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1. Integrated insulin pump therapy with continuous glucose monitoring for improved adherence: technology update

Author

Tumminia A, Sciacca L, Frittitta L, Squatrito S, Vigneri R, Le Moli R, and Tomaselli L

Subjects
Medicine (General), R5-920
Abstract

Andrea Tumminia,1 Laura Sciacca,1 Lucia Frittitta,1 Sebastiano Squatrito,1 Riccardo Vigneri,2 Rosario Le Moli,1 Letizia Tomaselli2 1Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Hospital, Catania, Italy; 2Endocrinology, Garibaldi-Nesima Hospital, Catania, Italy Abstract: Insulin pump therapy combined with real-time continuous glucose monitoring, known as sensor-augmented pump (SAP) therapy, has been shown to improve metabolic control and to reduce the rate of hypoglycemia in adults with type 1 diabetes compared to multiple daily injections or standard continuous subcutaneous insulin infusion. Glycemic variability is also reduced in patients on SAP therapy. This approach allows patients to monitor their glucose levels being informed of glycemic concentration and trend. Trained diabetic patients, therefore, can appropriately modify insulin infusion and/or carbohydrate intake in order to prevent hypo- or hyperglycemia. For these reasons, SAP therapy is now considered the gold standard for type 1 diabetes treatment. To be clinically effective, however, devices and techniques using advanced technology should not only have the potential to theoretically ameliorate metabolic control, but also be well accepted by patients in terms of satisfaction and health-related quality of life, because these factors will improve treatment adherence and consequently overall outcome. SAP therapy is generally well tolerated by patients; however, many clinical trials have identified significant noncompliance in the use of this device, most notably in the pediatric and adolescent populations. In this review we aim to analyze the main reasons for good or poor adherence to SAP therapy and to provide useful tips in order to fully benefit from this kind of novel therapeutic approach. Keywords: sensor-augmented insulin pump therapy, type 1 diabetes, quality of life, patient adherence, continuous subcutaneous insulin infusion

Published
2015

8. Rare diseases in clinical endocrinology: a taxonomic classification system

Author

Marcucci, G., Cianferotti, L., Beck-Peccoz, P., Capezzone, M., Cetani, F., Colao, A., Davì, M. V., degli Uberti, E., Del Prato, S., Elisei, R., Faggiano, A., Ferone, D., Foresta, C., Fugazzola, L., Ghigo, E., Giacchetti, G., Giorgino, F., Lenzi, A., Malandrino, P., Mannelli, M., Marcocci, C., Masi, L., Pacini, F., Opocher, G., Radicioni, A., Tonacchera, M., Vigneri, R., Zatelli, M. C., and Brandi, M. L.

Published
2015
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16. Prevalence and clinical characteristics of children and adolescents with metabolically healthy obesity:role of insulin sensitivity

Author

Vinciguerra, F. (Federica), Tumminia, A. (Andrea), Baratta, R. (Roberto), Ferro, A. (Alfredo), Alaimo, S. (Salvatore), Hagnäs, M. (Maria), Graziano, M. (Marco), Vigneri, R. (Riccardo), and Frittitta, L. (Lucia)

Subjects
children, insulin resistance, nutritional and metabolic diseases, metabolically healthy obesity, adolescents, metabolic syndrome
Abstract

Obesity represents a major risk factor for metabolic disorders, but some individuals, “metabolically healthy” (MHO), show less clinical evidence of these complications, in contrast to “metabolically unhealthy” (MUO) individuals. The aim of this cross-sectional study is to assess the prevalence of the MHO phenotype in a cohort of 246 overweight/obese Italian children and adolescents, and to evaluate their characteristics and the role of insulin resistance. Homeostasis model assessment–insulin resistance (HOMA-IR), insulin sensitivity index (ISI), insulinogenic index (IGI) and disposition index (DI) were all calculated from the Oral Glucose Tolerance Test (OGTT). MHO was defined by either: (1) HOMA-IR < 2.5 (MHO-IRes), or (2) absence of the criteria for metabolic syndrome (MHO-MetS). The MHO prevalence, according to MHO-MetS or MHO-IRes criteria, was 37.4% and 15.8%, respectively. ISI was the strongest predictor of the MHO phenotype, independently associated with both MHO-IRes and MHO-MetS. The MHO-MetS group was further subdivided into insulin sensitive or insulin resistant on the basis of HOMA-IR (either < or ≥ 2.5). Insulin sensitive MHO-MetS patients had a better metabolic profile compared to both insulin resistant MHO-MetS and MUO-MetS individuals. These data underscore the relevance of insulin sensitivity to identifying, among young individuals with overweight/obesity, the ones who have a more favorable metabolic phenotype.

Published
2020

42. Acromegaly is associated with increased cancer risk: a survey in Italy

Author

Terzolo, Massimo, Reimondo, Giuseppe, Berchialla, Paola, FERRANTE, EMANUELE, Malchiodi, Elena, De Marinis, Laura, Pivonello, Rosario, Grottoli, Silvia, Losa, Marco, Cannavo, Salvatore, Ferone, Diego, Montini, Marcella, Bondanelli, Marta, De Menis, Ernesto, Martini, Chiara, Puxeddu, Efisio, Velardo, Antonino, Peri, Alessandro, Faustini-Fustini, Marco, Tita, Patrizia, Pigliaru, Francesca, Peraga, Giulia, Borretta, Giorgio, Scaroni, Carla, Bazzoni, Nicoletta, Bianchi, Antonio, Berton, Alessandro, Serban, Andreea Liliana, Baldelli, Roberto, Fatti, Letizia Maria, Colao, Annamaria, Arosio, Maura, Lombardi, G., TRIMARCHI, LORENZO, Degli Uberti, E. C., Ambrosio, M. R., Pagani, G., Attanasio, R., Kara, E., Mantero, F., Ceccato, F., Mortini, P., Razzore, P., Angeletti, G., Della Torre, D., Mariotti, S., Ghigo, E., Mainini, A. L., Appetecchia, M., Vigneri, R., Minuto, F., Nazzari, E., Cavagnini, F., Persani, L., Terzolo, Massimo, Reimondo, Giuseppe, Berchialla, Paola, Ferrante, Emanuele, Malchiodi, Elena, De Marinis, Laura, Pivonello, Rosario, Grottoli, Silvia, Losa, Marco, Cannavo, Salvatore, Ferone, Diego, Montini, Marcella, Bondanelli, Marta, De Menis, Ernesto, Martini, Chiara, Puxeddu, Efisio, Velardo, Antonino, Peri, Alessandro, Faustini-Fustini, Marco, Tita, Patrizia, Pigliaru, Francesca, Peraga, Giulia, Borretta, Giorgio, Scaroni, Carla, Bazzoni, Nicoletta, Bianchi, Antonio, Berton, Alessandro, Serban, Andreea Liliana, Baldelli, Roberto, Fatti, Letizia Maria, Colao, Annamaria, Arosio, Maura for the Italian Study Group of Acromegaly, Arosio, Maura, Lombardi, G., Trimarchi, Lorenzo, Degli Uberti, E. C., Ambrosio, M. R., Pagani, G., Attanasio, R., Kara, E., Mantero, F., Ceccato, F., Mortini, P., Razzore, P., Angeletti, G., Della Torre, D., Mariotti, S., Ghigo, E., Mainini, A. L., Appetecchia, M., Vigneri, R., Minuto, F., Nazzari, E., Cavagnini, F., and Persani, L.

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Colorectal cancer, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, NO, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Neoplasms, Internal medicine, Gh IGF1, Acromegaly, Humans, Medicine, cancer, Family history, Thyroid cancer, Acromegaly cancer, Oncology, business.industry, GH, IGF1, acromegaly, Incidence, Risk Factor, Incidence (epidemiology), Cancer, Middle Aged, medicine.disease, Diabetes and Metabolism, Acromegaly, cancer, GH, IGF1, Italy, 030220 oncology & carcinogenesis, Neoplasm, Female, Cohort Studie, business, Kidney cancer, Human, Cohort study
Abstract

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 ± 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18–1.68, P P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55–5.34, P P

Published
2017

47. Characteristics of a nationwide cohort of patients presenting with isolated hypogonadotropic hypogonadism (IHH)

Author

Bonomi, M., Vezzoli, V., Krausz, C., Guizzardi, F., Vezzani, S., Simoni, M., Bassi, I., Duminuco, P., Di Iorgi, N., Giavoli, C., Pizzocaro, A., Russo, G., Moro, M., Fatti, L., Ferlin, A., Mazzanti, L., Zatelli, M. C., Cannavo, S., Isidori, A. M., Pincelli, A. I., Prodam, F., Mancini, A., Limone, P., Tanda, M. L., Gaudino, R., Salerno, M., Francesca, P., Maghnie, M., Maggi, M. C., Persani, L., Aimaretti, G., Altobell, M., Ambrosio, M. R., Andrioli, M., Angelett, G., Arecco, F., Arnald, G., Arosio, M., Balsamo, A., Baldassarr, M., Bartalena, L., Bazzon, N., Beccari, L., Beck-Peccoz, P., Bellastella, G., Bellizz, M., Benedicent, F., Bernasconi, S., Bizzarri, C., Bona, G., Bonadonna, S., Borrett, G., Boschetti, M., Brunani, A., Brunelli, V., Buz, F., Cacciatore, C., Cangiano, B., Cappa, M., Casalone, R., Cassio, A., Cavarzere, P., Cherubini, V., Ciampani, T., Cicognan, D., Cignarell, A., Cisternin, M., Colombo, P., Corbetta, S., Corciul, N., Corona, G., Cozzi, R., Crivellaro, C., Dalle Mule, I., Danesi, L., Eli, A. V. D., Degli Uberti, E., De Leo, S., Della Valle, E., De Marchi, M., Di Mambr, A., Fabbri, A., Foresta, C., Forti, G., Franceschi, A. R., Garolla, A., Ghezzi, M., Giacomozzi, C., Giusti, M., Grosso, E., Guabello, G., Guarneri, M. P., Grugni, G., Lanfranco, F., Lania, A., Lanzi, R., Larizza, L., Lenzi, A., Loche, S., Loli, P., Lombardi, V., Mandrile, G., Manieri, C., Mantovani, G., Marelli, S., Marzullo, M., Mencarelli, M. A., Migone, N., Motta, G., Neri, G., Padov, G., Parenti, G., Pasquino, B., Pia, A., Piantanida, E., Pignatti, E., Pilotta, A., Pivett, B., Pollazzon, M., Pontecorvi, A., Porcelli, P., Pozza, G. B., Pozzobon, G., Radetti, G., Razzore, P., Rocchett, L., Roncoron, R., Rossi, G., Sala, E., Salvatoni, A., Salvini, F., Secc, A., Segni, M., Selice, R., Sgaramella, P., Sileo, F., Sinisi, A. A., Sirchia, F., Spada, A., Tresoldi, A., Vigneri, R., Weber, G., Zucchini, S., Bassi I., Moro M., Pincelli A. I., Mancini A. (ORCID:0000-0002-7707-4564), Cappa M., Corbetta S., Corona G., Danesi L., Ghezzi M., Giusti M. (ORCID:0000-0001-5767-8785), Grugni G., Parenti G., Pontecorvi A. (ORCID:0000-0003-0570-6865), Sala E., Bonomi, M., Vezzoli, V., Krausz, C., Guizzardi, F., Vezzani, S., Simoni, M., Bassi, I., Duminuco, P., Di Iorgi, N., Giavoli, C., Pizzocaro, A., Russo, G., Moro, M., Fatti, L., Ferlin, A., Mazzanti, L., Zatelli, M. C., Cannavo, S., Isidori, A. M., Pincelli, A. I., Prodam, F., Mancini, A., Limone, P., Tanda, M. L., Gaudino, R., Salerno, M., Francesca, P., Maghnie, M., Maggi, M. C., Persani, L., Aimaretti, G., Altobell, M., Ambrosio, M. R., Andrioli, M., Angelett, G., Arecco, F., Arnald, G., Arosio, M., Balsamo, A., Baldassarr, M., Bartalena, L., Bazzon, N., Beccari, L., Beck-Peccoz, P., Bellastella, G., Bellizz, M., Benedicent, F., Bernasconi, S., Bizzarri, C., Bona, G., Bonadonna, S., Borrett, G., Boschetti, M., Brunani, A., Brunelli, V., Buz, F., Cacciatore, C., Cangiano, B., Cappa, M., Casalone, R., Cassio, A., Cavarzere, P., Cherubini, V., Ciampani, T., Cicognan, D., Cignarell, A., Cisternin, M., Colombo, P., Corbetta, S., Corciul, N., Corona, G., Cozzi, R., Crivellaro, C., Dalle Mule, I., Danesi, L., Eli, A. V. D., Degli Uberti, E., De Leo, S., Della Valle, E., De Marchi, M., Di Mambr, A., Fabbri, A., Foresta, C., Forti, G., Franceschi, A. R., Garolla, A., Ghezzi, M., Giacomozzi, C., Giusti, M., Grosso, E., Guabello, G., Guarneri, M. P., Grugni, G., Lanfranco, F., Lania, A., Lanzi, R., Larizza, L., Lenzi, A., Loche, S., Loli, P., Lombardi, V., Mandrile, G., Manieri, C., Mantovani, G., Marelli, S., Marzullo, M., Mencarelli, M. A., Migone, N., Motta, G., Neri, G., Padov, G., Parenti, G., Pasquino, B., Pia, A., Piantanida, E., Pignatti, E., Pilotta, A., Pivett, B., Pollazzon, M., Pontecorvi, A., Porcelli, P., Pozza, G. B., Pozzobon, G., Radetti, G., Razzore, P., Rocchett, L., Roncoron, R., Rossi, G., Sala, E., Salvatoni, A., Salvini, F., Secc, A., Segni, M., Selice, R., Sgaramella, P., Sileo, F., Sinisi, A. A., Sirchia, F., Spada, A., Tresoldi, A., Vigneri, R., Weber, G., Zucchini, S., Bassi I., Moro M., Pincelli A. I., Mancini A. (ORCID:0000-0002-7707-4564), Cappa M., Corbetta S., Corona G., Danesi L., Ghezzi M., Giusti M. (ORCID:0000-0001-5767-8785), Grugni G., Parenti G., Pontecorvi A. (ORCID:0000-0003-0570-6865), and Sala E.

Abstract

Objective: Isolated hypogonadotropic hypogonadism (IHH) is a rare disorder with pubertal delay, normal (normoosmic-IHH, nIHH) or defective sense of smell (Kallmann syndrome, KS). Other reproductive and nonreproductive anomalies might be present although information on their frequency are scanty, particularly according to the age of presentation. Design: Observational cohort study carried out between January 2008 and June 2016 within a national network of academic or general hospitals. Methods: We performed a detailed phenotyping of 503 IHH patients with: (1) manifestations of hypogonadism with low sex steroid hormone and low/normal gonadotropins; (2) absence of expansive hypothalamic/pituitary lesions or multiple pituitary hormone defects. Cohort was divided on IHH onset (PPO, pre-pubertal onset or AO, adult onset) and olfactory function: PPO-nIHH (n = 275), KS (n = 184), AO-nIHH (n = 36) and AO-doIHH (AO-IHH with defective olfaction, n = 8). Results: 90% of patients were classifed as PPO and 10% as AO. Typical midline and olfactory defects, bimanual synkinesis and familiarity for pubertal delay were also found among the AO-IHH. Mean age at diagnosis was signifcantly earlier and more frequently associated with congenital hypogonadism stigmata in patients with Kallmann's syndrome (KS). Synkinesis, renal and male genital tract anomalies were enriched in KS. Overweight/obesity are signifcantly associated with AO-IHH rather than PPO-IHH. Conclusions: Patients with KS are more prone to develop a severe and complex phenotype than nIHH. The presence of typical extra-gonadal defects and familiarity for PPO-IHH among the AO-IHH patients indicates a common predisposition with variable clinical expression. Overall, these fndings improve the understanding of IHH and may have a positive impact on the management of patients and their families.

Published
2018

49. Long-acting insulin analogs and cancer

Author

Sciacca, L., primary, Vella, V., additional, Frittitta, L., additional, Tumminia, A., additional, Manzella, L., additional, Squatrito, S., additional, Belfiore, A., additional, and Vigneri, R., additional

Published
2018
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50. Congenital Hypothyroidism due to Defects of Thyroid Development and Mild Increase of TSH at Screening: Data From the Italian National Registry of Infants With Congenital Hypothyroidism

Author

Olivieri A, Corbetta C, Weber G, Vigone MC, Fazzini C, Medda E, Angeloni U, Antonozzi I, Baserga M, Bernasconi S, Bona G, Bucci I, Calaciura F, Caldarera R, Camilot M, Cappa M, Caruso U, Casini M, Cavallo L, Cesaretti G, Chiarelli F, Ciannamea B, Ciatti R, Cicciò M, Cordova R, Correra A, Costa P, De Santis C, Di Maio S, Gallicchio G, Gastaldi R, Grasso G, Gurrado R, Lelli A, Leonardi D, Loche S, Lorini R, Manente G, Monaco F, Minelli G, Narducci P, Oggiano N, Pagliardini S, Parlato G, Pasquini E, Pinchera A, Pizzolante M, Radetti G, Righetti F, Rizzo A, Saggese G, Sala D, Salerno C, Sava L, Scognamiglio D, Stoppioni V, Tonacchera M, Vigneri R, Vignola G, De Luca F., CASSIO, ALESSANDRA, Olivieri, A, Corbetta, C, Weber, Giovanna, Vigone, Mc, Fazzini, C, Medda, E., Angeloni, U, Antonozzi, I, Baserga, M, Bernasconi, S, Bona, G, Bucci, I, Calaciura, F, Caldarera, R, Camilot, M, Cappa, M, Caruso, U, Casini, M, Cassio, A, Cavallo, L, Cesaretti, G, Chiarelli, F, Ciannamea, B, Ciatti, R, Cicciò, M, Cordova, R, Correra, A, Costa, P, De Santis, C, Di Maio, S, Gallicchio, G, Gastaldi, R, Grasso, G, Gurrado, R, Lelli, A, Leonardi, D, Loche, S, Lorini, R, Manente, G, Monaco, F, Minelli, G, Narducci, P, Oggiano, N, Pagliardini, S, Parlato, G, Pasquini, E, Pinchera, A, Pizzolante, M, Radetti, G, Righetti, F, Rizzo, A, Saggese, G, Sala, D, Salerno, Mariacarolina, Sava, L, Scognamiglio, D, Stoppioni, V, Tonacchera, M, Vigneri, R, Vignola, G, De Luca, F., Olivieri A, Corbetta C, Weber G, Vigone MC, Fazzini C, Medda E, Angeloni U, Antonozzi I, Baserga M, Bernasconi S, Bona G, Bucci I, Calaciura F, Caldarera R, Camilot M, Cappa M, Caruso U, Casini M, Cassio A, Cavallo L, Cesaretti G, Chiarelli F, Ciannamea B, Ciatti R, Cicciò M, Cordova R, Correra A, Costa P, De Santis C, Di Maio S, Gallicchio G, Gastaldi R, Grasso G, Gurrado R, Lelli A, Leonardi D, Loche S, Lorini R, Manente G, Monaco F, Minelli G, Narducci P, Oggiano N, Pagliardini S, Parlato G, Pasquini E, Pinchera A, Pizzolante M, Radetti G, Righetti F, Rizzo A, Saggese G, Sala D, Salerno C, Sava L, Scognamiglio D, Stoppioni V, Tonacchera M, Vigneri R, Vignola G, and De Luca F

Subjects
endocrine system, Pediatrics, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Thyroid Gland, Thyrotropin, IODINE, Context (language use), Infant, Premature, Diseases, Thyroid Function Tests, Biochemistry, Thyroid function tests, Thyroid dysgenesis, Severity of Illness Index, Endocrinology, Neonatal Screening, Thyroid Hormone Treatment, PRETERM INFANTS, Internal medicine, Congenital Hypothyroidism, Medicine, Humans, Registries, defects of thyroid development, Ultrasonography, Newborn screening, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Incidence, Biochemistry (medical), Thyroid, Infant, Newborn, medicine.disease, Congenital hypothyroidism, Up-Regulation, Thyroxine, medicine.anatomical_structure, Italy, Thyroid Dysgenesis, mild increase of TSH at screening, business, hormones, hormone substitutes, and hormone antagonists
Abstract

Context: Over the years lower TSH cutoffs have been adopted in some screening programs for congenital hypothyroidism (CH) worldwide. This has resulted in a progressive increase in detecting additional mild forms of the disease, essentially with normally located and shaped thyroid. However, the question of whether such additional mild CH cases can benefit from detection by newborn screening and early thyroid hormone treatment is still open. Objective: The aim of this study was to estimate the frequency of cases with mild increase of TSH at screening in the Italian population of babies with permanent CH and to characterize these babies in terms of diagnosis classification and neonatal features. Methods: Data recorded in the Italian National Registry of infants with CH were analyzed. Results: Between 2000 and 2006, 17 of the 25 Italian screening centers adopted a TSH cutoff at screening of < 15.0 mu U/mL. It was found that 21.6% of babies with permanent CH had TSH at screening of 15.0 mu U/mL or less, whereas this percentage was 54% in infants with transient hypothyroidism. Among the babies with permanent CH and mild increase of TSH at screening (

Published
2013

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