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

Stefano Zucchini, Andrea Scaramuzza, Riccardo Bonfanti, Pietro Buono, F. Cardella, Vittoria Cauvin, Valentino Cherubini, Giovanni Chiari, Giuseppe D'Annunzio, Anna Paola Frongia, D. Iafusco, Giulio Maltoni, Ippolita Patrizia Patera, Sonia Toni, Stefano Tumini, Ivana Rabbone, R. Lera, A. Bobbio, A. Gualtieri, E. PiccinnoC. Zecchino, Bruno Pasquino, B. Felappi, E. Prandi, F. Gallo, G. Morganti, C. Ripoli, G. Cardinale, G. Ponzi, V. Castaldo, F. Stamati, D. Lo Presti, L. Tomaselli, F. Citriniti, T. Suprani, M. Bensa, V. Graziani, F. De Berardinis, F. Chiarelli, R. De Marco, N. Lazzaro, V. De Donno, P. Banin, B. Piccini, L. Lenzi, B. Mainetti, M. S. Coccioli, Nicola Minuto, Renata Lorini, M. Trada, P. Sogno Valin, L. Beccaria, S. Lucchesi, M. Bruzzese, F. Mammì, D. Cirillo, D. Pardi, R. A. Taccardi, F. Lombardo, Gian Vincenzo Zuccotti, Franco Meschi, L. Iughetti, B. Predieri, A. Franzese, E. Mozzillo, F. Prisco, Francesco Cadario, S. Savastio, G. Piredda, C. Monciotti, A. Galderisi, C. Salvo, Valeria Calcaterra, M. G. Berioli, G. Federico, A. Favia, G. Zanette, A. Marsciani, Riccardo Schiaffini, Marco Cappa, Maurizio Delvecchio, A. Gaiero, G. Ignaccolo, F. Cerutti, F. Fontana, L. Guerraggio, S. Zonca, R. Franceschi, Gianluca Tornese, M. Biagioni, A. Salvatoni, R. Cardani, M. Marigliano, A. Sabbion, C. Maffeis, E. Schieven, C. Arnaldi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article number5719470
JournalJournal of Diabetes Research
Volume2016
DOIs
Publication statusPublished - 2016

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Diabetic Ketoacidosis
Type 1 Diabetes Mellitus
Preschool Children
Bicarbonates
Tertiary Care Centers
Guidelines
Insulin
Pediatrics
Endocrinology
Fluid Therapy
Brain Edema
Therapeutics
Surveys and Questionnaires

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes. / Zucchini, Stefano; Scaramuzza, Andrea; Bonfanti, Riccardo; Buono, Pietro; Cardella, F.; Cauvin, Vittoria; Cherubini, Valentino; Chiari, Giovanni; D'Annunzio, Giuseppe; Frongia, Anna Paola; Iafusco, D.; Maltoni, Giulio; Patera, Ippolita Patrizia; Toni, Sonia; Tumini, Stefano; Rabbone, Ivana; Lera, R.; Bobbio, A.; Gualtieri, A.; Piccinno, E.; Zecchino, C.; Pasquino, Bruno; 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, Nicola; Lorini, Renata; Trada, M.; Sogno Valin, P.; Beccaria, L.; Lucchesi, S.; Bruzzese, M.; Mammì, F.; Cirillo, D.; Pardi, D.; Taccardi, R. A.; Lombardo, F.; Zuccotti, Gian Vincenzo; Meschi, Franco; Iughetti, L.; Predieri, B.; Franzese, A.; Mozzillo, E.; Prisco, F.; Cadario, Francesco; Savastio, S.; Piredda, G.; Monciotti, C.; Galderisi, A.; Salvo, C.; Calcaterra, Valeria; Berioli, M. G.; Federico, G.; Favia, A.; Zanette, G.; Marsciani, A.; Schiaffini, Riccardo; Cappa, Marco; Delvecchio, Maurizio; Gaiero, A.; Ignaccolo, G.; Cerutti, F.; Fontana, F.; Guerraggio, L.; Zonca, S.; Franceschi, R.; Tornese, Gianluca; Biagioni, M.; Salvatoni, A.; Cardani, R.; Marigliano, M.; Sabbion, A.; Maffeis, C.; Schieven, E.; Arnaldi, C.

In: Journal of Diabetes Research, Vol. 2016, 5719470, 2016.

Research output: Contribution to journalArticle

Zucchini, S, Scaramuzza, A, Bonfanti, R, Buono, P, Cardella, F, Cauvin, V, Cherubini, V, Chiari, G, D'Annunzio, G, Frongia, AP, Iafusco, D, Maltoni, G, Patera, IP, Toni, S, Tumini, S, Rabbone, I, 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, MS, Minuto, N, Lorini, R, Trada, M, Sogno Valin, P, Beccaria, L, Lucchesi, S, Bruzzese, M, Mammì, F, Cirillo, D, Pardi, D, Taccardi, RA, Lombardo, F, Zuccotti, GV, Meschi, F, Iughetti, L, Predieri, B, Franzese, A, Mozzillo, E, Prisco, F, Cadario, F, Savastio, S, Piredda, G, Monciotti, C, Galderisi, A, Salvo, C, Calcaterra, V, Berioli, MG, 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 2016, 'A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes', Journal of Diabetes Research, vol. 2016, 5719470. https://doi.org/10.1155/2016/5719470
Zucchini, Stefano ; Scaramuzza, Andrea ; Bonfanti, Riccardo ; Buono, Pietro ; Cardella, F. ; Cauvin, Vittoria ; Cherubini, Valentino ; Chiari, Giovanni ; D'Annunzio, Giuseppe ; Frongia, Anna Paola ; Iafusco, D. ; Maltoni, Giulio ; Patera, Ippolita Patrizia ; Toni, Sonia ; Tumini, Stefano ; Rabbone, Ivana ; Lera, R. ; Bobbio, A. ; Gualtieri, A. ; Piccinno, E. ; Zecchino, C. ; Pasquino, Bruno ; 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, Nicola ; Lorini, Renata ; Trada, M. ; Sogno Valin, P. ; Beccaria, L. ; Lucchesi, S. ; Bruzzese, M. ; Mammì, F. ; Cirillo, D. ; Pardi, D. ; Taccardi, R. A. ; Lombardo, F. ; Zuccotti, Gian Vincenzo ; Meschi, Franco ; Iughetti, L. ; Predieri, B. ; Franzese, A. ; Mozzillo, E. ; Prisco, F. ; Cadario, Francesco ; Savastio, S. ; Piredda, G. ; Monciotti, C. ; Galderisi, A. ; Salvo, C. ; Calcaterra, Valeria ; Berioli, M. G. ; Federico, G. ; Favia, A. ; Zanette, G. ; Marsciani, A. ; Schiaffini, Riccardo ; Cappa, Marco ; Delvecchio, Maurizio ; Gaiero, A. ; Ignaccolo, G. ; Cerutti, F. ; Fontana, F. ; Guerraggio, L. ; Zonca, S. ; Franceschi, R. ; Tornese, Gianluca ; Biagioni, M. ; Salvatoni, A. ; Cardani, R. ; Marigliano, M. ; Sabbion, A. ; Maffeis, C. ; Schieven, E. ; Arnaldi, C. / A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes. In: Journal of Diabetes Research. 2016 ; Vol. 2016.
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title = "A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes",
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.",
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year = "2016",
doi = "10.1155/2016/5719470",
language = "English",
volume = "2016",
journal = "Journal of Diabetes Research",
issn = "2314-6745",
publisher = "Hindawi Limited",

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TY - JOUR

T1 - A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

AU - Zucchini, Stefano

AU - Scaramuzza, Andrea

AU - Bonfanti, Riccardo

AU - Buono, Pietro

AU - Cardella, F.

AU - Cauvin, Vittoria

AU - Cherubini, Valentino

AU - Chiari, Giovanni

AU - D'Annunzio, Giuseppe

AU - Frongia, Anna Paola

AU - Iafusco, D.

AU - Maltoni, Giulio

AU - Patera, Ippolita Patrizia

AU - Toni, Sonia

AU - Tumini, Stefano

AU - Rabbone, Ivana

AU - Lera, R.

AU - Bobbio, A.

AU - Gualtieri, A.

AU - Piccinno, E.

AU - Zecchino, C.

AU - Pasquino, Bruno

AU - Felappi, B.

AU - Prandi, E.

AU - Gallo, F.

AU - Morganti, G.

AU - Ripoli, C.

AU - Cardinale, G.

AU - Ponzi, G.

AU - Castaldo, V.

AU - Stamati, F.

AU - Lo Presti, D.

AU - Tomaselli, L.

AU - Citriniti, F.

AU - Suprani, T.

AU - Bensa, M.

AU - Graziani, V.

AU - De Berardinis, F.

AU - Chiarelli, F.

AU - De Marco, R.

AU - Lazzaro, N.

AU - De Donno, V.

AU - Banin, P.

AU - Piccini, B.

AU - Lenzi, L.

AU - Mainetti, B.

AU - Coccioli, M. S.

AU - Minuto, Nicola

AU - Lorini, Renata

AU - Trada, M.

AU - Sogno Valin, P.

AU - Beccaria, L.

AU - Lucchesi, S.

AU - Bruzzese, M.

AU - Mammì, F.

AU - Cirillo, D.

AU - Pardi, D.

AU - Taccardi, R. A.

AU - Lombardo, F.

AU - Zuccotti, Gian Vincenzo

AU - Meschi, Franco

AU - Iughetti, L.

AU - Predieri, B.

AU - Franzese, A.

AU - Mozzillo, E.

AU - Prisco, F.

AU - Cadario, Francesco

AU - Savastio, S.

AU - Piredda, G.

AU - Monciotti, C.

AU - Galderisi, A.

AU - Salvo, C.

AU - Calcaterra, Valeria

AU - Berioli, M. G.

AU - Federico, G.

AU - Favia, A.

AU - Zanette, G.

AU - Marsciani, A.

AU - Schiaffini, Riccardo

AU - Cappa, Marco

AU - Delvecchio, Maurizio

AU - Gaiero, A.

AU - Ignaccolo, G.

AU - Cerutti, F.

AU - Fontana, F.

AU - Guerraggio, L.

AU - Zonca, S.

AU - Franceschi, R.

AU - Tornese, Gianluca

AU - Biagioni, M.

AU - Salvatoni, A.

AU - Cardani, R.

AU - Marigliano, M.

AU - Sabbion, A.

AU - Maffeis, C.

AU - Schieven, E.

AU - Arnaldi, C.

PY - 2016

Y1 - 2016

N2 - 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.

AB - 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.

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U2 - 10.1155/2016/5719470

DO - 10.1155/2016/5719470

M3 - Article

VL - 2016

JO - Journal of Diabetes Research

JF - Journal of Diabetes Research

SN - 2314-6745

M1 - 5719470

ER -