Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0-18 years

After 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

Has COVID-19 Delayed the Diagnosis and Worsened the Presentation of Type 1 Diabetes in Children?

Objective: To evaluate whether the diagnosis of pediatric type 1 diabetes or its acute complications changed during the early phase of the coronavirus disease 2019 (COVID-19) pandemic in Italy. Research design and methods: This was a cross-sectional, Web-based survey of all Italian pediatric diabetes centers to collect diabetes, diabetic ketoacidosis (DKA), and COVID-19 data in patients presenting with new-onset or established type 1 diabetes between 20 February and 14 April in 2019 and 2020. Results: Fifty-three of 68 centers (77.9%) responded. There was a 23% reduction in new diabetes cases in 2020 compared with 2019. Among those newly diagnosed patient who presented in a state of DKA, the proportion with severe DKA was 44.3% in 2020 vs. 36.1% in 2019 (P = 0.03). There were no differences in acute complications. Eight patients with asymptomatic or mild COVID-19 had laboratory-confirmed severe acute respiratory syndrome coronavirus 2. Conclusions: The COVID-19 pandemic might have altered diabetes presentation and DKA severity. Preparing for any "second wave" requires strategies to educate and reassure parents about timely emergency department attendance for non-COVID-19 symptoms

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

To 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

Determination of alpha-dicarbonyl compounds in foods with a high content of free sugars

aplha-Dicarbonyl compounds are highly reactive substances found in foods and beverages. They are formed during processing, cooking and prolonged storage as end products of lipid peroxidation, microorganism metabolites, and caramelization or Maillard reaction products. Precise and accurate determination of their content in foods is important, because they exert both positive and negative effects on human health, even at low doses. The method most frequently applied to determine alpha-dicarbonyl compounds in foods and beverages involves their derivatization with 1,2- diaminobenzene, to obtain specific quinoxaline derivatives that can be detected by HPLC or GC. In the literature derivatization conditions vary widely, particularly the pH of the medium and temperature, without considering that alpha-dicarbonyl compounds can form as glucose and fructose fragmentation products. Our data demonstrate that derivatization conditions critically affect the fragmentation process in sugar-rich matrices. In this work we tested a range of derivatization conditions to find the combination that would allow accurate and precise determination of alpha-dicarbonyl compounds sugar-rich matrices. Formation of alpha-dicarbonyl compounds due to glucose and fructose fragmentation was found to be avoided by using an acidic medium (pH 3.0) at low temperature (25 °C) while allowing a derivatization yield close to 100% for the alpha-dicarbonyl compounds considered (methylglyoxal and diacetyl). Analysis of four types of red wine having different sugar contents (two table wines and two dessert wines) confirmed that these conditions prevent alpha-dicarbonyl compound overestimation as well as false positive results

Determination of alpha-dicarbonyl compounds in foods with a high content of free sugars

aplha-Dicarbonyl compounds are highly reactive substances found in foods and beverages. They are formed during processing, cooking and prolonged storage as end products of lipid peroxidation, microorganism metabolites, and caramelization or Maillard reaction products. Precise and accurate determination of their content in foods is important, because they exert both positive and negative effects on human health, even at low doses. The method most frequently applied to determine alpha-dicarbonyl compounds in foods and beverages involves their derivatization with 1,2- diaminobenzene, to obtain specific quinoxaline derivatives that can be detected by HPLC or GC. In the literature derivatization conditions vary widely, particularly the pH of the medium and temperature, without considering that alpha-dicarbonyl compounds can form as glucose and fructose fragmentation products. Our data demonstrate that derivatization conditions critically affect the fragmentation process in sugar-rich matrices. In this work we tested a range of derivatization conditions to find the combination that would allow accurate and precise determination of alpha-dicarbonyl compounds sugar-rich matrices. Formation of alpha-dicarbonyl compounds due to glucose and fructose fragmentation was found to be avoided by using an acidic medium (pH 3.0) at low temperature (25 °C) while allowing a derivatization yield close to 100% for the alpha-dicarbonyl compounds considered (methylglyoxal and diacetyl). Analysis of four types of red wine having different sugar contents (two table wines and two dessert wines) confirmed that these conditions prevent alpha-dicarbonyl compound overestimation as well as false positive results

Determinazione dei composti alfa-dicarbonilici in alimenti ad alto tenore di zuccheri

I composti alfa-dicarbonilici si trovano nei prodotti alimentari in quanto prodotti della reazione di Maillard e di caramellizzazione. Sono pertanto presenti in prodotti termicamente trattati quali pane e caffè tostato, ma anche in prodotti come vino rosso e bianco che hanno subito la fermentazione malolattica. Sono inoltre stati trovati negli oli vegetali e nel caffè verde dove si formano come prodotti finali della perossidazione lipidica. L’interesse per questi composti ha superato l’ambito analitico da quando ne sono state evidenziate le proprietà mutagene e citotossiche in vitro e genotossiche in animali da esperimento e si è volto alle possibili implicazioni tossicologiche della loro presenza negli alimenti. Tale interesse si è rinnovato da quando è stata evidenziata l’importanza dei prodotti di glicazione nello sviluppo delle malattie cardiovascolari, neurodegenerative e diabete. E’ stato infatti dimostrato che i derivati alfa-dicarbonilici portano in vivo alla formazione dei prodotti di glicazione avanzata ed è per questo molto attuale il dibattito riguardo le conseguenze della loro ingestione con gli alimenti. Numerosi sono i metodi proposti in letteratura per la determinazione dei composti alfa-dicarbonilici; il più utilizzato richiede la derivatizzazione con 1,2-diamminobenzene prima della determinazione delle risultanti chinossaline mediante CG-MS o RP-HPLC-DAD. Tuttavia tale metodo non trova applicazione generale a causa della variabilità delle matrici alimentari. Per la determinazione dei derivati alfa-dicarbonilici nel caffè è stata infatti necessaria l’estrazione di questi composti dalla bevanda prima della derivatizzazione per l’interferenza di un acido clorogenico. In altri alimenti, ricchi di zuccheri semplici, prodotti alfa-dicarbonilici si possono formare durante il processo di derivatizzazione, dipendentemente dalle condizioni di reazione, infatti, l’ambiente basico o/e le temperature indicate dalla gran parte degli autori, provocano la frammentazione degli zuccheri presenti e la formazione di diversi composti alfa-dicarbonilici. Questo determina falsi positivi o sovrastime dei derivati alfa-dicarbonilici effettivamente presenti nell’alimento. Scopo di questo lavoro è lo studio delle condizioni che permettano di ottenere una elevata resa di derivatizzazione senza provocare la frammentazione ossidativa degli zuccheri eventualmente presenti. L’analisi quali-quantitativa dei composti alfa-dicarbonilici derivatizzati è stata condotta mediante le tecniche RP-HPLC-DAD e RP-HPLC-ESI-MS ed applicata a differenti matrici alimentari ad alto tenore zuccherino

Isolation of high molecular weight components and contribution to the protective activity of coffee against lipid peroxidation in a rat liver microsome system.

One of the most extensively studied and best-established properties of coffee is its antioxidant activity. We have shown that coffee brew has the ability to inhibit lipid peroxidation completely in a rat liver microsome biological system. The inhibitory activity was mainly due to the high molecular weight (HMW) fraction; this consisted of five components that were isolated, purified, and seen to occur in different amounts in the brew. Each component had different spectra and element compositions, although they all contained nitrogen. HMW, nitrogen content, and brown color enabled three components to be attributed to the melanoidin family; the two nonbrown components could not be considered as melanoidins. Each melanoidin and nonmelanoidin component contributes to a different extent to the protective action exerted by coffee brew. None of the isolated components completely inhibited microsomal lipid peroxidation alone, suggesting that each acts at different sites and/or possesses different mechanisms of action. The protective activity of coffee brew is thus underpinned by the antiradical properties, reducing power, and metal chelating ability of the individual components, each contributing to a different extent

Isolation and determination of alpha-dicarbonyl compounds by RP-HPLC-DAD in green and roasted coffee

Glyoxal, methylglyoxal, and diacetyl formed as Maillard reaction products in heat-treated food were determined in coffee extracts (coffee brews) obtained from green beans and beans with different degrees of roast. The compounds have been reported to be mutagenic in vitro and genotoxic in experimental animals in a number of papers. More recently, α-dicarbonyl compounds have been implicated in the glycation process. Our data show that small amounts of glyoxal and methylglyoxal occur naturally in green coffee beans. Their concentrations increase in the early phases of the roasting process and then decline. Conversely, diacetyl is not found in green beans and forms later in the roasting process. Therefore, light and medium roasted coffees had the highest glyoxal and methylglyoxal content, whereas dark roasted coffee contained smaller amounts of glyoxal, methylglyoxal, and diacetyl. For the determination of coffee α-dicarbonyl compounds, a reversed-phase high performance liquid chromatography with a diode array detector (RP-HPLC-DAD) method was devised that involved the elimination of interfering compounds, such as chlorogenic acids, by solid phase extraction (SPE) and their derivatization with 1,2-diaminobenzene to give quinoxaline derivatives. Checks of SPE and derivatization conditions to verify recovery and yield, respectively, resulted in rates of 100%. The results of the validation procedure showed that the proposed method is selective, precise, accurate, and sensitive

Determinazione dei composti alfa-dicarbonilici in alimenti ad alto tenore di zuccheri

I composti alfa-dicarbonilici si trovano nei prodotti alimentari in quanto prodotti della reazione di Maillard e di caramellizzazione. Sono pertanto presenti in prodotti termicamente trattati quali pane e caffè tostato, ma anche in prodotti come vino rosso e bianco che hanno subito la fermentazione malolattica. Sono inoltre stati trovati negli oli vegetali e nel caffè verde dove si formano come prodotti finali della perossidazione lipidica. L’interesse per questi composti ha superato l’ambito analitico da quando ne sono state evidenziate le proprietà mutagene e citotossiche in vitro e genotossiche in animali da esperimento e si è volto alle possibili implicazioni tossicologiche della loro presenza negli alimenti. Tale interesse si è rinnovato da quando è stata evidenziata l’importanza dei prodotti di glicazione nello sviluppo delle malattie cardiovascolari, neurodegenerative e diabete. E’ stato infatti dimostrato che i derivati alfa-dicarbonilici portano in vivo alla formazione dei prodotti di glicazione avanzata ed è per questo molto attuale il dibattito riguardo le conseguenze della loro ingestione con gli alimenti. Numerosi sono i metodi proposti in letteratura per la determinazione dei composti alfa-dicarbonilici; il più utilizzato richiede la derivatizzazione con 1,2-diamminobenzene prima della determinazione delle risultanti chinossaline mediante CG-MS o RP-HPLC-DAD. Tuttavia tale metodo non trova applicazione generale a causa della variabilità delle matrici alimentari. Per la determinazione dei derivati alfa-dicarbonilici nel caffè è stata infatti necessaria l’estrazione di questi composti dalla bevanda prima della derivatizzazione per l’interferenza di un acido clorogenico. In altri alimenti, ricchi di zuccheri semplici, prodotti alfa-dicarbonilici si possono formare durante il processo di derivatizzazione, dipendentemente dalle condizioni di reazione, infatti, l’ambiente basico o/e le temperature indicate dalla gran parte degli autori, provocano la frammentazione degli zuccheri presenti e la formazione di diversi composti alfa-dicarbonilici. Questo determina falsi positivi o sovrastime dei derivati alfa-dicarbonilici effettivamente presenti nell’alimento. Scopo di questo lavoro è lo studio delle condizioni che permettano di ottenere una elevata resa di derivatizzazione senza provocare la frammentazione ossidativa degli zuccheri eventualmente presenti. L’analisi quali-quantitativa dei composti alfa-dicarbonilici derivatizzati è stata condotta mediante le tecniche RP-HPLC-DAD e RP-HPLC-ESI-MS ed applicata a differenti matrici alimentari ad alto tenore zuccherino