Correlations between parameters of glycaemic variability and foetal growth, neonatal hypoglycaemia and hyperbilirubinemia in women with gestational diabetes.

The diagnosis of gestational diabetes mellitus (GDM) is important to prevent maternal and neonatal complications. This study aimed to investigate the feasibility of parameters of glycaemic variability to predict neonatal complications in women with GDM. A retrospective study was conducted on pregnant women tested positive at the oral glucose tolerance test (OGTT) during 16-18 or 24-28 weeks of gestation.

Predicting Glycated Hemoglobin Through Continuous Glucose Monitoring in Real-Life Conditions: Improved Estimation Methods.

Background: The adoption of continuous glucose monitoring (CGM) already helps to improve glycemic control in diabetes. When coupled with appropriate data analysis techniques, CGM also provides dependable estimates for significant metrics, like glycated hemoglobin (HbA1c). Findings from the REALISM-T1D study can boost HbA1c estimation methods in diabetes care and stimulate their use in clinical practice.

A "Slide Rule" to Adjust Insulin Dose Using Trend Arrows in Adults with Type 1 Diabetes: Test in Silico and in Real Life.

Introduction: In persons with type 1 diabetes (T1D) insulin dosing can be adjusted based on trend arrows derived from continuous glucose monitoring (CGM). We propose a slide rule with narrower blood glucose intervals and more classes of insulin sensitivity than are available in current models.

Methods: The slide rule was tested in silico, in which a meal was simulated in 100 virtual subjects and the insulin bolus was calculated either in the standard way based on the insulin-to-carbohydrate ratio and the correction factor or according to the slide rule, following which the percentage time spent in range (70-180 mg/dl; %T), hypoglycemia (< 70 mg/dl; %T), and hyperglycemia (> 180 mg/dl; %T) was compared between the methods during the 4 h after the meal.

Time in range-A1c hemoglobin relationship in continuous glucose monitoring of type 1 diabetes: a real-world study.

Introduction: The availability of easily accessible continuous glucose monitoring (CGM) metrics can improve glycemic control in diabetes, and they may even become a viable alternative to hemoglobin A1c (HbA1c) laboratory tests in the next years. The REALISM-T1D study (REAl-Life glucoSe Monitoring in Type 1 Diabetes) was aimed at contributing, with real-world data, to a deeper understanding of these metrics, including the time in range (TIR)-HbA1c relationship, to facilitate their adoption by diabetologists in everyday practice.

Research Design And Methods: 70 adults affected by type 1 diabetes were monitored for 1 year by means of either flash (FGM) or real-time (rtCGM) glucose monitoring devices.

Placental and maternal sFlt1/PlGF expression in gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) and preeclampsia (PE) are both characterized by endothelial dysfunction and GDM women have higher incidence of PE. The placenta plays a key role in PE pathogenesis but its contribution to PE during GDM remains unclear. Herein, we compared placental and maternal blood anti-angiogenic soluble fms-like tyrosine kinase-1 (sFlt1) and pro-angiogenic Placental Growth Factor (PlGF) expressions in GDM and GDM-PE pregnancies compared to controls (CTRL) and PE cases.

Diabetic ketoacidosis: A consensus statement of the Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology and Pediatric Diabetoloy (SIEDP).

Background And Aim: Diabetic ketoacidosis (DKA) is a serious medical emergency once considered typical of type 1 diabetes (T1DM), but now reported to occur in type 2 and GDM patients as well. DKA can cause severe complications and even prove fatal. The aim of our study was to review recent international and national guidelines on diagnosis, clinical presentation and treatment of diabetic ketoacidosis, to provide practical clinical recommendations.

Helicobacter pylori and diabetes mellitus: a controversial relationship.

Research on Helicobacter pylori (H. pylori), a pathogenic bacterium that is widespread among humans, is investigating the medical implications of the infection in many fields beyond gastroenterology. Because of the ubiquitous presence of the infection, there is an increasing interest in finding a relationship between this bacterium and diabetes mellitus (DM).

Coping strategies in people with type 1 diabetes on insulin pump treatment.

Background: In stressed people with diabetes (PWD) glycemia varies idiosyncratically. Coping is a relatively stable personality trait that assesses how individual deals with stress. Insulin pumps are considered the best insulin delivery system but require more attention from PWD, virtually increasing stress levels.

Changes in the gut microbiota composition during pregnancy in patients with gestational diabetes mellitus (GDM).

Gestational diabetes mellitus (GDM), a common pregnancy complication, is associated with an increased risk of maternal/perinatal outcomes. We performed a prospective observational explorative study in 41 GDM patients to evaluate their microbiota changes during pregnancy and the associations between the gut microbiota and variations in nutrient intakes, anthropometric and laboratory variables. GDM patients routinely received nutritional recommendations according to guidelines.

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

Background And Aim: 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).

Methods And Results: Questionnaires investigating the organisation of diabetes care centres, individuals' clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems.

Low-Protein Diets in Diabetic Chronic Kidney Disease (CKD) Patients: Are They Feasible and Worth the Effort?

Low-protein diets (LPDs) are often considered as contraindicated in diabetic patients, and are seldom studied. The aim of this observational study was to provide new data on this issue. It involved 149 diabetic and 300 non-diabetic patients who followed a LPD, with a personalized approach aimed at moderate protein restriction (0.

New Insulin Delivery Recommendations.

Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions.

Diabetic Kidney Disease: A Syndrome Rather Than a Single Disease.

The term "diabetic kidney" has recently been proposed to encompass the various lesions, involving all kidney structures that characterize protean kidney damage in patients with diabetes. While glomerular diseases may follow the stepwise progression that was described several decades ago, the tenet that proteinuria identifies diabetic nephropathy is disputed today and should be limited to glomerular lesions. Improvements in glycemic control may have contributed to a decrease in the prevalence of glomerular lesions, initially described as hallmarks of diabetic nephropathy, and revealed other types of renal damage, mainly related to vasculature and interstitium, and these types usually present with little or no proteinuria.

Continuous subcutaneous insulin infusion in Italy: third national survey.

Background: Continuous subcutaneous insulin infusion (CSII) is increasing worldwide, mostly because of improved technology. The aim of this study was to evaluate the current status of CSII in Italy.

Materials And Methods: Physicians from 272 diabetes centers received a questionnaire investigating clinical features, pump technology, and management of patients on CSII.

Glycemic pattern in diabetic patients on hemodialysis: continuous glucose monitoring (CGM) analysis.

Background/aims: Recent evidences suggest that hemodialysis (HD) induces glycemic variations in diabetic patients. Continuous glucose monitoring (CGM) devices measure interstitial glucose in a 'Holter-like' manner thereby improving the glycemic control assessment method.

Methods: A CGM device (Medtronic iPRO) was used on 12 diabetic patients with chronic HD for 6 days to assess intra- and extra-dialytic interstitial glucose.

Optimizing insulin injection technique and its effect on blood glucose control.

Purpose: The purpose of the study is to assess whether proper Injection Technique (IT) is associated with improved glucose control over a three month period.

Methods: Patients ( = 346) with diabetes from 18 ambulatory centers throughout northern Italy who had been injecting insulin ≥ four years answered a questionnaire about their IT. The nurse then examined the patient's injection sites for the presence of lipohypertrophy (LH), followed by an individualized training session in which sub-optimal IT practices highlighted in the questionnaire were addressed.

Severe diabetic nephropathy in type 1 diabetes and pregnancy--a case series.

Background: Diabetes and nephropathy are important challenges during pregnancy, increasingly encountered because of the advances in maternal-fetal care.

Aim: To evaluate the maternal and fetal outcomes recorded in "severe" diabetic nephropathy in type 1 diabetic patients referred to nephrological healtcare.

Methods: The study was performed in an outpatient unit dedicated to kidney diseases in pregnancy (with joint nephrological and obstetric follow-up and strict cooperation with the diabetes unit).

Self-monitoring of blood glucose: guideline application rather than utilization restrictions on testing strips has potential to reduce diabetes healthcare costs in Italy.

Background: Self-monitoring of blood glucose (SMBG) is a proven tool to improve glycemic control, even if it might increase direct costs for diabetes management. In Italy, the purchase, prescription rules and responsibilities, and distribution of testing strips per type of patient are managed differently in each of the 20 Italian regions. The Italian scientific societies for diabetes (Società Italiana Diabetologia [SID] and Associazione Medici Diabetologi [AMD]) have issued validated guidelines for SMBG, but not all regions apply them.

Improved glycemic control with weight loss and a low risk of hypoglycemia with insulin detemir: insights from the Italian cohort of the PREDICTIVE study after 6-month observation in type 2 diabetic subjects.

Objective: PREDICTIVE (Predictable Results and Experience in Diabetes through Intensification and Control to Target: an International Variability Evaluation) is a large, multinational, open-label, prospective, observational study addressed to assess the efficacy and safety of insulin detemir in clinical practice. This paper reports 26 weeks of follow-up data, from 1298 type 2 diabetes patients from Italy.

Research Design And Methods: In this observational study, the primary end point was the incidence of serious adverse drug reactions (SADRs), including major hypoglycemia.

Human mesenchymal stem cells modulate cellular immune response to islet antigen glutamic acid decarboxylase in type 1 diabetes.

Context: Mesenchymal stem cells (MSCs) exert an immunosuppressive effect on the immune system. However, studies on the immunomodulatory potential of MSCs in type 1 diabetes are lacking.

Objective: We aimed to evaluate whether human MSCs may inhibit in vitro pancreatic islet antigen-specific T cell activation in type 1 diabetes.

Rethink Organization to iMprove Education and Outcomes (ROMEO): a multicenter randomized trial of lifestyle intervention by group care to manage type 2 diabetes.

Objective: A trial was performed to establish whether our group care model for lifestyle intervention in type 2 diabetes can be exported to other clinics.

Research Design And Methods: This study was a 4-year, two-armed, multicenter controlled trial in 13 hospital-based diabetes clinics in Italy (current controlled trials no. ISRCTN19509463).

Fasting plasma C-peptide and micro- and macrovascular complications in a large clinic-based cohort of type 1 diabetic patients.

Objective: A protective effect of residual beta-cell function on microvascular complications of type 1 diabetes has been suggested. Our aim was to retrospectively evaluate the association of fasting plasma C-peptide values with micro- and macrovascular complications.

Research Design And Methods: We recruited a clinic-based cohort of 471 type 1 diabetic patients born after 1945 and cared for in the period 1994-2004.