R Bonfanti1, G Lepore2, L Bozzetto3, A Corsi4, V Di Blasi5, A Girelli6, G Grassi7, D Iafusco8, I Rabbone9, R Schiaffini10, L Laviola11, D Bruttomesso12. 1. Pediatric Department and Diabetes Research Institute (OSR-DRI), IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy. bonfanti.riccardo@hsr.it. 2. Unit of Endocrine Disease and Diabetology, A.O Papa Giovanni XXIII, Bergamo, Italy. 3. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. 4. Unit of Diabetology and Endocrinology, P.O. Metropolitano, ASL 3, Genoa, Italy. 5. Department of Endocrinology and Diabetology, ASL Salerno, Salerno, Italy. 6. Unit of Diabetology, A.O. Spedali Civili, Brescia, Italy. 7. Division of Endocrinology, Diabetology and Metabolism, A.O Città della Salute e della Scienza, Turin, Italy. 8. Department of Pediatrics, Second University of Naples, Naples, Italy. 9. Department of Pediatrics, University of Turin, Turin, Italy. 10. Unit of Endocrinology and Diabetes, IRCCS Bambino Gesù Children's Hospital, Rome, Italy. 11. Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Aldo Moro, Bari, Italy. 12. Department of Medicine, DIMED, Metabolic Diseases, University of Padua, Padua, Italy.
Abstract
AIMS: The aim of the study was to evaluate and compare continuous subcutaneous insulin infusion (CSII) use in pediatric and adult age groups. METHODS: Data were collected with a questionnaire sent by e-mail to CSII-experienced Diabetes Centers. The questionnaire assessed: (1) number of CSII-treated patients; (2) patient demographic data and characteristics; (3) structure and organization of Diabetes Centers providing CSII therapy; (4) pump characteristics (conventional pump, sensor-augmented pump); and (5) CSII dropouts. RESULTS: A total of 217 out of 1093 Italian centers participated: 51 pediatric (23.5 %) and 166 (76.5 %) adult centers (AP). Compared to a survey performed in 2005, there was a significant increase in the number of pediatric units when compared to adult units (112 vs 37 %, respectively, p < 0.05). Pediatric age is characterized by a greater concern for quality of life and injections, and a higher dropout rate (10.6 vs 8.9 %) mainly related to pump wearability and site reactions. A complete diabetes-care team is associated with a superior use of technology (fewer dropouts, increased CGM and advanced bolus use) which is, however, still used in a small percentage of patients. CONCLUSIONS: In Italy, the number of CSII-treated pediatric patients (PP) is growing more significantly when compared to adults. Only 60 % of all patients are using advanced functions and 20 % are using CGMs continuously. This confirms the great interest in diabetes technology that is growing in pediatric diabetologists. However, much improvement is warranted in the organization and specialized training of pediatric, adult and transitional facilities.
AIMS: The aim of the study was to evaluate and compare continuous subcutaneous insulin infusion (CSII) use in pediatric and adult age groups. METHODS: Data were collected with a questionnaire sent by e-mail to CSII-experienced Diabetes Centers. The questionnaire assessed: (1) number of CSII-treated patients; (2) patient demographic data and characteristics; (3) structure and organization of Diabetes Centers providing CSII therapy; (4) pump characteristics (conventional pump, sensor-augmented pump); and (5) CSII dropouts. RESULTS: A total of 217 out of 1093 Italian centers participated: 51 pediatric (23.5 %) and 166 (76.5 %) adult centers (AP). Compared to a survey performed in 2005, there was a significant increase in the number of pediatric units when compared to adult units (112 vs 37 %, respectively, p < 0.05). Pediatric age is characterized by a greater concern for quality of life and injections, and a higher dropout rate (10.6 vs 8.9 %) mainly related to pump wearability and site reactions. A complete diabetes-care team is associated with a superior use of technology (fewer dropouts, increased CGM and advanced bolus use) which is, however, still used in a small percentage of patients. CONCLUSIONS: In Italy, the number of CSII-treated pediatric patients (PP) is growing more significantly when compared to adults. Only 60 % of all patients are using advanced functions and 20 % are using CGMs continuously. This confirms the great interest in diabetes technology that is growing in pediatric diabetologists. However, much improvement is warranted in the organization and specialized training of pediatric, adult and transitional facilities.
Authors: Maria Elena Lunati; Paola Silvia Morpurgo; Antonio Rossi; Alessandra Gandolfi; Irene Cogliati; Andrea Mario Bolla; Laura Plebani; Luciana Vallone; Laura Montefusco; Ida Pastore; Vincenzo Cimino; Sabrina Argenti; Graziella Volpi; Gian Vincenzo Zuccotti; Paolo Fiorina Journal: Front Endocrinol (Lausanne) Date: 2022-04-14 Impact factor: 6.055
Authors: J Milburn; M de Lange; E Wiltshire; P Ross; J Rayns; P Tomlinson; F Wu; I M Kumarasamy; J Armishaw; Benjamin J Wheeler Journal: J Diabetes Metab Disord Date: 2019-03-05