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

Authors :
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.
Prisco, Francesco
Source :
Journal of Diabetes Research, Journal of Diabetes Research, Vol 2016 (2016)
Publication Year :
2016

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.

Details

Language :
English
Database :
OpenAIRE
Journal :
Journal of Diabetes Research, Journal of Diabetes Research, Vol 2016 (2016)
Accession number :
edsair.doi.dedup.....7a9c0f8b00b78e06c5b22cc58ac5a6c7