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

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

Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy

The incidence of type 1 diabetes in childhood is increasing by 3 % per year, placing growing demands on healthcare professionals and medical expenditures. Aim of this study wars to assess the organization of care to children with diabetes in Italy

Abdominal adiposity and cardiovascular risk factors in adolescents with type 1 diabetes.

AIM: To analyze the prevalence of abdominal adiposity and other traditional risk factors for cardiovascular disease in a large sample of Italian adolescents with type 1 diabetes mellitus (T1DM). METHODS: T1DM adolescents (n=412 age: 17.3 \ub1 0.9 years) were enrolled from 18 clinical centres. Anthropometric and laboratory parameters, blood pressure and data on insulin treatment were registered. Metabolic syndrome (MetSy) was defined according to the International Diabetes Federation criteria. RESULTS: Abdominal obesity was the most common risk factor (20.1%) in females, while hypertension in males (25.1%). MetSy was found in 9.5% patients, predominantly in females. Patients with MetSy exhibited higher insulin requirement per body surface area and higher glycated hemoglobin than patients without MetSy. Overweight/obese patients had a much higher prevalence of MetSy than normal weight patients. The logistic regression analysis showed that just waist-to-height ratio and insulin dose per body surface area contributed to discriminate subjects with the MetSy from those without. CONCLUSION: Adolescence is a critical period in determining risk of future vascular complications in T1DM. Pediatric diabetologists need to be aware of the considerable occurrence of abdominal adiposity and MetSy in T1DM patients, particularly in females, and should make every effort to achieve normal weight and better health outcome

Erratum: Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy

Unfortunately, the original version of this article [1] contained an error. The name of one of the authors from the Study Group for Diabetes of ISPED was included incorrectly and it read “A. Galero” instead of “A. Gaiero” in the Acknowledgements section

Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion

The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII)