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1. 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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6. Growing up with type 1 diabetes mellitus: Data from the Verona Diabetes Transition Project.

Author

Pasquini, Silvia, Rinaldi, Elisabetta, Da Prato, Giuliana, Csermely, Alessandro, Indelicato, Liliana, Zaffani, Silvana, Santi, Lorenza, Sabbion, Alberto, Maffeis, Claudio, Bonora, Enzo, and Trombetta, Maddalena

Subjects
GLYCOSYLATED hemoglobin, TRANSITION to adulthood, ANALYSIS of variance, TRANSITIONAL care, RESEARCH methodology, GLYCEMIC control, TYPE 1 diabetes, INTERVIEWING, DESCRIPTIVE statistics, CHI-squared test, FACTOR analysis, DATA analysis software
Abstract

Aim: Transition from paediatric to adult care is a critical step in life of emerging adults with type 1 diabetes. We assessed, according to indicators established by panel of experts, clinical, socio‐demographic and psychosocial factors in young adults with type 1 diabetes throughout structured transition to investigate the associations, if any, with HbA1c value at time of transition. Methods: The "Verona Diabetes Transition Project" started in January 2009: a structured transition program, shared between paediatric and adult clinic, was organised with a multi‐disciplinary team. All young adults underwent a semi‐structured interview by a psychologist, before transition. Minimum age for transition was 18 years. Results: 222 (M/F = 113/109) young adults moved to adult care from January 2009 to March 2020. The mean time between the last paediatric visit and the first adult visit ranged from 13.6 ± 6.1 months at the beginning of the project to 3.6 ± 11.5 months over the following years. At first adult clinic attendance, women showed higher HbA1c values (70 ± 11 mmol/mol vs. 65 ± 7 mmol/mol or 8.57% ± 1.51% vs. 8.14% ± 0.98%, p = 0.01), higher frequency of disorders of eating behaviours (15.6% vs. 0%, p < 0.001) and poor diabetes acceptance (23.9% vs. 9.7%, p < 0.001) than men. Mediation analyses showed a significant mediating role of glucose control 2 years before transition in the relationship between poor diabetes acceptance and glucose control at transition. Conclusions: This study demonstrated a delay reduction in establishing care with an adult provider and suggested the potential role of low diabetes acceptance on glycemic control at transition. Further studies are needed to confirm and expand these data. [ABSTRACT FROM AUTHOR]

Published
2022
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8. The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey

Author

Gesuita, Rosaria, Skrami, Edlira, Bonfanti, Riccardo, Cipriano, Paola, Ferrito, Lucia, Frongia, Paola, Iannilli, Antonio, Lombardo, Fortunato, Mozzillo, Enza, Paleari, Renata, Rabbone, Ivana, Sabbion, Alberto, Salvatoni, Alessandro, Scaramuzza, Andrea, Schiaffini, Riccardo, Sulli, Nicoletta, Toni, Sonia, Carle, Flavia, Cherubini, Valentino, IAFUSCO, Dario, Gesuita, R., Skrami, E., Bonfanti, R., Cipriano, P., Ferrito, L., Frongia, P., Iafusco, D., Iannilli, A., Lombardo, F., Mozzillo, E., Paleari, R., Rabbone, I., Sabbion, A., Salvatoni, A., Scaramuzza, A., Schiaffini, R., Sulli, N., Toni, S., Carle, F., Cherubini, V., Gesuita, Rosaria, Skrami, Edlira, Bonfanti, Riccardo, Cipriano, Paola, Ferrito, Lucia, Frongia, Paola, Iafusco, Dario, Iannilli, Antonio, Lombardo, Fortunato, Mozzillo, Enza, Paleari, Renata, Rabbone, Ivana, Sabbion, Alberto, Salvatoni, Alessandro, Scaramuzza, Andrea, Schiaffini, Riccardo, Sulli, Nicoletta, Toni, Sonia, Carle, Flavia, and Cherubini, Valentino

Subjects
Glycated Hemoglobin A, Adolescent, Endocrinology, Diabetes and Metabolism, Mothers, Pediatrics, socioeconomic status, Diabetic, Endocrinology, Insulin Infusion Systems, Cost of Illness, Diet, Diabetic, Internal Medicine, Humans, Hypoglycemic Agents, Insulin, Socioeconomic statu, Child, Glycated Hemoglobin, child, Perinatology and Child Health, Combined Modality Therapy, child – Hb A1c – qualityof life – socioeconomic status – type1 diabetes mellitus, Hypoglycemia, Diet, Diabetes and Metabolism, Cross-Sectional Studies, Diabetes Mellitus, Type 1, quality of life, Italy, Socioeconomic Factors, Health Care Surveys, Hyperglycemia, Pediatrics, Perinatology and Child Health, Hb A1c, quality of life, socioeconomic status, type 1 diabetes mellitus, Adolescent, Child, Combined Modality Therapy, Cost of Illness, Cross-Sectional Studies, Diet, Diabetic, Educational Status, Glycated Hemoglobin A, Health Care Surveys, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Insulin, Italy, Mothers, Socioeconomic Factors, Insulin Infusion Systems, Internal Medicine, Pediatrics, Perinatology and Child Health, Endocrinology, Diabetes and Metabolism, Quality of Life, Educational Status, Hb A1c, type 1 diabetes mellitus, Type 1 diabetes mellitu
Abstract

Objective: To identify the role of the family's socio-economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes. Methods: In this cross-sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA1c values

Published
2015

9. Il pancreas artificiale in età pediatrica: Prima esperienza Italiana

Author

Federico Boscari, Simone Del Favero, Messori, M., Rabbone, I., Bonfanti, R., Sabbion, Alberto, Iafusco, D., Schiaffini, R., Roberto Visentin, Calore, R., Leal Moncada, Yenny Teresa, Galasso, S., Alfonso Galderisi, Vallone, V., Di Palma, F., Eleonora Losiouk, Lanzola, G., Tinti, D., Rigamonti, A., Marigliano, M., Zanfardino, A., Rapini, N., ANGELO AVOGARO, Chernavvsky, Daniel, Magni, L., Claudio Cobelli, Bruttomesso, Daniela, Boscari, F, Del Favero, S., Messori, M., Rabbone, I., Bonfanti, R., Sabbion, A., Iafusco, Dario, Schiaffini, R., Visentin, R., Calore, R., Leal, Y., Galasso, S., Galderisi, A., Vallone, V., Di Palma, F., Losiouk, E., Lanzola, G., Tinti, D., Rigamonti, A., Marigliano, M., Zanfardino, A., Rapini, N., Avogaro, A., Chernavvsky, D., Magni, L., Cobelli, C., and Bruttomesso, Daniela

Subjects
Diabetes and Metabolism, Endocrinology, Endocrinology, Diabetes and Metabolism, Artificial pancreas, Hypoglycemia, Type 1 diabetes mellitus in children, Internal Medicine, Artificial pancrea
Abstract

Background. The artificial pancreas (AP) system based on the Modular Model Predictive Control algorithm (MMPC) running on the wearable platform Diabetes Assistant (DiAs) has been used in adult outpatients with type 1 diabetes (T1D), reducing the time spent in hypoglycemia and increasing the time spent in the near-normal range of 70-180 mg/dl compared to Sensor Augmented Pump therapy (SAP). Objective. In the PEDiatric ARtificial PANcreas (PedArPan) project we tested a children-specific version of the MMPC on DiAs in 5-9 yearold children during a summer camp. This is the first outpatient AP trial in a population of this age. Study design and methods. Thirty 5-9 year-old children with T1D and their parents were recruited from five Italian pediatric centers and completed an open label, randomized, crossover trial in a summer camp (supervised outpatient setting). Glucose control in three days of AP use was compared with three days of parent-managed SAP. Results. Overnight (00:00-07:30). The AP significantly reduced time-in-hypo compared to SAP, 0% [0.00-2.22] vs. 2.19% [0.00- 12.30], p = 0.002, with no significant difference in time-in-target (70-180 mg/dl), 55.97% (22.53) vs. 59.69% (21.24), p = 0.430, or time-in-tight-target (80-140 mg/dl), 31.27% (20.23) vs. 33.02% (19.80), p = 0.694. Overall (00:00-24:00). There was a threefold reduction of time-in-hypo, 2.02% [1.17-4.54] vs. 6.67% [2.26-11.54], p < 0.001, with AP at the expense of some deterioration of time-in-target, 56.79% (13.47) vs. 63.09% (10.98), p = 0.022. Conclusions. This study showed the feasibility and safety of a wearable MMPC in young children. Next steps will include overnight testing at home and re-tuning the algorithm to boost efficacy during daytime.

Published
2016

10. Evaluating the Experience of Children With Type 1 Diabetes and Their Parents Taking Part in an Artificial Pancreas Clinical Trial Over Multiple Days in a Diabetes Camp Setting

Author

Troncone, Alda, primary, Bonfanti, Riccardo, additional, Iafusco, Dario, additional, Rabbone, Ivana, additional, Sabbion, Alberto, additional, Schiaffini, Riccardo, additional, Galderisi, Alfonso, additional, Marigliano, Marco, additional, Rapini, Novella, additional, Rigamonti, Andrea, additional, Tinti, Davide, additional, Vallone, Valeria, additional, Zanfardino, Angela, additional, Boscari, Federico, additional, Del Favero, Simone, additional, Galasso, Silvia, additional, Lanzola, Giordano, additional, Messori, Mirko, additional, Di Palma, Federico, additional, Visentin, Roberto, additional, Calore, Roberta, additional, Leal, Yenny, additional, Magni, Lalo, additional, Losiouk, Eleonora, additional, Chernavvsky, Daniel, additional, Quaglini, Silvana, additional, Cobelli, Claudio, additional, and Bruttomesso, Daniela, additional

Published
2016
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11. Randomized Summer Camp Crossover Trial in 5- to 9-Year-Old Children: Outpatient Wearable Artificial Pancreas Is Feasible and Safe

Author

Del Favero, Simone, primary, Boscari, Federico, additional, Messori, Mirko, additional, Rabbone, Ivana, additional, Bonfanti, Riccardo, additional, Sabbion, Alberto, additional, Iafusco, Dario, additional, Schiaffini, Riccardo, additional, Visentin, Roberto, additional, Calore, Roberta, additional, Moncada, Yenny Leal, additional, Galasso, Silvia, additional, Galderisi, Alfonso, additional, Vallone, Valeria, additional, Di Palma, Federico, additional, Losiouk, Eleonora, additional, Lanzola, Giordano, additional, Tinti, Davide, additional, Rigamonti, Andrea, additional, Marigliano, Marco, additional, Zanfardino, Angela, additional, Rapini, Novella, additional, Avogaro, Angelo, additional, Chernavvsky, Daniel, additional, Magni, Lalo, additional, Cobelli, Claudio, additional, and Bruttomesso, Daniela, additional

Published
2016
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12. The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey

Author

Gesuita, Rosaria, primary, Skrami, Edlira, additional, Bonfanti, Riccardo, additional, Cipriano, Paola, additional, Ferrito, Lucia, additional, Frongia, Paola, additional, Iafusco, Dario, additional, Iannilli, Antonio, additional, Lombardo, Fortunato, additional, Mozzillo, Enza, additional, Paleari, Renata, additional, Rabbone, Ivana, additional, Sabbion, Alberto, additional, Salvatoni, Alessandro, additional, Scaramuzza, Andrea, additional, Schiaffini, Riccardo, additional, Sulli, Nicoletta, additional, Toni, Sonia, additional, Carle, Flavia, additional, and Cherubini, Valentino, additional

Published
2016
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14. The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey.

Author

Gesuita, Rosaria, Skrami, Edlira, Bonfanti, Riccardo, Cipriano, Paola, Ferrito, Lucia, Frongia, Paola, Iafusco, Dario, Iannilli, Antonio, Lombardo, Fortunato, Mozzillo, Enza, Paleari, Renata, Rabbone, Ivana, Sabbion, Alberto, Salvatoni, Alessandro, Scaramuzza, Andrea, Schiaffini, Riccardo, Sulli, Nicoletta, Toni, Sonia, Carle, Flavia, and Cherubini, Valentino

Subjects
TYPE 1 diabetes, CONFIDENCE intervals, GLYCOSYLATED hemoglobin, INSULIN, MOTHERS, LOGISTIC regression analysis, SOCIOECONOMIC factors, EDUCATIONAL attainment, CROSS-sectional method, ODDS ratio, PREVENTION
Abstract

Objective To identify the role of the family's socio-economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes. Methods In this cross-sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA1c values <7.5% (<58 mmol/mol). A multiple correspondence analysis ( MCA) was performed to analyze the association between the socio-economic and clinical characteristics of the participants. A logistic regression analysis was performed to identify factors associated with the subjects metabolic control. In both analyses, the family's socio-economic status was represented, measured by the Hollingshead Four-Factor Index of Social Status ( SES) or by parental years of education. Results A total of 28.1% of subjects reached target HbA1c values. The MCA identified a strong association between at-target condition and several factors: high levels of SES or high levels of parental education, the use of the carbohydrate counting system, the use of insulin pumps, the use of the insulin delivery system over a short period of time, a normal body mass index. The logistic regression analysis showed that SES and the mother's years of education were significantly associated with the target condition [odds ratio ( OR): 1.01, 95% confidence interval ( CI): 1.01-1.03, p = 0.029; OR: 1.05, 95% CI: 1.01-1.10, p = 0.027, respectively). Conclusions Personal, clinical, and family characteristics were found to be associated with HbA1c target. Their identification can be crucial in addressing strategies to optimize metabolic control and improve diabetes management. [ABSTRACT FROM AUTHOR]

Published
2017
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15. Asma nei bambini

Author

Peroni, Diego, Piacentini, Giorgio, Sabbion, Alberto, and Boner, Attilio

Subjects
Bambini, Asma, Terapia
Published
2003

17. Diet, physical, and biochemical characteristics of children and adolescents with type 1 diabetes: relationship between dietary fat and glucose control

Author

Maffeis, Claudio, primary, Morandi, Anita, additional, Ventura, Emily, additional, Sabbion, Alberto, additional, Contreas, Giovanna, additional, Tomasselli, Francesca, additional, Tommasi, Mara, additional, Fasan, Ilaria, additional, Costantini, Silvia, additional, and Pinelli, Leonardo, additional

Published
2011
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18. A retrospective analysis of 24-month real-world glucose control for children and adolescents with type 1 diabetes using the MiniMed™ 670G insulin pump

Author

Maurizio Delvecchio, Alessio Galati, Claudio Maffeis, Stefano Passanisi, Riccardo Bonfanti, Roberto Franceschi, Gianluca Tornese, Elena Calzi, Angela Zanfardino, Giulia Patrizia Bracciolini, Elvira Piccinno, Alberto Sabbion, Fortunato Lombardo, Elena Fornari, Giuseppina Salzano, Andrea Rigamonti, Francesco Scialabba, Vittoria Cauvin, Elena Faleschini, Dario Iafusco, Caterina Grosso, Cinzia Ciullo, Graziella Fichera, Irene Rutigliano, Delvecchio, Maurizio, Galati, Alessio, Maffeis, Claudio, Passanisi, Stefano, Bonfanti, Riccardo, Franceschi, Roberto, Tornese, Gianluca, Calzi, Elena, Zanfardino, Angela, Patrizia Bracciolini, Giulia, Piccinno, Elvira, Sabbion, Alberto, Lombardo, Fortunato, Fornari, Elena, Salzano, Giuseppina, Rigamonti, Andrea, Scialabba, Francesco, Cauvin, Vittoria, Faleschini, Elena, Iafusco, Dario, Grosso, Caterina, Ciullo, Cinzia, Fichera, Graziella, and Rutigliano, Irene

Subjects
continuous glucose monitoring (CGM), CSII, insulin pump therapy, realworld evidence, type 1 diabetes
Abstract

The MiniMed™ 670G insulin pump was the first hybrid closed-loop (HCL) system available for clinical use. Data on metabolic outcomes in children, adolescents and young adults over the first 12 months with auto-mode use of this device are available, but no data with longer follow-up have been published. We aimed to assess the metabolic outcomes in children and adolescents using the MiniMed™ 670G for 24 months.

Published
2022

19. 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

20. Randomized Summer Camp Crossover Trial in 5- to 9-Year-Old Children: Outpatient Wearable Artificial Pancreas Is Feasible and Safe

Author

Giordano Lanzola, Davide Tinti, Simone Del Favero, Alfonso Galderisi, Angelo Avogaro, Yenny Leal Moncada, Daniela Bruttomesso, Silvia Galasso, Andrea Rigamonti, Lalo Magni, Valeria Vallone, Daniel R. Cherñavvsky, Federico Di Palma, Federico Boscari, Dario Iafusco, Marco Marigliano, Novella Rapini, Claudio Cobelli, Eleonora Losiouk, Ivana Rabbone, Riccardo Schiaffini, Riccardo Bonfanti, Roberta Calore, Roberto Visentin, Mirko Messori, A. Sabbion, Angela Zanfardino, Del Favero, S., Boscari, F., Messori, M., Rabbone, I., Bonfanti, R., Sabbion, A., Iafusco, D., Schiaffini, R., Visentin, R., Calore, R., Moncada, Y. L., Galasso, S., Galderisi, A., Vallone, V., Di Palma, F., Losiouk, E., Lanzola, G., Tinti, D., Rigamonti, A., Marigliano, M., Zanfardino, A., Rapini, N., Avogaro, A., Chernavvsky, D., Magni, L., Cobelli, C., Bruttomesso, D., Del Favero, Simone, Boscari, Federico, Messori, Mirko, Rabbone, Ivana, Bonfanti, Riccardo, Sabbion, Alberto, Iafusco, Dario, Schiaffini, Riccardo, Visentin, Roberto, Calore, Roberta, Moncada, Yenny Leal, Galasso, Silvia, Galderisi, Alfonso, Vallone, Valeria, Di Palma, Federico, Losiouk, Eleonora, Lanzola, Giordano, Tinti, Davide, Rigamonti, Andrea, Marigliano, Marco, Zanfardino, Angela, Rapini, Novella, Avogaro, Angelo, Chernavvsky, Daniel, Magni, Lalo, Cobelli, Claudio, and Bruttomesso, Daniela

Subjects
Blood Glucose, Male, Pediatrics, Endocrinology, Diabetes and Metabolism, law.invention, Endocrinology, 0302 clinical medicine, Randomized controlled trial, law, Insulin, 030212 general & internal medicine, Child, education.field_of_study, Cross-Over Studies, Diabetes and Metabolism, Anesthesia, Child, Preschool, Artificial, Female, Algorithms, Type 1, Pancreas, Artificial, medicine.medical_specialty, Population, 030209 endocrinology & metabolism, Hypoglycemia, Artificial pancreas, 03 medical and health sciences, Insulin Infusion Systems, Internal Medicine, Advanced and Specialized Nursing, Diabetes mellitus, medicine, Summer camp, Diabetes Mellitus, Humans, Hypoglycemic Agents, education, Preschool, Pancreas, Type 1 diabetes, business.industry, Diabetes Mellitus, Type 1, Feasibility Studies, medicine.disease, Crossover study, business
Abstract

OBJECTIVE The Pediatric Artificial Pancreas (PedArPan) project tested a children-specific version of the modular model predictive control (MMPC) algorithm in 5- to 9-year-old children during a camp. RESEARCH DESIGN AND METHODS A total of 30 children, 5- to 9-years old, with type 1 diabetes completed an outpatient, open-label, randomized, crossover trial. Three days with an artificial pancreas (AP) were compared with three days of parent-managed sensor-augmented pump (SAP). RESULTS Overnight time-in-hypoglycemia was reduced with the AP versus SAP, median (25th–75th percentiles): 0.0% (0.0–2.2) vs. 2.2% (0.0–12.3) (P = 0.002), without a significant change of time-in-target, mean: 56.0% (SD 22.5) vs. 59.7% (21.2) (P = 0.430), but with increased mean glucose 173 mg/dL (36) vs. 150 mg/dL (39) (P = 0.002). Overall, the AP granted a threefold reduction of time-in-hypoglycemia (P < 0.001) at the cost of decreased time-in-target, 56.8% (13.5) vs. 63.1% (11.0) (P = 0.022) and increased mean glucose 169 mg/dL (23) vs. 147 mg/dL (23) (P < 0.001). CONCLUSIONS This trial, the first outpatient single-hormone AP trial in a population of this age, shows feasibility and safety of MMPC in young children. Algorithm retuning will be performed to improve efficacy.

Published
2016

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