Publications by authors named "Francesca Di Candia"

Objective: To assess the association between daily carbohydrate (CHO) entries and glycemic outcomes in youth with type 1 diabetes after automated insulin delivery (AID) initiation in real-life settings.

Research Design And Methods: In this longitudinal, multinational observational study, 347 young individuals (7-21 years old) with type 1 diabetes for >1 year were followed for >6 months after AID initiation. Clinical data, including daily and overall continuous glucose monitoring-based time in range (TIR) (70-180 mg/dL), time in tight range (TITR) (70-140 mg/dL), and CHO entry metrics, were evaluated.

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Aims: New technology has been reported as a factor driving people to choose an automatic insulin delivery system (AIDs) and to sustain its acceptance. We aimed to explore the role of continuous glucose monitoring (CGM) technology (instant scanning vs. real-time) and insulin treatment modality to determine the future acceptance of AIDs among T1D individuals.

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Article Synopsis
  • The study aimed to create a questionnaire that evaluates how likely individuals with type 1 diabetes (T1D) are to accept Automatic Insulin Delivery systems (AIDs), focusing on their usefulness, ease of use, and trust in the technology.
  • A comprehensive questionnaire was developed using a 5-point Likert scale and completed by 239 participants, including children and their parents, demonstrating excellent reliability and agreement in their responses about AIDs.
  • The results showed a positive acceptance level of AIDs among both youths and parents, with parents generally recognizing more benefits, indicating the tool could be useful for clinicians and researchers in assessing the acceptance of these insulin delivery systems.
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Context: The pathophysiological mechanisms underlying the natural history of glucose intolerance and its fluctuations in subjects with cystic fibrosis (CF) are still unclear.

Objective: To investigate the relationship between longitudinal changes in glucose tolerance and concomitant changes in the main parameters of insulin secretion/metabolism/action determining glucose regulation in subjects with CF.

Methods: Insulin sensitivity and glucose-stimulated insulin secretion (GSIS, a biomarker of beta cell functional mass), as estimated by the Oral Glucose Sensitivity Index (OGIS) and by a sophisticated mathematical model, respectively, and insulin clearance were assessed in 127 subjects with CF, aged 10-25 years, who underwent 2 oral glucose tolerance tests over an at least 1-year follow-up period.

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Background: Skin reactions due to technological devices pose a significant concern in the management of type 1 diabetes (T1D). This multicentric, comparative cross-sectional study aimed to assess the psychological impact of device-related skin issues on youths with T1D and their parents.

Methods: Participants with skin reactions were matched in a 1:1 ratio with a control group.

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Article Synopsis
  • Prader-Willi syndrome (PWS) is a genetic disorder caused by different problems on chromosome 15, affecting how some genes work.
  • People with PWS often feel super hungry all the time, can become very overweight, and may have other health and learning issues.
  • The review explores how different genetic causes of PWS can lead to specific health problems and looks for ways to improve diagnosis and treatments for those affected.
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Objective: To investigate glucose metrics and identify potential predictors of the achievement of glycemic outcomes in children and adolescents during their first 12 months of MiniMed 780G use.

Research Design And Methods: This multicenter, longitudinal, real-world study recruited 368 children and adolescents with type 1 diabetes (T1D) starting SmartGuard technology between June 2020 and June 2022. Ambulatory glucose profile data were collected during a 15-day run-in period (baseline), 2 weeks after automatic mode activation, and every 3 months.

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  • The study aimed to determine how having both type 1 diabetes (T1D) and celiac disease (CD) affects the quality of life (QoL) in youths compared to those with T1D only.
  • Researchers compared 86 youths with both conditions and their parents to 167 youths with T1D, using the KINDL questionnaire for QoL assessment and dietary interviews to evaluate gluten-free diet (GFD) adherence.
  • Results showed that while the combination of T1D and CD minimally impacts overall QoL, those not strictly following a GFD reported significantly lower QoL scores, highlighting the need for psychological support in managing the diet to improve QoL.
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Aims: To analyze metabolic outcomes, diabetes impact and device satisfaction in children and adolescents with type 1 diabetes in Italy who used different treatment modalities for diabetes care in a real-life context.

Methods: In this multicenter, nationwide, cross-sectional study, 1464 participants were enrolled at a routine visit. The following treatment modalities were considered MDI + SMBG; MDI + CGM; Sensor Augmented Pump Therapy; predictive management of low glucose; Hybrid Closed Loop (HCL); Advanced Hybrid Closed Loop (AHCL).

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Article Synopsis
  • The study evaluated how continuous glucose monitoring (CGM) affects quality of life (QoL) for young people with type 1 diabetes (T1D) and their caregivers, focusing on the relationship between CGM satisfaction and QoL.
  • Researchers used a cross-sectional approach, analyzing responses from 210 youths with T1D and their parents through specific questionnaires that measure QoL and CGM satisfaction.
  • Results indicated that higher satisfaction with CGMs correlated with better QoL across all dimensions, suggesting that enhancing CGM experiences could improve well-being for youths with T1D, regardless of the treatment method used.
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Aims/hypothesis: Type 1 diabetes is an autoimmune disorder that is characterised by destruction of pancreatic beta cells by autoreactive T lymphocytes. Although islet autoantibodies (AAb) are an indicator of disease progression, specific immune biomarkers that can be used as target molecules to halt development of type 1 diabetes have not been discovered. Soluble immune checkpoint molecules (sICM) play a pivotal role in counteracting excessive lymphocyte responses, but their role in type 1 diabetes is unexplored.

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Article Synopsis
  • The study aimed to compare glucose control metrics in youths with type 1 diabetes (T1D) and celiac disease (CD) versus those with T1D alone, focusing on the impact of gluten-free diets (GFD) on metabolic control.
  • An observational study included 86 participants with both T1D and CD and 167 controls with T1D only, assessing dietary adherence and its effects using continuous glucose monitoring (CGM).
  • Results showed similar CGM metrics for both groups, but those not fully adhering to GFD had higher rates of hyperglycemia compared to T1D-only participants, emphasizing the importance of strict dietary compliance for metabolic control.
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Background: Individuals with thiamine-responsive megaloblastic anemia (TRMA) mainly manifest macrocytic anemia, sensorineural deafness, ocular complications, and nonautoimmune diabetes. Macrocytic anemia and diabetes may be responsive to high-dosage thiamine treatment, in contrast to sensorineural deafness. Little is known about the efficacy of thiamine treatment on ocular manifestations.

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Aims: Continuous glucose monitoring (CGM) can improve glucometrics in children with type 1 diabetes (T1D), and its efficacy is positively related to glucose sensor use for at least 60% of the time. We therefore investigated the relationship between CGM satisfaction as assessed by a robust questionnaire and glucose control in pediatric T1D patients.

Methods: This was a cross-sectional study of children and adolescents with T1D using CGM.

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In people with type 1 diabetes, Automated Insulin Delivery (AID) systems adjust insulin delivery in response to sensor glucose data and consist of three components: an insulin pump, a continuous glucose sensor, and an algorithm that determines insulin delivery. To date, all the available AID systems require users to announce carbohydrate intake and deliver meal boluses, as well as respond to system alarms. The use of AID devices both initially and over time may be influenced by a variety of psychological factors.

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Background: To evaluate corneal deformation in Maturity Onset Diabetes of the Young type 2 (MODY2), paediatric subjects were analysed using a Scheimpflug-based device. The purpose of this analysis was to find new biomarkers for MODY2 disease and to gain a better understanding of the pathogenesis of the disease.

Methods: A total of 15 patients with genetic and metabolic diagnoses of MODY2 (mean age 12.

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Glycemia risk index (GRI) is a novel composite metric for the evaluation of the safety of glycemic management and control. The aim of this study was to evaluate GRI and its correlations with continuous glucose monitoring (CGM) metrics by analyzing real-life CGM data in 1067 children/adolescents with type 1 diabetes (T1D) using four different treatment strategies (intermittently scanned CGM [isCGM]-multiple daily injections [MDIs]; real-time CGM-MDIs; rtCGM-insulin pump; hybrid closed-loop [HCL] therapy). GRI was positively correlated with high blood glucose index, low blood glucose index, mean glycemia, its standard deviation, coefficient of variation, and HbA1c.

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Aim: To systematically assess the impact of commercially available hybrid closed loop (HCL) systems on psychological outcomes in youths with type 1 diabetes and their parents.

Methods: We performed a systematic review including studies published in the last 10 years. PICOS framework was used in the selection process, and evidence was assessed using the GRADE system.

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Article Synopsis
  • The study focuses on translating and validating the Italian version of the continuous glucose monitoring Satisfaction (CGM-SAT) scale to assess patient satisfaction with diabetes technologies.
  • The validation process included thorough methods like forward and backward translation, leading to an excellent completion rate of nearly 100% when administered to 210 patients and 232 parents.
  • Results showed moderate to good internal consistency and moderate agreement between parent and young people assessments, indicating the scale effectively measures satisfaction with CGM systems for type 1 diabetes patients in Italy.
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The aim of this multicenter observational real-world study was to investigate glycemic outcomes in children and adolescents with type 1 diabetes over the first 6-month use of MiniMed™ 780G. The secondary objective was to evaluate demographic and clinical factors that may be significantly associated with the achievement of therapeutic goals. Demographic, anamnestic, and clinical data of study participants were collected at the time of enrollment.

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The aim of this systematic review was to report the evidence on optimal prandial timing of insulin bolus in youths with type 1 diabetes. A systematic search was performed including studies published in the last 20 years (2002-2022). A PICOS framework was used in the selection process and evidence was assessed using the GRADE system.

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Aims: To evaluate the impact of gluten free diet (GFD) on growth, metabolic control and quality of life in children and adolescents with type 1 diabetes (T1D) and celiac disease (CD).

Methods: A systematic search was performed including studies published in the last 15 years. PICOS framework was used in the selection process and evidence was assessed using the GRADE system.

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