Zucchini S.,Centro Regionale per la Diabetologia Pediatrica |
Maltoni G.,Centro Regionale per la Diabetologia Pediatrica |
Scipione M.,Centro Regionale per la Diabetologia Pediatrica |
Balsamo C.,Centro Regionale per la Diabetologia Pediatrica |
Rollo A.,Centro Regionale per la Diabetologia Pediatrica
Giornale Italiano di Diabetologia e Metabolismo | Year: 2012
We assessed the efficacy of an automatic bolus calculator (Accu-Chek ® Aviva Expert) in a 30-day observational study in 30 children with type 1 diabetes who had already learned to count carbohydrates (carbo-counting). The primary end-point was the percentage of within-target glucose values two hours after meals. Fifteen children were randomized to use the Accu-Chek ® Aviva Expert calculator, and 15 used the Accu-Chek ® Aviva Nano glucometer and calculated the boluses manually. hey were all seen at three visits (0, 15, 30 days) and HbA 1c (DCA 2000) was measured at the start and end of the study. Glucose patterns were better in the group using the Aviva Expert calculator and their after-breakfast and after-dinner glucose values were lower than in the patients calculating their boluses manually. The group using the bolus calculator had a significantly higher frequency of within-target glucose values than the other group (67% vs 25%, p = 0.036). The frequency of hypoglycemic episodes (< 60 mg/dl) and the average number of correction boluses were similar in both groups. HbA 1c was 0.5% lower than baseline in the Aviva Expert group and 0.3% in the control group (p < 0.05). These findings indicate that an automatic bolus calculator (Aviva Expert) may be helpful in improving metabolic control, possibly by reducing errors in calculating bolus insulin doses. Long-term trials are needed to confirm these results and to determine whether the automatic calculator use improves clinical outcomes and glucose variability.
Costantini S.,Centro Regionale per la Diabetologia Pediatrica |
Contreas G.,Centro Regionale per la Diabetologia Pediatrica |
Barbetti F.,University of Rome Tor Vergata |
Maffeis C.,Centro Regionale per la Diabetologia Pediatrica
Giornale Italiano di Diabetologia e Metabolismo | Year: 2016
A sizeable number of cases of diabetes are monogenic, and this must be borne in mind in the etiologic diagnosis of the disease. Maturity-onset diabetes of the young (MODY) is the most prevalent monogenic form. It is characterized by autosomal dominant transmission, early onset, and a primary defect of pancreatic β-cell function. MODY has long been and still is under-reported, because it is frequently either not diagnosed or is misdiagnosed as type 1 or type 2 diabetes, with negative consequences on prognosis and treatment. Correct molecular diagnosis of MODY ensures multiple benefits, including appropriate, effective treatment, more precise prognosis, and genetic counseling for the risk of diabetes among family members. Here we discuss the main clinical and molecular features of the most common MODY subtypes, with particular focus on differential diagnosis in the clinical setting. © 2016, UTET Periodici Scientifici srl. All rights reserved.