المؤلفون: DI Dalmazi G., Maltoni G., Bongiorno C., Tucci L., DI Natale V., Moscatiello S., Laffi G., Pession A., Zucchini S., Pagotto U.

المساهمون: DI Dalmazi G., Maltoni G., Bongiorno C., Tucci L., DI Natale V., Moscatiello S., Laffi G., Pession A., Zucchini S., Pagotto U.

مصطلحات موضوعية: diabetes mellitu, type 1, Adolescent, Adult, Betacoronaviru, Blood Glucose, Blood Glucose Self-Monitoring, COVID-19, Child, Diabetes Mellitus, Exercise, Female, Human, Hypoglycemic Agent, Insulin, Italy, Male, Middle Aged, Monitoring, Ambulatory, SARS-CoV-2, Stress, Psychological, Communicable Disease Control, Coronavirus Infection, Pandemic, Pneumonia, Viral

الوصف: Introduction The COVID-19 pandemic forced the Italian government to issue extremely restrictive measures on daily activities since 11 March 2020 ('lockdown'), which may have influenced the metabolic control of type 1 diabetes mellitus (T1D). The aims of the study were to investigate continuous glucose monitoring (CGM) metrics in children and adults with T1D during lockdown and to identify their potentially related factors. Research design and methods We enrolled 130 consecutive patients with T1D (30 children (≤12 years), 24 teenagers (13-17 years), and 76 adults (≥18 years)) using either Dexcom or FreeStyle LibreCGM>70% during the study period, without hybrid closed-loop insulin pump. CGM metrics during the 20 days before and the 20 days after lockdown were calculated. By telephonic contact, we performed validated physical activity and perceived stress questionnaires. Results In children, significantly lower glucose SD (SDglu) (p=0.029) and time below range (TBR)<54 mg/dL (TBR2) (p=0.029) were detected after lockdown. CGM metrics were comparable in teenagers before and during lockdown. After lockdown, adults improved significantly time in range (TIR) 70-180 mg/dL (p<0.001) and remaining metrics, except percent coefficient of variation and TBR2. In adults, considering the changes in SDglu and TIR occurred before and during lockdown, we identified a group with improved TIR and SDglu who performed more physical activity, one with improved glucose variability who was younger than the other patients, and one with worsened glucose variability who showed higher perceived stress than others. Conclusion In patients with T1D during lockdown, CGM metrics mostly improved in children and adults, whereas it was unchanged in teenagers. In adults, age, physical activity, and perceived stress may be relevant contributing factors.

وصف الملف: ELETTRONICO

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/33115820; info:eu-repo/semantics/altIdentifier/wos/WOS:000588056400007; volume:8; issue:2; firstpage:e001664; lastpage:N/A; numberofpages:9; journal:BMJ OPEN DIABETES RESEARCH AND CARE; http://hdl.handle.net/11585/815022Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85094842816; https://drc.bmj.com/content/8/2/e001664Test

الإتاحة: https://doi.org/10.1136/bmjdrc-2020-001664Test
http://hdl.handle.net/11585/815022Test
https://drc.bmj.com/content/8/2/e001664Test

المؤلفون: Bonora E., Cataudella S., Marchesini G., Miccoli R., Vaccaro O., Fadini G. P., Martini N., Rossi E.

المساهمون: Bonora E., Cataudella S., Marchesini G., Miccoli R., Vaccaro O., Fadini G.P., Martini N., Rossi E.

مصطلحات موضوعية: Diabetes mellitu, Glucose lowering medication, Insulin, Oral agent, Treatment, Adolescent, Adult, Aged, 80 and over, Biomarker, Blood Glucose, Child, Preschool, Databases, Factual, Diabetes Mellitus, Type 1, Type 2, Drug Prescription, Drug Substitution, Drug Therapy, Combination, Drug Utilization, Female, Human, Hypoglycemic Agent, Infant, Newborn, Italy, Male

الوصف: Background and aims: To investigate diabetes treatment initiation and continuation in the next sixth months in newly diagnosed Italian subjects. Methods and results: We analyzed administrative claims of 11,300,750 Italian residents. Subjects with incident diabetes were identified by glucose lowering drug prescriptions, disease-specific co-payment exemptions and hospital discharge codes occurring in 2018 but not in 2017. Incident cases were 65,932 of whom 91.4% received the prescription of a glucose lowering drug. Among the latter, those receiving a prescription of a noninsulin medication but no insulin were 84.8%, those receiving a prescription of insulin only were 9.4%, and those receiving prescriptions of both insulin and noninsulin drugs were 5.8%. Metformin was the most frequently drug initially prescribed in noninsulin treated subjects (~85%) and sulphonylurea receptor (SUR) agonists collectively ranked as second (~13%). Lispro (35%) and glargine (34%) were the most frequently prescribed molecules in subjects who were insulin treated. Differences in prescriptions were found in age categories, with increased use of SUR agonists across decades. In the first six months, as many as 50% of noninsulin treated patients continued with the initial drug, ~15% added a second agent, ~5% switched to another medication, and ~30% discontinued any glucose lowering treatment. Conclusions: These data document that current guidelines are often neglected because prescriptions of SUR agonists as first agent are still quite common and insulin is prescribed more than expected. They point out the urgent need to improve the dissemination and implementations of guidelines in diabetes care.

وصف الملف: STAMPA

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34218990; info:eu-repo/semantics/altIdentifier/wos/WOS:000685642500015; volume:31; issue:9; firstpage:2661; lastpage:2668; numberofpages:8; journal:NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES; http://hdl.handle.net/11585/839566Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85110206839; https://www.ncbi.nlm.nih.gov/pubmed/34218990Test

الإتاحة: https://doi.org/10.1016/j.numecd.2021.06.006Test
http://hdl.handle.net/11585/839566Test
https://www.ncbi.nlm.nih.gov/pubmed/34218990Test