Publications by authors named "Roberto Franceschi"

Background: Untreated patients affected by hereditary fructose intolerance (HFI) present an abnormal transferrin (Tf) glycosylation pattern suggestive of N-hypoglycosylation. Analysis of defects in N-glycosylation is possible by analysis of serum sialotransferrin (sialoTf) pattern. The sialoTf profile is a valuable tool to facilitate the diagnosis of HFI.

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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 analyze how often type 1 diabetes (T1D) and diabetic ketoacidosis (DKA) occurred in kids aged 0-14 in the Trentino-Alto Adige region of Italy from 2014 to 2023.
  • Results showed an overall T1D incidence of 21.5 per 100,000 person-years, peaking at 31.1 during 2021, and DKA occurred in about 36.9% of cases, with younger patients showing higher HbA1c levels.
  • The findings suggest that the incidence of T1D in the region is similar to other northern Italian areas, highlighting the need for educational campaigns to raise
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In the post-COVID-19 era, telehealth experience and knowledge must be structured to deliver high-quality care. Type 1 diabetes is a chronic disease that lends itself to being a model for telehealth diffusion, especially in the pediatric setting where the use of cloud-connected technologies is widespread. Here, we present "how to set the tone" and manage a telemedicine session according to our experiences and those reported in the literature, according to the health professional perspective.

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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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Background: sepiapterine reductase deficiency (SRD) is a rare levodopa (L-dopa)-responsive disorder treated with a combination therapy of controlled-release L-dopa and carbidopa. The currently available formulation of controlled-release carbidopa/L-dopa does not entirely meet the requirements for the long-term therapy in pediatric patients. In fact, administration of a manufactured tablet at a dose intended for adults necessitates its adjustment to the child's needs, as the splitting of the tablet into smaller portions or its dilution in water.

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Methylmalonyl-CoA epimerase enzyme (MCEE) is responsible for catalyzing the isomeric conversion between D- and L-methylmalonyl-CoA, an intermediate along the conversion of propionyl-CoA to succinyl-CoA. A dedicated test for MCEE deficiency is not included in the newborn screening (NBS) panels but it can be incidentally identified when investigating methylmalonic acidemia and propionic acidemia. Here, we report for the first time the biochemical description of a case detected by NBS.

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Article Synopsis
  • * Hypoglycemia continues to be a major concern for those using insulin therapy, prompting the need for evidence-based recommendations for its recognition, treatment, and management among pediatric diabetologists.
  • * The guidelines suggest raising blood glucose levels above 70 mg/dL using oral glucose, with specific dosages tailored for different treatment settings, and they include practical flow charts to assist in clinical decision-making, aiming for a global applicability.
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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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  • * 143 participants were divided into two groups: those who regularly used AGP (group A) and those who did not (group B), with follow-ups to compare metabolic outcomes and glucose metrics over 12 months.
  • * Results showed that group A had higher sensor usage and better TIR, while experiencing lower Time Above Range and HbA1c levels, indicating that consistent AGP use can lead to better metabolic control despite no significant predictors found for sustained usage.
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Rickets results from impaired mineralization of growing bone due to alterations in calcium and phosphate homeostasis. Clinical signs of rickets are related to the age of the patient, the duration of the disease, and the underlying disorder. The most common signs of rickets are swelling of the wrists, knees or ankles, bowing of the legs (knock-knees, outward bowing, or both) and inability to walk.

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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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The Special Issue "Diabetes Mellitus: Current Research and Future Perspectives" is focused on the importance of customized medicine in monogenic diabetes of the young (MODY) and type 2 diabetes (T2D) [...

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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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Diet is an essential element of treating and managing type 1 diabetes (T1D). However, limited research has examined food behaviour in children and adolescents with T1D and their relationship to glycaemic control. This study evaluated food behaviour, metabolic characteristics and their impact on the glycaemic control of children and adolescents with T1D.

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  • 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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Different studies and systematic reviews have reported weight increase after tonsillectomy. However, the odds of a child being overweight or obese after tonsillectomy were no different than before surgery, according to a few studies. This systematic review aims to analyze the impact of adenotonsillectomy (TA) on weight gain and identify subgroups of children and adolescents at risk of experiencing weight gain.

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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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The prompt identification of at-risk newborns for drug-induced hypoglycemia can minimize the risk for adverse side effects, inappropriate investigations, and considerable unnecessary costs. Existing literature discusses drug-induced hypoglycemia, but a systematic description of neonatal hypoglycemia induced or exacerbated by maternal medications is missing. We reviewed the association between neonatal hypoglycemia and maternal medications.

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No data are available on insulin clearance (Cl) trends during the pubertal transition. The aim of this study was to investigate in 973 youths with obesity whether Cl in fasting and post-oral glucose challenge (OGTT) conditions varies at the pubertal transition in relation to the severity of obesity and the presence of steatosis liver disease (SLD). The severity of obesity was graded according to the Centers for Disease Control.

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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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The initial step for the differential diagnosis of hypoglycemia is to determine whether it is hyperinsulinemic or non hyperinsulinemic. Existing literature discusses drug-related hypoglycemia, but it misses a focus on drug-induced hyperinsulinemic hypoglycemia (DHH). Here we reviewed the association existing between drugs and hyperinsulinemic hypoglycemia.

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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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