underline that approach to diabetes care in migrants needs to be improved.

Published
2014

18. Epidemiology of diabetic ketoacidosis in Italy

Author

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

Published
2014

19. Caractérisation de nouveaux modèles de poissons zèbres transgéniques pour étudier l’impact de perturbateurs endocriniens sur la différenciation sexuelle du poisson zèbre

Author

Caulier, Morgane, Brion, F., Chadili, E., Piccini, B., Cauty, Chantal, Guiguen, Yann, Hinfray, N., Laboratoire de Physiologie et Génomique des Poissons (LPGP), Institut National de la Recherche Agronomique (INRA)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut National de l'Environnement Industriel et des Risques (INERIS), and Association pour la Recherche en Toxicologie (ARET). FRA.

Subjects
[SDV.BA]Life Sciences [q-bio]/Animal biology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, ComputingMilieux_MISCELLANEOUS
Abstract

National audience

Published
2013

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

Author

Pinelli, M, Acquaviva, F, Barbetti, F, Caredda, E, Cocozza, S, Delvecchio, M, Mozzillo, E, Pirozzi, D, Prisco, F, Rabbone, I, Sacchetti, L, Tinto, N, Toni, S, Zucchini, S, Iafusco, D, Italian Study Group on Diabetes of the Italian Society of Pediatric Endocrinology, Diabetology, Biagioni, M, Carloni, I, Cester, Am, Cherubini, V, Giorgetti, C, Iannilli, A, Bruzzese, M, Mammì, F, Guasti, M, Lenzi, L, Pepe, R, Piccini, B, Benelli, M, Cadario, F, Calcaterra, V, Cerutti, F, Sicignano, S, Mammì, C, Lazzaro, N, Comberiati, P, Scaramuzza, A, Zuccotti, G, Redaelli, F, Gallo, F, Cappa, M, Patera, P, Schiaffini, R, Cardella, F, Salvo, C, De Marco, R, Chessa, M, Frongia, P, Ricciardi, Mr, Ripoli, C, Zedda, Ma, Citriniti, F, Chiarelli, F, Tumini, S, Coccioli, Ms, De Berardinis, F, Santoro, E, DE LUCA, Filippo, Lombardo, Fortunato, Salzano, Giuseppina, Felappi, B, Prandi, E, Frezza, E, Piccinno, E, Torelli, C, Zecchino, C, Galderisi, A, Monciotti, C, Ingletto, D, Kaufmann, P, Pasquino, B, Lera, R, Lucchesi, S, Perrotta, A, Salardi, S, Scipioni, M, Luceri, S, Stamati, F, Pianese, L, Piceno, A, Tomaselli, L, Vergerio, A, Casaburo, F, Cocca, A, Confetto, S, Forgione, E, Pelliccia, C, Picariello, S, Pisani, F, Piscopo, A, Villano, P, Zanfardino, A, Buono, P, Franzese, A, Nugnes, R, Valerio, G, Maffeis, C, Marigliano, M, Chiari, G, Iovene, B, Vanelli, M., Pinelli, Michele, Acquaviva, Fabio, Barbetti, F, Caredda, E, Cocozza, Sergio, Delvecchio, M, Mozzillo, Enza, Pirozzi, Daniele, Prisco, F, Rabbone, I, Sacchetti, Lucia, Tinto, Nadia, Toni, S, Zucchini, S, and Iafusco, D.

Subjects
Genetics and Molecular Biology (all), Pediatrics, medicine.medical_specialty, Science, Cost-Benefit Analysis, Decision tree, Medicine (all), Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), Biochemistry, Maturity onset diabetes of the young, Settore MED/13 - Endocrinologia, Quality of life, Surveys and Questionnaires, Glucokinase, medicine, Humans, Genetic Testing, Prospective Studies, Age of Onset, Prospective cohort study, Child, Wasting, Children, Genetic testing, Retrospective Studies, Glycated Hemoglobin, Multidisciplinary, MODY2, medicine.diagnostic_test, business.industry, Decision Trees, Retrospective cohort study, medicine.disease, Test (assessment), Diabetes Mellitus, Type 2, Italy, Child, Preschool, Mutation, Quality of Life, Medicine, Female, medicine.symptom, business, gene testing, Research Article
Abstract

MODY2 is the most prevalent monogenic form of diabetes in Italy with an estimated prevalence of about 0.5-1.5%. MODY2 is potentially indistinguishable from other forms of diabetes, however, its identification impacts on patients' quality of life and healthcare resources. Unfortunately, DNA direct sequencing as diagnostic test is not readily accessible and expensive. In addition current guidelines, aiming to establish when the test should be performed, proved a poor detection rate. Aim of this study is to propose a reliable and easy-to-use tool to identify candidate patients for MODY2 genetic testing. We designed and validated a diagnostic flowchart in the attempt to improve the detection rate and to increase the number of properly requested tests. The flowchart, called 7-iF, consists of 7 binary "yes or no" questions and its unequivocal output is an indication for whether testing or not. We tested the 7-iF to estimate its clinical utility in comparison to the clinical suspicion alone. The 7-iF, in a prospective 2-year study (921 diabetic children) showed a precision of about the 76%. Using retrospective data, the 7-iF showed a precision in identifying MODY2 patients of about 80% compared to the 40% of the clinical suspicion. On the other hand, despite a relatively high number of missing MODY2 patients, the 7-iF would not suggest the test for 90% of the non-MODY2 patients, demonstrating that a wide application of this method might 1) help less experienced clinicians in suspecting MODY2 patients and 2) reducing the number of unnecessary tests. With the 7-iF, a clinician can feel confident of identifying a potential case of MODY2 and suggest the molecular test without fear of wasting time and money. A Qaly-type analysis estimated an increase in the patients' quality of life and savings for the health care system of about 9 million euros per year.

Published
2012

21. Screening estrogens with the cyp19a1b-GFP transgenic line

Author

Kah, Olivier, Le Page, Yann, Piccini, B., Chung, Bon-Chu, Brion, F., Brébion, Alice, Interactions cellulaires et moléculaires (ICM), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), Institute of Molecular Biology (IMB Sinica), Academia Sinica, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SDV.TOX] Life Sciences [q-bio]/Toxicology, [SDV.TOX]Life Sciences [q-bio]/Toxicology
Published
2010

25. Seasonality at the clinical onset of type 1 diabetes-Lessons from the SWEET database.

Author

Gerasimidi Vazeou, A., Kordonouri, O., Witsch, M., Hermann, J.M., Forsander, G., de Beaufort, C., Veeze, H.J., Maffeis, C., Cherubini, V., Cinek, O., Piccini, B., Holl, R.W., and Danne, T.

Subjects
AGE distribution, CHI-squared test, DATABASES, REGRESSION analysis, TYPE 1 diabetes, RESEARCH funding, SEASONS, DATA analysis, PATIENT selection, SUDDEN onset of disease, DIAGNOSIS
Abstract

Background Seasonality at the clinical onset of type 1 diabetes ( T1D) has been suggested by different studies, however, the results are conflicting. This study aimed to evaluate the presence of seasonality at clinical onset of T1D based on the SWEET database comprising data from 32 different countries. Methods The study cohort included 23 603 patients (52% males) recorded in the international multicenter SWEET database (48 centers), with T1D onset ≤20 years, year of onset between 1980 and 2015, gender, year and month of birth and T1D-diagnosis documented. Data were stratified according to four age groups (<5, 5-<10, 10-<15, 15-20 years) at T1D onset, the latitude of European center (Northern ≥50°N and Southern Europe <50°N) and the year of onset ≤ or >2009. Results Analysis by month revealed significant seasonality with January being the month with the highest and June with the lowest percentage of incident cases ( P < .001). Winter, early spring and late autumn months had higher percentage of incident cases compared with late spring and summer months. Stratification by age showed similar seasonality patterns in all four age groups ( P ≤ .003 each), but not in children <24 months of age. There was no gender or latitude effect on seasonality pattern, however, the pattern differed by the year of onset ( P < .001). Seasonality of diagnosis conformed to a sinusoidal model for all cases, females and males, age groups, northern and southern European countries. Conclusions Seasonality at T1D clinical onset is documented by the large SWEET database with no gender or latitude (Europe only) effect except from the year of manifestation. [ABSTRACT FROM AUTHOR]

Published
2016
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28. BFCOD activity in fish cell lines and zebrafish embryos and its modulation by chemical ligands of human aryl hydrocarbon and nuclear receptors.

Author

Creusot, N., Brion, F., Piccini, B., Budzinski, H., Porcher, J., and Aït-Aïssa, S.

Subjects
EFFECT of water quality on fish embryos, ZEBRA danio, MOLECULAR structure of ligands, ARYL hydrocarbon receptors, NUCLEAR receptors (Biochemistry), BEHAVIOR
Abstract

Assessment of exposure and effect of fish to pharmaceuticals that contaminate aquatic environment is a current major issue in ecotoxicology and there is a need to develop specific biological marker to achieve this goal. Benzyloxy-4-trifluoromethylcoumarin-O-debenzyloxylase (BFCOD) enzymatic activity has been commonly used to monitor CYP3A activity in fish. In this study, we assessed the capacity of a panel of toxicologically relevant chemicals to modulate BFCOD activity in fish, by using in vitro and in vivo bioassays based on fish liver cell lines (PLHC-1, ZFL, RTL-W1) and zebrafish embryos, respectively. Basal BFCOD activity was detectable in all biological models and was differently modulated by chemicals. Ligands of human androgens, glucocorticoids, or pregnanes X receptors (i.e., dexamethasone, RU486, rifampicin, SR12813, T0901317, clotrimazole, ketoconazole, testosterone, and dihydrotestosterone) moderately increased or inhibited BFCOD activity, with some variations between the models. No common feature could be drawn by regards to their capacity to bind to these receptors, which contrasts with their known effect on mammalian CYP3A. In contrast, dioxins and polycyclic aromatic hydrocarbons (PAHs) strongly induced BFCOD activity (up to 30-fold) in a time- and concentration-dependent manner, both in vitro in all cell lines and in vivo in zebrafish embryos. These effects were AhR dependent as indicated by suppression of induced BFCOD by the AhR pathway inhibitors 8-methoxypsoralen and α-naphthoflavone. Altogether our result further question the relevance of using liver BFCOD activity as a biomarker of fish exposure to CYP3A-active compounds such as pharmaceuticals. [ABSTRACT FROM AUTHOR]

Published
2015
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29. Epidemiology of diabetic ketoacidosis in Italy,Epidemiologia della chetoacidosi diabetica in Italia

Author

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

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

30. Epidemiology of diabetic ketoacidosis in Italy | Epidemiologia della chetoacidosi diabetica in Italia

Author

valentino cherubini, Gesuita, R., Sternardi, S., Ferrito, L., Lenzi, L., Iannilli, A., Piccini, B., Skrami, E., Nicolucci, A., Pintaudi, B., Toni, S., Lera, R., Luna, L., Kienberger, B., Gualtieri, A., Zecchino, C., Piccino, E., Ortolani, F., Zucchini, S., Maltoni, G., Pasquino, B., Reinstadler, P., Prandi, E., Zattoni, V., Gallo, F., Morganti, G., Guerraggio, L., Ripoli, C., Frongia, M., Pusceddu, P., La Loggia, A., Scanu, P., Cardinale, G., Ponzi, G., Tomaselli, L. G., Rapisarda, V., Citriniti, F., Soprani, T., Tumini, S., Lazzaro, N., Donno, V., Banin, P., Mainetti, B., Coccioli, M. S., D Annunzio, G., Minuto, N., Montani, E., Maccioni, R., Marongiu, U., Beccaria, L., Bruzzese, M., Mammì, F., Pardi, D., Lombardo, F., Ventrici, C., Scaramazza, A., Ferrari, M., Bonfanti, R., Rigamonti, A., Iughetti, L., Predieri, B., Iafusco, D., Confetto, S., Zanfardino, A., Prisco, F., Franzese, A., Nitto, E., Cadario, F., Milia, A., Piredda, G., Mereu, L., Soro, M., Correddu, A., Pipia, A., Monciotti, C., Cardella, F., Berardinis, F., Santoro, G., Chiari, G., Berioli, M. G., Federico, G., Zanette, G., Marsciani, A., Pedini, A., Patera, I. P., Schiaffini, R., Bitti, M., Lidano, R., Pietrosanti, S., Delvecchio, M., Trada, M., Marinaro, A., Meloni, G., Galero, A., Fichera, G., Bulciolu, P., Rabbone, I., Ignaccolo, G., Cauvin, V., Franceschi, R., Faleschini, E., Tornese, G., Salvatoni, A., Cardani, R., Maffeis, C., Marigliano, M., Sabbion, A., and Arnaldi, C.

31. 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

32. Differences between Transient Neonatal Diabetes Mellitus Subtypes can Guide Diagnosis and Therapy

Author

Riccardo Bonfanti, Dario Iafusco, Ivana Rabbone, Giacomo Diedenhofen, Carla Bizzarri, Patrizia Ippolita Patera, Petra Reinstadler, Francesco Costantino, Valeria Calcaterra, Lorenzo Iughetti, Silvia Savastio, Anna Favia, Francesca Cardella, Donatella Lo Presti, Ylenia Girtler, Sarah Rabbiosi, Giuseppe D’Annunzio, Angela Zanfardino, Alessia Piscopo, Francesca Casaburo, Letizia Pintomalli, Lucia Russo, Valeria Grasso, Nicola Minuto, Mafalda Mucciolo, Antonio Novelli, Antonella Marucci, Barbara Piccini, Sonia Toni, Francesca Silvestri, Paola Carrera, Andrea Rigamonti, Giulio Frontino, Michela Trada, Davide Tinti, Maurizio Delvecchio, Novella Rapini, Riccardo Schiaffini, Corrado Mammì, Fabrizio Barbetti, Monica Aloe, Simona Amadeo, Claudia Arnaldi, Marta Bassi, Luciano Beccaria, Marzia Benelli, Giulia Maria Berioloi, Enrica Bertelli, Martina Biagioni, Adriana Bobbio, Stefano Boccato, Oriana Bologna, Franco Bontempi, Clara Bonura, Giulia Bracciolini, Claudia Brufani, Patrizia Bruzzi, Pietro Buono, Roberta Cardani, Giuliana Cardinale, Alberto Casertano, Maria Cristina Castiglione, Vittoria Cauvin, Valentino Cherubini, Franco Chiarelli, Giovanni Chiari, Stefano Cianfarani, Dante Cirillo, Felice Citriniti, Susanna Coccioli, Anna Cogliardi, Santino Confetto, Giovanna Contreas, Anna Corò, Elisa Corsini, Nicoletta Cresta, Fiorella De Berardinis, Valeria De Donno, Giampaolo De Filippo, Rosaria De Marco, Annalisa Deodati, Elena Faleschini, Valentina Fattorusso, Valeria Favalli, Barbara Felappi, Lucia Ferrito, Graziella Fichera, Franco Fontana, Elena Fornari, Roberto Franceschi, Francesca Franco, Adriana Franzese, Anna Paola Frongia, Alberto Gaiero, Francesco Gallo, Luigi Gargantini, Elisa Giani, Chiara Giorgetti, Giulia Bianchi, Vanna Graziani, Antonella Gualtieri, Monica Guasti, Gennaro Iannicelli, Antonio Iannilli, Ignaccolo Giovanna, Dario Ingletto, Stefania Innaurato, Elena Inzaghi, Brunella Iovane, Peter Kaufmann, Alfonso La Loggia, Rosa Lapolla, Anna Lasagni, Nicola Lazzaro, Lorenzo Lenzi, Riccardo Lera, Gabriella Levantini, Fortunato Lombardo, Antonella Lonero, Silvia Longhi, Sonia Lucchesi, Lucia Paola Guerraggio, Sergio Lucieri, Patrizia Macellaro, Claudio Maffeis, Bendetta Mainetti, Giulio Maltoni, Chiara Mameli, Francesco Mammì, Maria Luisa Manca-Bitti, Melania Manco, Monica Marino, Matteo Mariano, Marco Marigliano, Alberto Marsciani, Costanzo Mastrangelo, Maria Cristina Matteoli, Elena Mazzali, Franco Meschi, Antonella MIgliaccio, Anita Morandi, Gianfranco Morganti, Enza Mozzillo, Gianluca Musolino, Rosa Nugnes, Federica Ortolani, Daniela Pardi, Filomena Pascarella, Stefano Passanisi, Annalisa Pedini, Cristina Pennati, Angelo Perrotta, Sonia Peruzzi, Paola Peverelli, Giulia Pezzino, Anita Claudia Piona, Gavina Piredda, Carmelo Pistone, Elena Prandi, Barbara Pedieri, Procolo Di Bonito, Anna Pulcina, Maria Quinci, Emioli Randazzo, Rossella Ricciardi, Carlo Ripoli, Rosanna Roppolo, Irene Rutigliano, Alberto Sabbio, Silvana salardi, Alessandro Salvatoni, Anna Saporiti, Rita Sardi, Mariapiera Scanu, Andrea Scaramuzza, Eleonardo Schiven, Andrea Secco, Linda Sessa, Paola Sogno Valin, Silvia Sordelli, Luisa Spallino, Stefano Stagi, Filomena Stamati, Tosca Suprani, Valentina Talarico, Tiziana Timapanaro, Antonella Tirendi, Letizia Tomaselli, Gianluca Tornese, Adolfo Andrea Trettene, Stefano Tumini, Giuliana Valerio, Claudia Ventrici, Matteo Viscardi, Silvana Zaffani, Maria Zampolli, Giorgio Zanette, Clara Zecchino, Maria Antonietta Zedda, Silvia Zonca, Stefano Zucchini, Bonfanti, R., Iafusco, D., Rabbone, I., Diedenhofen, G., Bizzarri, C., Patera, P. I., Reinstadler, P., Costantino, F., Calcaterra, V., Iughetti, L., Savastio, S., Favia, A., Cardella, F., Presti, D. L., Girtler, Y., Rabbiosi, S., D'Annunzio, G., Zanfardino, A., Piscopo, A., Casaburo, F., Pintomalli, L., Russo, L., Grasso, V., Minuto, N., Mucciolo, M., Novelli, A., Marucci, A., Piccini, B., Toni, S., Silvestri, F., Carrera, P., Rigamonti, A., Frontino, G., Trada, M., Tinti, D., Delvecchio, M., Rapini, N., Schiaffini, R., Mammi, C., and Barbetti, F.

Subjects
Proband, Male, Pediatrics, Potassium Channels, Endocrinology, Diabetes and Metabolism, Datasets as Topic, Diagnosis, Differential, Diagnostic Techniques, Endocrine, Female, Humans, Infant, Infant, Newborn, Italy, Mutation, Potassium Channels, Inwardly Rectifying, Remission Induction, Retrospective Studies, Sulfonylurea Receptors, Diabetes Mellitus, Infant, Newborn, Diseases, Diseases, Gastroenterology, Diabetes mellitus genetics, Endocrinology, Settore MED/13, Retrospective Studie, Diagnosis, Medicine, Endocrine pancreas, Transient Neonatal Diabetes Mellitus, 6q24 TNDM, KATP TNDM, Sulfonylureas, Sulfonylureas, Sulfonylurea Receptor, biology, Diabetes Mellitu, General Medicine, Metformin, Inwardly Rectifying, Settore MED/03, 6q24 TNDM, medicine.symptom, Endocrine, hormones, hormone substitutes, and hormone antagonists, medicine.drug, Human, endocrine system, medicine.medical_specialty, KATP TNDM, ABCC8, Transient Neonatal Diabetes Mellitus, Internal medicine, Diabetes mellitus, Macroglossia, Endocrine pancreas, business.industry, medicine.disease, Newborn, Diagnostic Techniques, Transient neonatal diabetes mellitus, Differential, biology.protein, Sulfonylurea receptor, business
Abstract

Objective Transient neonatal diabetes mellitus (TNDM) is caused by activating mutations in ABCC8 and KCNJ11 genes (KATP/TNDM) or by chromosome 6q24 abnormalities (6q24/TNDM). We wanted to assess whether these different genetic aetiologies result in distinct clinical features. Design Retrospective analysis of the Italian data set of patients with TNDM. Methods Clinical features and treatment of 22 KATP/TNDM patients and 12 6q24/TNDM patients were compared. Results Fourteen KATP/TNDM probands had a carrier parent with abnormal glucose values, four patients with 6q24 showed macroglossia and/or umbilical hernia. Median age at diabetes onset and birth weight were lower in patients with 6q24 (1 week; −2.27 SD) than those with KATP mutations (4.0 weeks; −1.04 SD) (P = 0.009 and P = 0.007, respectively). Median time to remission was longer in KATP/TNDM than 6q24/TNDM (21.5 weeks vs 12 weeks) (P = 0.002). Two KATP/TNDM patients entered diabetes remission without pharmacological therapy. A proband with the ABCC8/L225P variant previously associated with permanent neonatal diabetes entered 7-year long remission after 1 year of sulfonylurea therapy. Seven diabetic individuals with KATP mutations were successfully treated with sulfonylurea monotherapy; four cases with relapsing 6q24/TNDM were treated with insulin, metformin or combination therapy. Conclusions If TNDM is suspected, KATP genes should be analyzed first with the exception of patients with macroglossia and/or umbilical hernia. Remission of diabetes without pharmacological therapy should not preclude genetic analysis. Early treatment with sulfonylurea may induce long-lasting remission of diabetes in patients with KATP mutations associated with PNDM. Adult patients carrying KATP/TNDM mutations respond favourably to sulfonylurea monotherapy.

Published
2021

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

Author

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

Subjects
Blood Glucose, medicine.medical_specialty, Glucose control, Diabetic ketoacidosis, Adolescent, type 1 diabetes, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, continuous glucose monitoring, CSII, glycaemic control, insulin pump therapy, observational study, Target range, Endocrinology, Insulin Infusion Systems, Interquartile range, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Diabetes Mellitus, Humans, Hypoglycemic Agents, Insulin, Prospective Studies, Child, Type 1 diabetes, Hypoglycemic Agent, type 1 diabete, business.industry, Blood Glucose Self-Monitoring, medicine.disease, Prospective Studie, Diabetes Mellitus, Type 1, Insulin Infusion System, business, Life study, Human, Type 1
Abstract

Aim: To evaluate the impact of a virtual educational camp (vEC) on glucose control in children and adolescents with type 1 diabetes using a closed-loop control (CLC) system. Materials and Methods: This was a prospective multicentre study of children and adolescents with type 1 diabetes using the Tandem Basal-IQ system. Insulin pumps were upgraded to Control-IQ, and children and their parents participated in a 3-day multidisciplinary vEC. Clinical data, glucose metrics and HbA1c were evaluated over the 12 weeks prior to the Control-IQ update and over the 12 weeks after the vEC. Results: Forty-three children and adolescents (aged 7-16 years) with type 1 diabetes and their families participated in the vEC. The median percentage of time in target range (70-180 mg/dL; TIR) increased from 64% (interquartile range [IQR] 56%-73%) with Basal-IQ to 76% (IQR 71%-81%) with Control-IQ (P&nbsp

Published
2021

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

Author

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

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

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

Published
2016

35. The Changing Landscape of Neonatal Diabetes Mellitus in Italy Between 2003 and 2022.

Author

Rapini N, Delvecchio M, Mucciolo M, Ruta R, Rabbone I, Cherubini V, Zucchini S, Cianfarani S, Prandi E, Schiaffini R, Bizzarri C, Piccini B, Maltoni G, Predieri B, Minuto N, Di Paola R, Giordano M, Tinto N, Grasso V, Russo L, Tiberi V, Scaramuzza A, Frontino G, Maggio MC, Musolino G, Piccinno E, Tinti D, Carrera P, Mozzillo E, Cappa M, Iafusco D, Bonfanti R, Novelli A, and Barbetti F

Subjects
Humans, Italy epidemiology, Infant, Newborn, Male, Female, Infant, High-Throughput Nucleotide Sequencing, Infant, Newborn, Diseases epidemiology, Infant, Newborn, Diseases genetics, Genetic Testing methods, Insulin Resistance genetics, Mutation, Incidence, Retrospective Studies, Diabetes Mellitus epidemiology, Diabetes Mellitus genetics
Abstract

Context: In the last decade the Sanger method of DNA sequencing has been replaced by next-generation sequencing (NGS). NGS is valuable in conditions characterized by high genetic heterogeneity such as neonatal diabetes mellitus (NDM)., Objective: To compare results of genetic analysis of patients with NDM and congenital severe insulin resistance (c.SIR) identified in Italy in 2003-2012 (Sanger) vs 2013-2022 (NGS)., Methods: We reviewed clinical and genetic records of 104 cases with diabetes onset before 6 months of age (NDM + c.SIR) of the Italian dataset., Results: Fifty-five patients (50 NDM + 5 c.SIR) were identified during 2003-2012 and 49 (46 NDM + 3 c.SIR) in 2013-2022. Twenty-year incidence was 1:103 340 (NDM) and 1:1 240 082 (c.SIR) live births. Frequent NDM/c.SIR genetic defects (KCNJ11, INS, ABCC8, 6q24, INSR) were detected in 41 and 34 probands during 2003-2012 and 2013-2022, respectively. We identified a pathogenic variant in rare genes in a single proband (GATA4) (1/42 or 2.4%) during 2003-2012 and in 8 infants (RFX6, PDX1, GATA6, HNF1B, FOXP3, IL2RA, LRBA, BSCL2) during 2013-2022 (8/42 or 19%, P = .034 vs 2003-2012). Notably, among rare genes 5 were recessive. Swift and accurate genetic diagnosis led to appropriate treatment: patients with autoimmune NDM (FOXP3, IL2RA, LRBA) were subjected to bone marrow transplant; patients with pancreas agenesis/hypoplasia (RFX6, PDX1) were supplemented with pancreatic enzymes, and the individual with lipodystrophy caused by BSCL2 was started on metreleptin., Conclusion: NGS substantially improved diagnosis and precision therapy of monogenic forms of neonatal diabetes and c.SIR in Italy., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Published
2024
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36. Glycemic Control, Basal/Bolus Distribution, BMI and Meal Management in Children and Adolescents with Type 1 Diabetes and Advanced Hybrid Closed Loop.

Author

Piccini B, Felicioni M, Pessina B, Bertini M, Casalini E, Ceccotti C, Farina S, Ferrari M, Lenzi L, Monzali F, and Toni S

Subjects
Child, Humans, Adolescent, Body Mass Index, Hypoglycemic Agents therapeutic use, Glycated Hemoglobin, Glycemic Control, Blood Glucose, Insulin therapeutic use, Meals, Diabetes Mellitus, Type 1 drug therapy
Abstract

Evidence about the impact of advanced hybrid closed loop (AHCL) on body mass index (BMI) and eating habits in children with type 1 diabetes (T1D) is lacking. This real-world study aimed at evaluating glycemic control, BMI, meals and basal/bolus distribution in young subjects with T1D treated by AHCL. Glycemic metrics, HbA1c, basal/bolus distribution, meals/day, BMI, total daily dose (TDD), and carbohydrates/kg (CHO/kg) have been evaluated in 83 subjects, aged 13 ± 4.5 years, in manual mode, 3 and 6 months after auto-mode. Time in range (TIR) increased after 3 months, exceeding the target of 70% and was maintained at 6 months. While coefficient of variation (CV) did not change, the glucose management indicator (GMI) decreased in auto-mode (6.7 ± 0.3 vs. 7.1 ± 0.5%; p < 0.001), as well as HbA1c. Basal proportion decreased in favor of boluses (38.3 ± 7.3 vs. 43.6 ± 10.9%; p < 0.001). Meals increased at 3 and 6 months (4.4 ± 1.2 vs. 5.0 ± 1.5, p 0.002 and 5.1 ± 1.7, p < 0.001), as well as TDD/kg, without changes in BMI and CHO consumed. No differences in meal composition have arisen from food diaries. In conclusion, AHCL ensured the achievement and maintenance of target TIR in young T1D subjects. The number of meals, TDD, and insulin bolus proportion increased over time, but BMI remained stable.

Published
2023
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37. The Assessment of Ankle Range-of-Motion and Its Relationship with Overall Muscle Strength in a Cross-Section of Soccer Players.

Author

Francia P, Ferri Marini C, Bocchi L, Piccini B, Seghieri G, Federici A, Toni S, and Lucertini F

Abstract

Soccer (football) practice can induce a limitation of ankle range of motion (ROM) that is a possible risk factor for injury and other negative consequences over time. The main objective of this research was to investigate the effects of soccer practice on ankle ROM throughout the entire period of a sports career of soccer players (SP). Furthermore, the relationship between ankle ROM and muscle strength in SP of different ages was studied. A total of 204 SP (range 6.7−45.1 years) and 87 controls (range: 7.5−45.2 years) matched for age, body mass index (BMI), and gender, were assessed. Ankle ROM in both plantar flexion (APF) and dorsiflexion (ADF) in addition to handgrip strength (HGS) were evaluated using an inclinometer and the Jamar hydraulic hand dynamometer, respectively. The comparison between SP and control groups showed a significant reduction in ankle ROM of both APF (26.3 ± 7.2° vs. 32.6 ± 7.4°; d = −0.90; p < 0.001) and ADF (95.5 ± 15.6° vs. 105.5 ± 15.8°; d = −0.66; p < 0.001). In SP, the results of the ANOVAs test indicate that age had a significant effect on ADF (F = 4.352, p = 0.038, partial eta-squared (ηp2) = 0.015) but not on APF (F = 0.430, p = 0.746, ηp2 = 0.001). Moreover, considering only the SP, a weak inverse correlation between ADF and HGS group ADF was found (rs = −0.27; p < 0.001). Factors such as the non-linear trend of growth in young SP could hinder the definition of the relationship between ankle ROM, age, and muscle strength. However, the appropriate consideration of age and muscle strength could facilitate the management of ankle ROM in PF of different ages.

Published
2023
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38. Increased prevalence of cardiovascular risk factors in children and adolescents with type 1 diabetes and hypertension: The SWEET international database.

Author

Vazeou A, Tittel SR, Kordonouri O, Birkebaek NH, Iotova V, Piccini B, Seget S, Guness PK, Maahs DM, and Stergiou GS

Subjects
Child, Male, Female, Humans, Adolescent, Prevalence, Glycated Hemoglobin analysis, Risk Factors, Heart Disease Risk Factors, Obesity complications, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 epidemiology, Cardiovascular Diseases etiology, Cardiovascular Diseases complications, Hypertension complications, Hypertension epidemiology, Dyslipidemias complications, Dyslipidemias epidemiology
Abstract

Aims: To investigate the prevalence of modifiable cardiovascular risk factors (CVRFs), including dyslipidaemia, obesity and high glycated haemoglobin (HbA1c) concentration, in patients with type 1 diabetes (T1D), and to evaluate their association with blood pressure (BP) categories., Methods: We analysed 21 634 children and adolescents with T1D from the SWEET international database with office BP values assessed at a three or more visits within a year from 2010 to 2021. Participants were classified into a normotensive group, a group with elevated BP (90 to 94th percentile) or a hypertensive group (≥95th percentile), based on the median BP for the visits within the last treatment year. The prevalences of dyslipidaemia [cholesterol ≥ 5.18 mmol/L (200 mg/dL)  and/or HDL cholesterol ≤ 1.036 mmol/L (40 mg/dL)  and/or LDL cholesterol ≥ 2.59 mmol/L (100 mg/dL)], obesity (body mass index ≥2 standard deviation score) and elevated HbA1c [≥ 75 mmol/mol (9%)] were evaluated in patients within each BP group., Results: Patients with hypertension/elevated BP had less favourable lipid profiles, and a higher prevalence of obesity and HbA1c ≥ 75 mmol/mol than normotensive patients. A total of 38.4% of hypertensive patients and 36.0% of those with elevated BP had one CVRF, 15.1% and 10.1%, respectively, had two CVRFs, and 2.3% and 0.8%, respectively, had three CVRFs. Patients with hypertension/elevated BP had a higher prevalence of one or more CVRFs versus normotensive patients (P < 0.001). Obesity was the CVRF most strongly related to hypertension. Girls had a higher prevalence of one or more CVRFs than boys. Similar results were found in patients aged ≥13 years with hypertension compared to those aged <13 years., Conclusions: The prevalence of modifiable CVRFs is higher in children and adolescents with T1D who have elevated BP/hypertension than in those with normotension, suggesting that they are more vulnerable to future morbidity and mortality requiring early detection and intervention., (© 2022 John Wiley & Sons Ltd.)

Published
2022
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39. Long-term effectiveness of advanced hybrid closed loop in children and adolescents with type 1 diabetes.

Author

Piccini B, Pessina B, Casalini E, Lenzi L, and Toni S

Subjects
Adolescent, Child, Humans, Male, Blood Glucose metabolism, Blood Glucose Self-Monitoring, Glycated Hemoglobin, Diabetes Mellitus, Type 1 drug therapy, Hypoglycemic Agents therapeutic use, Insulin therapeutic use, Insulin Infusion Systems
Abstract

Background: Advanced hybrid closed loop (AHCL) systems are the newest tool to improve metabolic control in type 1 diabetes (T1D). Long-term glycemic control of children and adolescents with T1D switching to MiniMed™ 780G in a real clinical setting was evaluated., Methods: Time in range (TIR) and in different glucose ranges, glycemic variability indexes, HbA1c and basal-bolus insulin distribution were evaluated in 44 subjects (mean age 14.2 ± 4.0 years, 22 males) during manual mode period, first 14 days (A14d) and first month after auto-mode activation (A1M), first 14 days after 3 months (A3M) and 6 months (A6M) in auto-mode., Results: Mean TIR at A14d was 76.3 ± 9.6% versus 69.3 ± 12.6% in manual mode (p < 0.001), and this improvement was maintained over 6 months. Subjects with TIR >70% and >80% in manual mode were 45% and 23%, respectively, and increased to 80% (p = 0.041) and 41% (p = 0.007) at A14d. Basal-bolus distribution changed in favor of bolus, and auto-correction boluses inversely correlated with TIR. HbA1c was 7.2 ± 0.7% (55 mmol/mol) at baseline and significantly improved after 3 months (6.7 ± 0.5%, 50 mmol/mol, p < 0.001) and 6 months (6.6 ± 0.5%, 49 mmol/mol, p < 0.001). TIR was higher in individuals >13 years at all time periods (p < 0.001). Glycemic target <120 mg/dl was associated with better TIR., Conclusions: AHCL MiniMed™ 780G allowed rapid and sustained improvement of glycemic control in young T1D patients, reaching recommended TIR. Teenagers showed good technology adherence with optimal TIR, maintained better over time compared to younger children. Stricter settings were associated with better metabolic control, without increase in severe hypoglycemia occurrence., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Published
2022
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40. DR4/DQ2 haplotype confers susceptibility to T1DM with early clinical disease onset: A retrospective analysis in a tertiary-care hospital in Italy.

Author

Ricci S, Perugia F, Piccini B, Lodi L, Pegoraro F, Giovannini M, Rombolà G, Perferi G, Toni S, and Azzari C

Subjects
Humans, Case-Control Studies, Haplotypes genetics, Retrospective Studies, Tertiary Care Centers, HLA-DR4 Antigen genetics, Diabetes Mellitus, Type 1 genetics, HLA-DQ Antigens genetics
Abstract

Introduction: T1DM is the most frequent form of diabetes in children. It has a multifactorial pathogenesis in which genetic, environmental and immunological factors are involved. Among genetic explanations a major role is attributed to second class HLA genes, with the greatest risk associated with the simultaneous presence of the haplotypes DR3DQ2 and DR4DQ8. Based on results obtained in other countries, the aim of this research is to verify a possible association between the haplotype DRB1 * 04: 05-DQA1 * 03-DQB1 * 02 and the onset of T1DM among Italian children with possible genotype-phenotype correlations. Greater knowledge of genes which increase or decrease susceptibility is important for genome analysis., Materials and Methods: 165 patients with type 1 diabetes treated at the Diabetology Unit of the Meyer Children's University Hospital, were clinically analyzed. Data relating to age at diagnosis, pancreatic anti-beta cell autoimmunity, comorbidities with date of diagnosis and family history were retrospectively collected from medical data. A case-control study was conducted to investigate the HLA types of the patients compared to a control group of 819 Tuscan donors enrolled in the National Bone Marrow Donor Register. Typing was carried out using the Eurospital "DIABEGEN" kit, currently in use at the immunology laboratory of the Meyer Children's University Hospital., Results: Mean age at diagnosis was 9.3 years; most children (97%) had anti-pancreatic beta cell autoimmunity; the anti-insulin antibody (IAA) was more frequent among children with early clinical disease onset (0-5 years of age). From the case control comparison performed on HLA typing, it emerged that the greatest risk for the development of type 1 diabetes is conferred by the haplotypes DR3DQ2 and DR4DQ8, but in addition to these haplotypes, already known in other countries, we identified another haplotype, DR4DQ2 (DRB1 * 04: 05-DQA1 * 03-DQB1 * 02) which appears to predispose children to type 1 diabetes (p value 2.80E-08) and it is associated with early clinical disease onset (p-value = 0.002)., Conclusions: We report a new haplotype which increases susceptibility to type 1 diabetes among Italian children and which is associated with early clinical disease onset. Given the central role attributed to genetic factors in the pathogenesis of T1DM and to the II class HLA genes, this new haplotype ought to be recognized as a risk factor and included in tests routinely carried out to identify patients with a genetic predisposition to type I diabetes in Italy. These findings could have practical implications in research and prevention programs., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Ricci et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2022
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41. 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

Cherubini V, Marino M, Scaramuzza AE, Tiberi V, Bobbio A, Delvecchio M, Piccinno E, Ortolani F, Innaurato S, Felappi B, Gallo F, Ripoli C, Ricciardi MR, Pascarella F, Stamati FA, Citriniti F, Arnaldi C, Monti S, Graziani V, De Berardinis F, Giannini C, Chiarelli F, Zampolli M, De Marco R, Bracciolini GP, 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 AS, 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 MG, Lasagni A, Pampanini V, Patera PI, Schiaffini R, Rutigliano I, Meloni G, De Sanctis L, Tinti D, Trada M, Guerraggio LP, Franceschi R, Cauvin V, Tornese G, Franco F, Musolino G, Maltoni G, Talarico V, Iannilli A, Lenzi L, Matteoli MC, Pozzi E, Moretti C, Zucchini S, Rabbone I, and Gesuita R

Abstract

[This corrects the article .]., (Copyright © 2022 Cherubini, Marino, Scaramuzza, Tiberi, Bobbio, Delvecchio, Piccinno, Ortolani, Innaurato, Felappi, Gallo, Ripoli, Ricciardi, Pascarella, Stamati, Citriniti, Arnaldi, Monti, Graziani, De Berardinis, Giannini, Chiarelli, Zampolli, De Marco, Bracciolini, Grosso, De Donno, Piccini, Toni, Coccioli, Cardinale, Bassi, Minuto, D’Annunzio, Maffeis, Marigliano, Zanfardino, Iafusco, Rollato, Piscopo, Curto, Lombardo, Bombaci, Sordelli, Mameli, Macedoni, Rigamonti, Bonfanti, Frontino, Predieri, Bruzzi, Mozzillo, Rosanio, Franzese, Piredda, Cardella, Iovane, Calcaterra, Berioli, Lasagni, Pampanini, Patera, Schiaffini, Rutigliano, Meloni, De Sanctis, Tinti, Trada, Guerraggio, Franceschi, Cauvin, Tornese, Franco, Musolino, Maltoni, Talarico, Iannilli, Lenzi, Matteoli, Pozzi, Moretti, Zucchini, Rabbone and Gesuita.)

Published
2022
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42. 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

Cherubini V, Marino M, Scaramuzza AE, Tiberi V, Bobbio A, Delvecchio M, Piccinno E, Ortolani F, Innaurato S, Felappi B, Gallo F, Ripoli C, Ricciardi MR, Pascarella F, Stamati FA, Citriniti F, Arnaldi C, Monti S, Graziani V, De Berardinis F, Giannini C, Chiarelli F, Zampolli M, De Marco R, Bracciolini GP, 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 AS, 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 MG, Lasagni A, Pampanini V, Patera PI, Schiaffini R, Rutigliano I, Meloni G, De Sanctis L, Tinti D, Trada M, Guerraggio LP, Franceschi R, Cauvin V, Tornese G, Franco F, Musolino G, Maltoni G, Talarico V, Iannilli A, Lenzi L, Matteoli MC, Pozzi E, Moretti C, Zucchini S, Rabbone I, and Gesuita R

Subjects
Adolescent, Child, Communicable Disease Control, Humans, Incidence, Italy epidemiology, Longitudinal Studies, Pandemics, COVID-19 diagnosis, COVID-19 epidemiology, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 1 epidemiology, Diabetic Ketoacidosis diagnosis, Diabetic Ketoacidosis epidemiology
Abstract

Aim/hypothesis: To 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., Methods: Forty-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., Results: Overall, 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<0.001). DKA and severe DKA increased during the early pandemic period by 10.4% (p=0.004) and 8% (p=0.002), respectively, and the increase continued throughout 2020. Immigrant background increased and high household income decreased the probability of presenting with DKA (OR: 1.55; 95%CI, 1.24-1.94; p<0.001 and OR: 0.60; 95 CI, 0.41-0.88; p=0.010, respectively)., Conclusions/interpretation: There was an increase in the frequency of DKA and severe DKA in children newly diagnosed with type 1 diabetes during the COVID-19 pandemic in 2020, with no apparent association with the severity of COVID-19 infection severity or containment measures. There has been a silent outbreak of DKA in children during the pandemic, and preventive action is required to prevent this phenomenon in the event of further generalized lockdowns or future outbreaks., Competing Interests: No author reported any conflict of interest as regards this study. The following conflicts of interest pointed out are referred to a period from January 2020 to the submission of this manuscript. VCh’s institution has received research grants from AstraZeneca, Novonordisk, Eli Lilly, Movi, Dompè, and Menarini, and VCh received honoraria from Eli Lilly, Tandem, and Insulet for participating on speakers’ bureaus and scientific advisory boards. CR, DT, IRa, BPr, BPi, SZ, ST, and AR has received support Eli Lilly. In addition, SZ’s institution has received support from Pfeizer, ST, BPi, and DT have received support from Abbott and Theras. MM and AR have received support from Menarini. BPr and PB received honoraria for participating on speakers’ bureaus and scientific advisory boards for Sandoz. Lastly, RS has received research grants by Sanofi and received honoraria for participating on speakers’ bureaus and scientific advisory boards for Movi. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cherubini, Marino, Scaramuzza, Tiberi, Bobbio, Delvecchio, Piccinno, Ortolani, Innaurato, Felappi, Gallo, Ripoli, Ricciardi, Pascarella, Stamati, Citriniti, Arnaldi, Monti, Graziani, De Berardinis, Giannini, Chiarelli, Zampolli, De Marco, Bracciolini, Grosso, De Donno, Piccini, Toni, Coccioli, Cardinale, Bassi, Minuto, D’Annunzio, Maffeis, Marigliano, Zanfardino, Iafusco, Rollato, Piscopo, Curto, Lombardo, Bombaci, Sordelli, Mameli, Macedoni, Rigamonti, Bonfanti, Frontino, Predieri, Bruzzi, Mozzillo, Rosanio, Franzese, Piredda, Cardella, Iovane, Calcaterra, Berioli, Lasagni, Pampanini, Patera, Schiaffini, Rutigliano, Meloni, De Sanctis, Tinti, Trada, Guerraggio, Franceschi, Cauvin, Tornese, Franco, Musolino, Maltoni, Talarico, Iannilli, Lenzi, Matteoli, Pozzi, Moretti, Zucchini, Rabbone and Gesuita.)

Published
2022
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43. The Importance of Office Blood Pressure Measurement Frequency and Methodology in Evaluating the Prevalence of Hypertension in Children and Adolescents With Type 1 Diabetes: The SWEET International Database.

Author

Vazeou A, Tittel SR, Birkebaek NH, Kordonouri O, Iotova V, Piccini B, Saboo B, Pundziute Lyckå A, Seget S, Maahs DM, and Stergiou G

Subjects
Adolescent, Blood Pressure physiology, Blood Pressure Monitoring, Ambulatory, Child, Female, Humans, Male, Prevalence, Retrospective Studies, Autonomic Nervous System Diseases, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 epidemiology, Hypertension epidemiology
Abstract

Objective: The prevalence of hypertension is higher in children and adolescents with type 1 diabetes (T1D) compared with those without. This retrospective analysis of a large cohort of children and adolescents with T1D from the SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) international consortium of pediatric diabetes centers aimed to 1) estimate the prevalence of elevated office blood pressure (BP) and hypertension and 2) investigate the influence of BP measurement methodology on the prevalence of hypertension., Research Design and Methods: A total of 27,120 individuals with T1D, aged 5-18 years, were analyzed. Participants were grouped into those with BP measurements at three or more visits (n = 10,440) and fewer than 3 visits (n = 16,680) per year and stratified by age and sex. A subgroup analysis was performed on 15,742 individuals from centers providing a score indicating BP measurement accuracy., Results: Among participants with BP measurement at three or more visits, the prevalence of hypertension was lower compared with those with fewer than three visits (10.8% vs. 17.5% P < 0.001), whereas elevated BP and normotension were higher (17.5% and 71.7% vs. 15.3% and 67.1%, respectively; both P < 0.001). The prevalence of hypertension and elevated BP was higher in individuals aged ≥13 years than in younger ones (P < 0.001) and in male than female participants (P < 0.001). In linear regression models, systolic and diastolic BP was independently determined by the BP measurement methodology., Conclusions: The estimated prevalence of elevated BP and hypertension in children and adolescents with T1D is ∼30% and depends on the BP measurement methodology. Less frequent BP evaluation may overestimate the prevalence of hypertension., (© 2022 by the American Diabetes Association.)

Published
2022
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44. COVID-19 vaccination in adolescents and young adults with type 1 diabetes: Glycemic control and side effects.

Author

Piccini B, Pessina B, Pezzoli F, Casalini E, and Toni S

Subjects
Adolescent, Blood Glucose, Blood Glucose Self-Monitoring, Glycemic Control, Humans, Hypoglycemic Agents therapeutic use, SARS-CoV-2, Vaccination adverse effects, Young Adult, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 2 drug therapy
Abstract

Background: Two vaccines against SARS-CoV-2 are approved by the World Health Organization (WHO) for minors aged 12 years and over. Currently, people with both type 1 diabetes (T1D) and type 2 diabetes (T2D) are prioritized for vaccination., Objective: To evaluate possible glycemic control modification, insulin dose adjustment and adverse effects after COVID-19 vaccination in young T1D individuals, users of different technology levels., Methods: Thirty-nine T1D individuals, who received a whole vaccination cycle of either Moderna or Pfizer- BioNTech vaccines, were enrolled, 24 of whom using advanced hybrid closed loop systems (AHCLs) and 15 using intermittently scanned continuous glucose monitoring (isCGM). Symptoms after each dose and the following variables were considered: time in range 70-180 mg/dl (TIR), time in different glucose ranges, mean glucose levels, coefficient of variation (CV), total daily dose (TDD) and bolus proportion RESULTS: No significant differences in TIR, time in different glucose ranges, mean glucose levels, TDD, bolus proportion, were observed before and after any dose nor before and after the whole vaccination cycle. CV was significantly lower after the whole vaccination cycle (CV pre-vaccination 35.1 ± 6.9% vs. CV post-vaccination 33.5 ± 6.3%; p 0.031) in subjects treated by AHCLs. Side effects after the vaccination were mild and more frequent after the second dose. No severe adverse reactions were reported., Conclusions: COVID-19 vaccination was safe and not associated with significant perturbation of glycemic control in adolescents and young adults with T1D. This information could be of clinical use when counseling families about SARS-CoV-2 vaccination in young people with T1D., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Published
2022
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47. Cocreation of Massive Open Online Courses to Improve Digital Health Literacy in Diabetes: Pilot Mixed Methods Study.

Author

Alvarez-Perez Y, Perestelo-Perez L, Rivero-Santana A, Wagner AM, Torres-Castaño A, Toledo-Chávarri A, Duarte-Díaz A, Alvarado-Martel D, Piccini B, Van den Broucke S, Vandenbosch J, González-González C, Perello M, and Serrano-Aguilar P

Abstract

Background: Self-management education is a fundamental aspect in the health care of people with diabetes to develop the necessary skills for the improvement of health outcomes. Patients are required to have the competencies to manage electronic information resources-that is, an appropriate level of digital health literacy. The European project IC-Health aimed to improve digital health literacy among people with diabetes through the cocreation of massive open online courses (MOOCs)., Objective: We report the preliminary results obtained in 3 participating countries in the IC-Health project (Italy, Spain, and Sweden) regarding (1) experience of the participants during the cocreation process of MOOCs, (2) perceived changes in their digital health literacy level after using MOOCs, and (3) a preliminary assessment of the acceptability of MOOCs., Methods: The cocreation of the MOOCs included focus groups with adults and adolescents with diabetes and the creation of independent communities of practice for type 1 diabetes and type 2 diabetes participants aimed to co-design the MOOCs. Quantitative measures of the acceptability of MOOCs, experience in the cocreation process, and increase in digital health literacy (dimensions of finding, understanding, and appraisal) were assessed., Results: A total of 28 participants with diabetes participated in focus groups. Adults and adolescents agreed that the internet is a secondary source of health-related information. A total of 149 participants comprised the diabetes communities of practice. A total of 9 MOOCs were developed. Acceptability of the MOOCs and the cocreation experience were positively valued. There was a significant improvement in digital health literacy in both adults and adolescents after using MOOCs (P<.001)., Conclusions: Although the results presented on self-perceived digital health literacy are preliminary and exploratory, this pilot study suggests that IC-Health MOOCs represent a promising tool for the medical care of diabetes, being able to help reduce the limitations associated with low digital health literacy and other communication barriers in the diabetes population., (©Yolanda Alvarez-Perez, Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Ana M Wagner, Alezandra Torres-Castaño, Ana Toledo-Chávarri, Andrea Duarte-Díaz, Dácil Alvarado-Martel, Barbara Piccini, Stephan Van den Broucke, Jessica Vandenbosch, Carina González-González, Michelle Perello, Pedro Serrano-Aguilar, IC-Health Project Consortium. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 13.12.2021.)

Published
2021
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48. Effectiveness of a closed-loop control system and a virtual educational camp for children and adolescents with type 1 diabetes: A prospective, multicentre, real-life study.

Author

Cherubini V, Rabbone I, Berioli MG, Giorda S, Lo Presti D, Maltoni G, Mameli C, Marigliano M, Marino M, Minuto N, Mozzillo E, Piccinno E, Predieri B, Ripoli C, Schiaffini R, Rigamonti A, Salzano G, Tinti D, Toni S, Zanfardino A, Scaramuzza AE, Gesuita R, Tiberi V, Savastio S, Pigniatiello C, Trada M, Zucchini S, Redaelli FC, Maffeis C, Bassi M, Rosanio FM, Delvecchio M, Buzzi P, Ricciardi MR, Carducci C, Bonfanti R, Lombardo F, Piccini B, Iafusco D, Calandretti M, and Daga FA

Subjects
Adolescent, Blood Glucose, Blood Glucose Self-Monitoring, Child, Humans, Hypoglycemic Agents therapeutic use, Insulin therapeutic use, Insulin Infusion Systems, Prospective Studies, Diabetes Mellitus, Type 1 drug therapy
Abstract

Aim: To evaluate the impact of a virtual educational camp (vEC) on glucose control in children and adolescents with type 1 diabetes using a closed-loop control (CLC) system., Materials and Methods: This was a prospective multicentre study of children and adolescents with type 1 diabetes using the Tandem Basal-IQ system. Insulin pumps were upgraded to Control-IQ, and children and their parents participated in a 3-day multidisciplinary vEC. Clinical data, glucose metrics and HbA1c were evaluated over the 12 weeks prior to the Control-IQ update and over the 12 weeks after the vEC., Results: Forty-three children and adolescents (aged 7-16 years) with type 1 diabetes and their families participated in the vEC. The median percentage of time in target range (70-180 mg/dL; TIR) increased from 64% (interquartile range [IQR] 56%-73%) with Basal-IQ to 76% (IQR 71%-81%) with Control-IQ (P < .001). After the vEC, more than 75% of participants achieved a TIR of more than 70%. The percentage of time between 180 and 250 mg/dL and above 250 mg/dL decreased by 5% (P < .01) and 6% (P < .01), respectively, while the time between 70 and 54 mg/dL and below 54 mg/dL remained low and unaltered. HbA1c decreased by 0.5% (P < .01). There were no episodes of diabetic ketoacidosis or severe hypoglycaemia., Conclusions: In this study of children managing their diabetes in a real-world setting, more than 75% of children who participated in a vEC after starting a CLC system could obtain and maintain a TIR of more than 70%. The vEC was feasible and resulted in a significant and persistent improvement in TIR in children and adolescents with type 1 diabetes., (© 2021 John Wiley & Sons Ltd.)

Published
2021
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49. Retrospective Evaluation on the Use of a New Polysaccharide Complex in Managing Paediatric Type 1 Diabetes with Metabolic Syndrome (MetS).

Author

Stagi S, Papacciuoli V, Ciofi D, Piccini B, Farello G, Toni S, Ferrari M, and Chiarelli F

Subjects
Adolescent, Blood Glucose metabolism, Body Mass Index, Child, Cholesterol, HDL blood, Cholesterol, LDL blood, Diabetes Mellitus, Type 1 blood, Diabetes Mellitus, Type 1 complications, Female, Humans, Hypoglycemic Agents administration & dosage, Insulin administration & dosage, Male, Metabolic Syndrome blood, Metabolic Syndrome complications, Multiprotein Complexes, Pediatric Obesity blood, Pediatric Obesity complications, Retrospective Studies, Treatment Outcome, Triglycerides blood, Diabetes Mellitus, Type 1 drug therapy, Metabolic Syndrome drug therapy, Pediatric Obesity drug therapy, Polysaccharides administration & dosage
Abstract

Background: Children and adolescents affected by type 1 diabetes have an increased risk of being overweight or obese and of suffering from cardiometabolic symptoms., Aims: To retrospectively evaluate the effects of a new complex of polysaccharide macromolecules, Policaptil Gel Retard ® (PGR), on auxological and metabolic parameters, glycaemic variability and control parameters in paediatric patients with type 1 diabetes and metabolic syndrome (MetS)., Patients and Methods: Data for 27 paediatric patients with a diagnosis of type 1 diabetes in conjunction with obesity and MetS of at least 5 years' standing were collected and retrospectively studied. Of these, 16 (median age 12.9, range 9.5-15.8 years) had been adjunctively treated with PGR and 11 (median age 12.6, range 9.4-15.6 years) had not been treated with PGR. Auxological, metabolic and glycaemic control and variability parameters and insulin dosing were compared after 6 months in the two groups., Results: PGR significantly reduced BMI standard deviation score (SDS) ( p < 0.005), waist SDS ( p < 0.005), HbA1c ( p < 0.05) and daily mean insulin dose requirement ( p < 0.005). A significant improvement was also observed in the metabolic and glycaemic variability parameters of mean daily blood glucose (BG) levels ( p < 0.005), SD of daily BG levels ( p < 0.0001), mean coefficient of variation ( p < 0.05), LBGI ( p < 0.0001), HBGI ( p < 0.0001), J-index ( p < 0.005), total cholesterol ( p < 0.005), HDL-cholesterol ( p < 0.005) and LDL-cholesterol ( p < 0.005) and triglycerides ( p < 0.05)., Conclusions: PGR produces a good auxological and metabolic response in obese patients with MetS who are affected by type 1 diabetes. It led to a significant reduction in BMI SDS, waist SDS and an improvement in glucose control and variability as well as in other MetS parameters. The use of polysaccharide compounds, especially if associated with appropriate dietary changes, may help achieve treatment targets in type 1 diabetes and reduce the risk that patients develop metabolic syndrome.

Published
2021
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50. Differences between transient neonatal diabetes mellitus subtypes can guide diagnosis and therapy.

Author

Bonfanti R, Iafusco D, Rabbone I, Diedenhofen G, Bizzarri C, Patera PI, Reinstadler P, Costantino F, Calcaterra V, Iughetti L, Savastio S, Favia A, Cardella F, Lo Presti D, Girtler Y, Rabbiosi S, D'Annunzio G, Zanfardino A, Piscopo A, Casaburo F, Pintomalli L, Russo L, Grasso V, Minuto N, Mucciolo M, Novelli A, Marucci A, Piccini B, Toni S, Silvestri F, Carrera P, Rigamonti A, Frontino G, Trada M, Tinti D, Delvecchio M, Rapini N, Schiaffini R, Mammì C, and Barbetti F

Subjects
Datasets as Topic, Diagnosis, Differential, Diagnostic Techniques, Endocrine standards, Female, Humans, Infant, Infant, Newborn, Italy, Male, Mutation, Potassium Channels, Inwardly Rectifying genetics, Remission Induction methods, Retrospective Studies, Sulfonylurea Receptors genetics, Diabetes Mellitus classification, Diabetes Mellitus congenital, Diabetes Mellitus diagnosis, Diabetes Mellitus genetics, Diabetes Mellitus therapy, Infant, Newborn, Diseases classification, Infant, Newborn, Diseases diagnosis, Infant, Newborn, Diseases genetics, Infant, Newborn, Diseases therapy
Abstract

Objective: Transient neonatal diabetes mellitus (TNDM) is caused by activating mutations in ABCC8 and KCNJ11 genes (KATP/TNDM) or by chromosome 6q24 abnormalities (6q24/TNDM). We wanted to assess whether these different genetic aetiologies result in distinct clinical features., Design: Retrospective analysis of the Italian data set of patients with TNDM., Methods: Clinical features and treatment of 22 KATP/TNDM patients and 12 6q24/TNDM patients were compared., Results: Fourteen KATP/TNDM probands had a carrier parent with abnormal glucose values, four patients with 6q24 showed macroglossia and/or umbilical hernia. Median age at diabetes onset and birth weight were lower in patients with 6q24 (1 week; -2.27 SD) than those with KATP mutations (4.0 weeks; -1.04 SD) (P = 0.009 and P = 0.007, respectively). Median time to remission was longer in KATP/TNDM than 6q24/TNDM (21.5 weeks vs 12 weeks) (P = 0.002). Two KATP/TNDM patients entered diabetes remission without pharmacological therapy. A proband with the ABCC8/L225P variant previously associated with permanent neonatal diabetes entered 7-year long remission after 1 year of sulfonylurea therapy. Seven diabetic individuals with KATP mutations were successfully treated with sulfonylurea monotherapy; four cases with relapsing 6q24/TNDM were treated with insulin, metformin or combination therapy., Conclusions: If TNDM is suspected, KATP genes should be analyzed first with the exception of patients with macroglossia and/or umbilical hernia. Remission of diabetes without pharmacological therapy should not preclude genetic analysis. Early treatment with sulfonylurea may induce long-lasting remission of diabetes in patients with KATP mutations associated with PNDM. Adult patients carrying KATP/TNDM mutations respond favourably to sulfonylurea monotherapy.

Published
2021
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