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2. Recommendations for recognizing, risk stratifying, treating, and managing children and adolescents with hypoglycemia

Author

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

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

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

Published
2024
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3. Uric acid and cardiometabolic risk by gender in youth with type 1 diabetes

Author

Di Bonito, Procolo, Rosanio, Francesco Maria, Marcovecchio, Maria Loredana, Cherubini, Valentino, Delvecchio, Maurizio, Di Candia, Francesca, Iafusco, Dario, Zanfardino, Angela, Iovane, Brunella, Maffeis, Claudio, Maltoni, Giulio, Ripoli, Carlo, Piccinno, Elvira, Piona, Claudia Anita, Ricciardi, Maria Rossella, Schiaffini, Riccardo, Franzese, Adriana, and Mozzillo, Enza

Published
2022
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5. Significant and persistent improvements in time in range and positive emotions in children and adolescents with type 1 diabetes using a closed-loop control system after attending a virtual educational camp

Author

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

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

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

Published
2022

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

Published
2022
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7. 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, Valentino, primary, Marino, Monica, additional, Scaramuzza, Andrea E., additional, Tiberi, Valentina, additional, Bobbio, Adriana, additional, Delvecchio, Maurizio, additional, Piccinno, Elvira, additional, Ortolani, Federica, additional, Innaurato, Stefania, additional, Felappi, Barbara, additional, Gallo, Francesco, additional, Ripoli, Carlo, additional, Ricciardi, Maria Rossella, additional, Pascarella, Filomena, additional, Stamati, Filomena A., additional, Citriniti, Felice, additional, Arnaldi, Claudia, additional, Monti, Sara, additional, Graziani, Vanna, additional, De Berardinis, Fiorella, additional, Giannini, Cosimo, additional, Chiarelli, Francesco, additional, Zampolli, Maria, additional, De Marco, Rosaria, additional, Bracciolini, Giulia Patrizia, additional, Grosso, Caterina, additional, De Donno, Valeria, additional, Piccini, Barbara, additional, Toni, Sonia, additional, Coccioli, Susanna, additional, Cardinale, Giuliana, additional, Bassi, Marta, additional, Minuto, Nicola, additional, D’Annunzio, Giuseppe, additional, Maffeis, Claudio, additional, Marigliano, Marco, additional, Zanfardino, Angela, additional, Iafusco, Dario, additional, Rollato, Assunta S., additional, Piscopo, Alessia, additional, Curto, Stefano, additional, Lombardo, Fortunato, additional, Bombaci, Bruno, additional, Sordelli, Silvia, additional, Mameli, Chiara, additional, Macedoni, Maddalena, additional, Rigamonti, Andrea, additional, Bonfanti, Riccardo, additional, Frontino, Giulio, additional, Predieri, Barbara, additional, Bruzzi, Patrizia, additional, Mozzillo, Enza, additional, Rosanio, Francesco, additional, Franzese, Adriana, additional, Piredda, Gavina, additional, Cardella, Francesca, additional, Iovane, Brunella, additional, Calcaterra, Valeria, additional, Berioli, Maria Giulia, additional, Lasagni, Anna, additional, Pampanini, Valentina, additional, Patera, Patrizia Ippolita, additional, Schiaffini, Riccardo, additional, Rutigliano, Irene, additional, Meloni, Gianfranco, additional, De Sanctis, Luisa, additional, Tinti, Davide, additional, Trada, Michela, additional, Guerraggio, Lucia Paola, additional, Franceschi, Roberto, additional, Cauvin, Vittoria, additional, Tornese, Gianluca, additional, Franco, Francesca, additional, Musolino, Gianluca, additional, Maltoni, Giulio, additional, Talarico, Valentina, additional, Iannilli, Antonio, additional, Lenzi, Lorenzo, additional, Matteoli, Maria Cristina, additional, Pozzi, Erica, additional, Moretti, Carlo, additional, Zucchini, Stefano, additional, Rabbone, Ivana, additional, and Gesuita, Rosaria, additional

Published
2022
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8. Uric acid and cardiometabolic risk profile in youths with type 1 diabetes: sex-related associations

Author

Bonito, Procolo Di, primary, Rosanio, Francesco Maria, additional, Marcovecchio, Maria Loredana, additional, Cherubini, Valentino, additional, Delvecchio, Maurizio, additional, Candia, Francesca Di, additional, Iafusco, Dario, additional, Zanfardino, Angela, additional, Iovane, Brunella, additional, Maffeis, Claudio, additional, Maltoni, Giulio, additional, Ripoli, Carlo, additional, Piccinno, Elvira, additional, Piona, Claudia Anita, additional, Ricciardi, Maria Rossella, additional, Schiaffini, Riccardo, additional, Franzese, Adriana, additional, and Mozzillo, Enza, additional

Published
2022
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9. PRF1 mutation alters immune system activation, inflammation, and risk of autoimmunity

Author

Sidore, Carlo, primary, Orrù, Valeria, additional, Cocco, Eleonora, additional, Steri, Maristella, additional, Inshaw, Jamie RJ, additional, Pitzalis, Maristella, additional, Mulas, Antonella, additional, McGurnaghan, Stuart, additional, Frau, Jessica, additional, Porcu, Eleonora, additional, Busonero, Fabio, additional, Dei, Mariano, additional, Lai, Sandra, additional, Sole, Gabriella, additional, Virdis, Francesca, additional, Serra, Valentina, additional, Poddie, Fausto, additional, Delitala, Alessandro, additional, Marongiu, Michele, additional, Deidda, Francesca, additional, Pala, Mauro, additional, Floris, Matteo, additional, Masala, Marco, additional, Onengut-Gumuscu, Suna, additional, Robertson, Catherine C, additional, Leoni, Lidia, additional, Frongia, Annapaola, additional, Ricciardi, Maria Rossella, additional, Chessa, Margherita, additional, Olla, Nazario, additional, Lovicu, Mario, additional, Loizedda, Annalisa, additional, Maschio, Andrea, additional, Mereu, Luisa, additional, Ferrigno, Paola, additional, Curreli, Nicolo, additional, Balaci, Lenuta, additional, Loi, Francesco, additional, Ferreli, Liana AP, additional, Pilia, Maria Grazia, additional, Pani, Antonello, additional, Marrosu, Maria Giovanna, additional, Abecasis, Goncalo R, additional, Rich, Stephen S, additional, Colhoun, Helen, additional, Todd, John A, additional, Schlessinger, David, additional, Fiorillo, Edoardo, additional, Cucca, Francesco, additional, and Zoledziewska, Magdalena, additional

Published
2020
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10. MSJ963937_supplemental_material – Supplemental material for PRF1 mutation alters immune system activation, inflammation, and risk of autoimmunity

Author

Sidore, Carlo, Orrù, Valeria, Cocco, Eleonora, Steri, Maristella, Inshaw, Jamie RJ, Pitzalis, Maristella, Mulas, Antonella, McGurnaghan, Stuart, Frau, Jessica, Porcu, Eleonora, Busonero, Fabio, Dei, Mariano, Lai, Sandra, Sole, Gabriella, Virdis, Francesca, Serra, Valentina, Poddie, Fausto, Delitala, Alessandro, Marongiu, Michele, Deidda, Francesca, Pala, Mauro, Floris, Matteo, Masala, Marco, Onengut-Gumuscu, Suna, Robertson, Catherine C, Leoni, Lidia, Annapaola Frongia, Ricciardi, Maria Rossella, Chessa, Margherita, Olla, Nazario, Lovicu, Mario, Loizedda, Annalisa, Maschio, Andrea, Mereu, Luisa, Ferrigno, Paola, Curreli, Nicolo, Lenuta Balaci, Loi, Francesco, Ferreli, Liana AP, Pilia, Maria Grazia, Pani, Antonello, Marrosu, Maria Giovanna, Goncalo R Abecasis, Rich, Stephen S, Colhoun, Helen, Todd, John A, Schlessinger, David, Fiorillo, Edoardo, Cucca, Francesco, and Zoledziewska, Magdalena

Subjects
FOS: Clinical medicine, 111702 Aged Health Care, FOS: Health sciences, 3. Good health, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, MSJ963937_supplemental_material for PRF1 mutation alters immune system activation, inflammation, and risk of autoimmunity by Carlo Sidore, Valeria Orrù, Eleonora Cocco, Maristella Steri, Jamie RJ Inshaw, Maristella Pitzalis, Antonella Mulas, Stuart McGurnaghan, Jessica Frau, Eleonora Porcu, Fabio Busonero, Mariano Dei, Sandra Lai, Gabriella Sole, Francesca Virdis, Valentina Serra, Fausto Poddie, Alessandro Delitala, Michele Marongiu, Francesca Deidda, Mauro Pala, Matteo Floris, Marco Masala, Suna Onengut-Gumuscu, Catherine C Robertson, Lidia Leoni, Annapaola Frongia, Maria Rossella Ricciardi, Margherita Chessa, Nazario Olla, Mario Lovicu, Annalisa Loizedda, Andrea Maschio, Luisa Mereu, Paola Ferrigno, Nicolo Curreli, Lenuta Balaci, Francesco Loi, Liana AP Ferreli, Maria Grazia Pilia, Antonello Pani, Maria Giovanna Marrosu, Goncalo R Abecasis, Stephen S Rich, Helen Colhoun, John A Todd, David Schlessinger, Edoardo Fiorillo, Francesco Cucca and Magdalena Zoledziewska in Multiple Sclerosis Journal

11. MSJ963937_supplemental_material – Supplemental material for PRF1 mutation alters immune system activation, inflammation, and risk of autoimmunity

Author

Sidore, Carlo, Orrù, Valeria, Cocco, Eleonora, Steri, Maristella, Inshaw, Jamie RJ, Pitzalis, Maristella, Mulas, Antonella, McGurnaghan, Stuart, Frau, Jessica, Porcu, Eleonora, Busonero, Fabio, Dei, Mariano, Lai, Sandra, Sole, Gabriella, Virdis, Francesca, Serra, Valentina, Poddie, Fausto, Delitala, Alessandro, Marongiu, Michele, Deidda, Francesca, Pala, Mauro, Floris, Matteo, Masala, Marco, Onengut-Gumuscu, Suna, Robertson, Catherine C, Leoni, Lidia, Annapaola Frongia, Ricciardi, Maria Rossella, Chessa, Margherita, Olla, Nazario, Lovicu, Mario, Loizedda, Annalisa, Maschio, Andrea, Mereu, Luisa, Ferrigno, Paola, Curreli, Nicolo, Lenuta Balaci, Loi, Francesco, Ferreli, Liana AP, Pilia, Maria Grazia, Pani, Antonello, Marrosu, Maria Giovanna, Goncalo R Abecasis, Rich, Stephen S, Colhoun, Helen, Todd, John A, Schlessinger, David, Fiorillo, Edoardo, Cucca, Francesco, and Zoledziewska, Magdalena

Subjects
FOS: Clinical medicine, 111702 Aged Health Care, FOS: Health sciences, 3. Good health, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, MSJ963937_supplemental_material for PRF1 mutation alters immune system activation, inflammation, and risk of autoimmunity by Carlo Sidore, Valeria Orrù, Eleonora Cocco, Maristella Steri, Jamie RJ Inshaw, Maristella Pitzalis, Antonella Mulas, Stuart McGurnaghan, Jessica Frau, Eleonora Porcu, Fabio Busonero, Mariano Dei, Sandra Lai, Gabriella Sole, Francesca Virdis, Valentina Serra, Fausto Poddie, Alessandro Delitala, Michele Marongiu, Francesca Deidda, Mauro Pala, Matteo Floris, Marco Masala, Suna Onengut-Gumuscu, Catherine C Robertson, Lidia Leoni, Annapaola Frongia, Maria Rossella Ricciardi, Margherita Chessa, Nazario Olla, Mario Lovicu, Annalisa Loizedda, Andrea Maschio, Luisa Mereu, Paola Ferrigno, Nicolo Curreli, Lenuta Balaci, Francesco Loi, Liana AP Ferreli, Maria Grazia Pilia, Antonello Pani, Maria Giovanna Marrosu, Goncalo R Abecasis, Stephen S Rich, Helen Colhoun, John A Todd, David Schlessinger, Edoardo Fiorillo, Francesco Cucca and Magdalena Zoledziewska in Multiple Sclerosis Journal

12. The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

Author

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

Subjects
COVID - 19, Adolescent, type 1 diabetes, Endocrinology, Diabetes and Metabolism, Longitudinal Studie, Diabetic Ketoacidosis, socioeconomic status, DKA, Diabetes Mellitus, Humans, Longitudinal Studies, Child, Pandemics, Settore MED/38 - Pediatria Generale e Specialistica, Pandemic, type 1 diabete, Incidence, COVID-19, diabetes onset, Communicable Disease Control, Italy, Diabetes Mellitus, Type 1, socioeconomic statu, Human, Type 1
Abstract

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

Published
2022

13. Albuminuric and non-albuminuric reduced eGFR phenotypes in youth with type 1 diabetes: Factors associated with cardiometabolic risk

Author

Maurizio Delvecchio, C. Ripoli, Claudia Piona, Alberto Casertano, Roberto Franceschi, Riccardo Schiaffini, Maria R Ricciardi, Valentino Tiberi, Elvira Piccinno, T. Suprani, Giulio Maltoni, Enza Mozzillo, Procolo Di Bonito, Angela Zanfardino, Dario Iafusco, Gianluca Tornese, Silvia Savastio, C. Arnaldi, Valentino Cherubini, Francesco Maria Rosanio, Brunella Iovane, Claudio Maffeis, Adriana Franzese, Di Bonito, P., Mozzillo, E., Rosanio, F. M., Maltoni, G., Piona, C. A., Franceschi, R., Ripoli, C., Ricciardi, M. R., Tornese, G., Arnaldi, C., Iovane, B., Iafusco, D., Zanfardino, A., Suprani, T., Savastio, S., Cherubini, V., Tiberi, V., Piccinno, E., Schiaffini, R., Delvecchio, M., Casertano, A., Maffeis, C., Franzese, A., Di Bonito, Procolo, Mozzillo, Enza, Rosanio, Francesco Maria, Maltoni, Giulio, Piona, Claudia Anita, Franceschi, Roberto, Ripoli, Carlo, Ricciardi, Maria Rossella, Tornese, Gianluca, Arnaldi, Claudia, Iovane, Brunella, Iafusco, Dario, Zanfardino, Angela, Suprani, Tosca, Savastio, Silvia, Cherubini, Valentino, Tiberi, Valentina, Piccinno, Elvira, Schiaffini, Riccardo, Delvecchio, Maurizio, Casertano, Alberto, Maffeis, Claudio, and Franzese, Adriana

Subjects
Male, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), White, Diabetic nephropathy, 030204 cardiovascular system & hematology, Kidney, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, cardiovascular disease, Retrospective Studie, Prevalence, eGFR, Medicine, Age Factor, Diabetic Nephropathies, Child, Children, Nutrition and Dietetics, cardiometabolic risk factor, type 1 diabete, Age Factors, Cardiovascular disease, Phenotype, Type 1 diabetes, Italy, Child, Preschool, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Human, Glomerular Filtration Rate, Type 1, medicine.medical_specialty, microalbuminuria, Type 1 diabete, Adolescent, Renal function, 030209 endocrinology & metabolism, Risk Assessment, White People, Autoimmune thyroiditis, 03 medical and health sciences, children, Internal medicine, Diabetes Mellitus, Humans, Albuminuria, Diabetic kidney disease, diabetic nephropathy, diabetic kidney disease, cardiometabolic risk factors, type 1 diabetes, Retrospective Studies, Cross-Sectional Studie, Creatinine, Cardiometabolic risk factor, business.industry, Thyroiditis, Autoimmune, Biomarker, medicine.disease, Cardiometabolic risk factors, Cross-Sectional Studies, Diabetes Mellitus, Type 1, chemistry, Diabetic Nephropathie, Uric acid, Microalbuminuria, business, Biomarkers
Abstract

Background and aim: Albuminuria and reduced eGFR are hallmarks of Diabetic Kidney Disease in adults. Our aim was to analyze factors associated with albuminuric and non-albuminuric mildly reduced eGFR phenotypes in youths with type 1 diabetes. Methods and results: This multicenter cross-sectional study included 1549 youths (age 5–17 years) with type 1 diabetes enrolled at 14 Italian Pediatric Diabetes Centers. Albuminuria, creatinine, glycosylated hemoglobin (HbA1c), lipids, blood pressure (BP), neutrophils (N) and lymphocytes (L) count were analyzed. Uric acid (UA) was available in 848 individuals. Estimated GFR (eGFR) was calculated using bedside Schwartz's equation. The sample was divided in three phenotypes: 1) normoalbuminuria and eGFR ≥90 mL/min/1.73 m2 (reference category, n = 1204), 2) albuminuric and normal GFR phenotype (n = 106), 3) non-albuminuric mildly reduced GFR (MRGFR) phenotype (eGFR 60–89 mL/min/1.73 m2, n = 239). Albuminuric and non-albuminuric reduced eGFR phenotypes were significantly associated with autoimmune thyroiditis (P =0.028 and P=0.044, respectively). Albuminuric phenotype showed high risk of high HbA1c (P=0.029), high BP (P < 0.001), and low HDL-C (P =0.045) vs reference category. Non-albuminuric MRGFR phenotype showed high risk of high BP (P < 0.0001), low HDL-C (P =0.042), high Triglycerides/HDL-C ratio (P =0.019), and high UA (P < 0.0001) vs reference category. Conclusion: Non albuminuric MRGFR phenotype is more prevalent than albuminuric phenotype and shows a worst cardiometabolic risk (CMR) profile). Both phenotypes are associated with autoimmune thyroiditis. Our data suggest to evaluate both albuminuria and eGFR earlier in type 1 diabetes to timely identify young people with altered CMR profile.

Published
2021

14. 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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15. PRF1 mutation alters immune system activation, inflammation, and risk of autoimmunity.

Author

Sidore C, Orrù V, Cocco E, Steri M, Inshaw JR, Pitzalis M, Mulas A, McGurnaghan S, Frau J, Porcu E, Busonero F, Dei M, Lai S, Sole G, Virdis F, Serra V, Poddie F, Delitala A, Marongiu M, Deidda F, Pala M, Floris M, Masala M, Onengut-Gumuscu S, Robertson CC, Leoni L, Frongia A, Ricciardi MR, Chessa M, Olla N, Lovicu M, Loizedda A, Maschio A, Mereu L, Ferrigno P, Curreli N, Balaci L, Loi F, Ferreli LA, Pilia MG, Pani A, Marrosu MG, Abecasis GR, Rich SS, Colhoun H, Todd JA, Schlessinger D, Fiorillo E, Cucca F, and Zoledziewska M

Subjects
Child, Humans, Inflammation, LIM-Homeodomain Proteins, Muscle Proteins, Mutation, Perforin genetics, Transcription Factors, Autoimmunity genetics, Immune System
Abstract

Background: Defective alleles within the PRF1 gene, encoding the pore-forming protein perforin, in combination with environmental factors, cause familial type 2 hemophagocytic lymphohistiocytosis (FHL2), a rare, severe autosomal recessive childhood disorder characterized by massive release of cytokines-cytokine storm., Objective: The aim of this study was to determine the function of hypomorph PRF1:p.A91V g.72360387 G > A on multiple sclerosis (MS) and type 1 diabetes (T1D)., Methods: We cross-compare the association data for PRF1:p.A91V mutation derived from GWAS on adult MS and pediatric T1D in Sardinians. The novel association with T1D was replicated in metanalysis in 12,584 cases and 17,692 controls from Sardinia, the United Kingdom, and Scotland. To dissect this mutation function, we searched through the coincident association immunophenotypes in additional set of general population Sardinians., Results: We report that PRF1:p.A91V , is associated with increase of lymphocyte levels, especially within the cytotoxic memory T-cells, at general population level with reduced interleukin 7 receptor expression on these cells. The minor allele increased risk of MS, in 2903 cases and 2880 controls from Sardinia p  = 2.06 × 10 -4 , odds ratio OR = 1.29, replicating a previous finding, whereas it protects from T1D p  = 1.04 × 10 -5 , OR = 0.82., Conclusion: Our results indicate opposing contributions of the cytotoxic T-cell compartment to MS and T1D pathogenesis.

Published
2021
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