Basilio Pintaudi

Azienda Ospedaliera Niguarda Ca' Granda, Milano, Lombardy, Italy

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Publications (23)55.46 Total impact

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    ABSTRACT: We evaluated empowerment in T2DM and identified its correlates. A sample of individuals self-administered the Diabetes Empowerment Scale-Short Form (DES-SF) and other 9 validated instruments (person-centered outcomes). Correlates of DES-SF were identified through univariate and multivariate analyses. For person-centered outcomes, ORs express the likelihood of being in upper quartile of DES-SF (Q4) by 5 units of the scale. Overall, 2390 individuals were involved. Individuals in Q4 were younger, more often males, had higher levels of school education, lower HbA1c levels and prevalence of complications as compared to individuals in the other quartiles. The likelihood of being in Q4 was directly associated with higher selfreported self-monitoring of blood glucose (SDSCA6-SMBG) (OR=1.09; 95% CI: 1.03-1.15), higher satisfaction with diabetes treatment (GSDT) (OR=1.15; 95% CI: 1.07-1.25), perceived quality of chronic illness care and patient support (PACIC-SF) (OR=1.23; 95% CI: 1.16-1.31), and better person-centered communication (HCC-SF) (OR=1.10; 95% CI: 1.01-1.19) and inversely associated with diabetes-related distress (PAID-5) (OR=0.95; 95% CI: 0.92-0.98). Adjusted DES-SF mean scores ranged between centers from 69.8 to 93.6 (intra-class correlation=0.10; p<0.0001). Empowerment was associated with better glycemic control, psychosocial functioning and perceived access to person-centered chronic illness care. Practice of diabetes center plays a specific role. DES-SF represents a process and outcome indicator in the practice of diabetes centers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Patient Education and Counseling 05/2015; DOI:10.1016/j.pec.2015.05.012 · 2.60 Impact Factor
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    ABSTRACT: Objective: The goal of this study was to design, develop, and evaluate a game for health, ''Gustavo in Gnam's Planet'' (''Gustavo''), aimed to improve knowledge on healthy foods and to increase consumption of healthy foods. Subjects and Methods: Eighty-three high school students were enrolled in the study. The game was designed and developed by a multidisciplinary team. Behavioral change theories were adopted to guide the design of the health messages. Participants were assessed about food frequency, healthy food knowledge, and the game's interest. Results: Forty-seven subjects (mean age, 14.9 – 1.0 years; 72.3 percent males) completed the study. At posttest, participants showed significant higher scores (i.e., increased knowledge) in the questionnaire on knowledge of healthy foods (70.0 – 9.2 versus 71.3 – 10.0 for pretest and posttest, respectively; P < 0.05). Improvements in healthy eating habits were also detected: higher frequency of consumption during a week of white meat (1 [1–2] versus 2 [1–2]; P = 0.01), eggs (1 [1–1] versus 1 [1–2]; P = 0.01], and legumes (1 [0–1] versus 1 [1–2]; P = 0.03) and lower frequency of consumption of sugar-containing packaged snacks (1 [0–1] versus 0 [0–1]; P = 0.009). Most of the participants found the game easy to use and clear in its content. Half of the participants found the game interesting. Conclusions: Our study shows that ''Gustavo'' is a promising tool for health education, in schools or in other environments. Limitations of the study and future directions are discussed.
    03/2015; 4(4):Not available-ahead of print. DOI:10.1089/g4h.2014.0107
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    ABSTRACT: Context: Autoimmune thyroid diseases (AITD) can be associated with type 1 diabetes (T1D). The prevalence of serum antibodies against thyroid hormones (THAb) in subjects with autoimmune diseases others than T1D is increasing. No data are available for T1D. Objective: To evaluate: the rate of associated AITD; the rate of positiveness for serum THAb; the panel of THAb based on thyroid hormone interaction and on immunoglobulin class; the association of AITD alone, THAb alone or AITD plus THAb with diabetes-related complications. Design: Observational, prospective, study with six years (2005-2011) follow-up. Setting: Outpatient diabetes clinic. Patients: 52 consecutive subjects (53.8% males, mean age 37.4±7.4 years, diabetes duration 19.9±8.2 years) with T1D. All participants completed the study. Main Outcome Measures: AITD rate; THAb positivity according to hormone interaction and to immunoglobulin class; association of AITD and THAb with diabetes-related complications. Results: AITD rate increased from baseline (34.6%) to follow-up (38.5%). Subjects with T1D had a high prevalence of THAb (92.3%). The presence of AITD at baseline was associated with subsequent development of macroangiopathy (0% vs. 33% at baseline and follow-up, respectively; p=0.029). Some THAb patterns, the majority having T3 binding in common, were associated with the progression and the development of diabetes-related complications. Conclusions: THAb synthesis in T1D might be driven by increased glycosylation of thyroglobulin. Anti T3-THAb may cause a relative "tissue hypothyroidism" by sequestering thyroid hormone, this at least partially contributing in worsening diabetes-related vascular complications. In a clinical setting THAb positivity could identify subjects more likely to develop diabetes complications.
    Journal of Clinical Endocrinology &amp Metabolism 02/2015; 100(5):jc20143950. DOI:10.1210/jc.2014-3950 · 6.31 Impact Factor
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    ABSTRACT: The study aimed to evaluate the frequency of episodes of symptomatic hypoglycemia (SH) in elderly patients with type 2 diabetes and their impact on quality of life. The study was conducted in 12 Italian regions. Participants filled in a questionnaire collecting data on socio-demographic and clinical characteristics and episodes of SH occurred in the last 4 weeks. The questionnaire included validated scales measuring fear of hypoglycemia (FHQ), psychological well-being (WHO-5), and diabetes-related distress (PAID-5). Overall, 1,323 participants were involved (mean age 70.0 ± 8.7, 47.6 % male, disease duration 15.6 ± 11.7, 63.2 % treated with oral agents, 16.9 % with insulin alone, 14.4 % with insulin plus oral agents), of whom 44.6 % reported 1-3 episodes of SH and 23.8 % reported more than 3 episodes. Patients who reported SH had significantly higher levels of fear of hypoglycemia, lower psychological well-being, and higher diabetes-related distress (p < 0.0001 for all the scales). At multivariate analysis, the experience of more than 3 episodes of hypoglycemia was associated with a 13-fold higher risk of high fear of hypoglycemia (aOR = 13.3; CI 95 % 8.4-21.0), an almost 60-fold higher risk of high diabetes-related distress (PAID-5 score ≥40) (aOR = 59.1; CI 95 % 29.2-119.8), and a higher risk of low psychological well-being (WHO-5 <50) (aOR = 1.5; CI 95 % 0.9-2.4). The occurrence of symptoms of hypoglycemia is very common among older adults with diabetes and their presence is associated with an extremely negative impact on quality of life. Minimizing the risk of hypoglycemia represents a high priority in the diabetes treatment of elderly people.
    Acta Diabetologica 02/2015; DOI:10.1007/s00592-015-0717-0 · 3.68 Impact Factor
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    ABSTRACT: Background. Dyslipidemia contribute to the excess of coronary heart disease (CHD) risk observed in women with type 2 diabetes (T2DM). Low density lipoprotein-cholesterol (LDL-C) is the major target for CHD prevention, and T2DM women seem to reach LDL-C targets less frequently than men. Aim. To explore age- and gender-related differences in LDL-C management in a large sample of outpatients with T2DM. Results. Overall, 415.294 patients (45.3% women) from 236 diabetes centers in Italy were included. Women were older and more obese, with longer diabetes duration, higher total-cholesterol, LDL-C, and HDL-C serum levels compared to men (P < 0.0001). Lipid profile was monitored in ~75% of subjects, women being monitored less frequently than men, irrespective of age. More women did not reach the LDL-C target as compared to men, particularly in the subgroup treated with lipid-lowering medications. The between-genders gap in reaching LDL-C targets increased with age and diabetes duration, favouring men in all groups. Conclusions. LDL-C management is worst in women with T2DM, who are monitored and reach targets less frequently than T2DM men. Similarly to men, they do not receive medications despite high LDL-C. These gender discrepancies increase with age and diabetes duration, exposing older women to higher CHD risk.
    International Journal of Endocrinology 01/2015; 2015:957105. DOI:10.1155/2015/957105 · 1.52 Impact Factor
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    ABSTRACT: The aim of this study was to estimate the incidence of type 2 diabetes (primary objective) and hospitalisation for cardiovascular events (secondary objective) in women with previous gestational diabetes mellitus (GDM) and in those with normal glucose tolerance (NGT) in pregnancy, and to evaluate the role of stillbirth in differentiating the risks.
    Diabetologia 10/2014; DOI:10.1007/s00125-014-3403-9 · 6.88 Impact Factor
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    ABSTRACT: Background and aims: Women with gestational diabetes mellitus (GDM) are at increased risk for the onset of type 2 diabetes (T2DM) and cardiovascular disease in the years following pregnancy. Aim of the study was to estimate the incidence of T2DM and cardiovascular events in women with previous GDM and in those with normal glucose tolerance in pregnancy and to evaluate the rol e of stillbirth in differentiating the risks. Materials and methods: A population - based cohort study using administrative data of 12 local health authorities in Puglia, Italy, during the index period from January 1, 2002, to December 31, 2010 was conducted . From a population - based sample of 2.1 million women we identified those with a diagnosis of GDM during the index period and they were propensity - matched on a 1 - to - 3 basis with women without GDM or diabetes mellitus. Characteristics that were matched were age, local health authority code, use of antihypertensive and antithrombotic agents. Main outcome measures were T2DM development and hospitalizations for cardiovascular events occurring after a pregnancy complicated by GDM and ended at term or in miscarri age. Results: There were 3851 women with GDM (mean age 37.1±5.9 years) and 11553 matched controls without GDM. During a median follow - up of 5.4 years, the incidence rate of T2DM was of 2.1 per 1000 person - years in women without GDM, of 54.0 per 1000 person - years among women with GDM and pregnancy at term, and 115.0 per 1000 person - years among women with GDM and a pregnancy ended in stillbirth. The cumulative IRs of T2DM development showed that GDM increased the risk of T2DM by 21.7 times, while GDM complica ted by stillbirth increased the risk of T2DM by 46.9 times as compared with women with a normal pregnancy. GDM and stillbirth during GDM were associated with a significantly higher risk of cardiovascular events compared with normal pregnancy (IRR, 2.4;95% CI, 1.5 to 3.8 and IRR, 16.7; 95% CI, 3.7 to 74.7, respectively). Conclusion: Pregnancy complicated by GDM and ended in stillbirth represents a decisive factor in determining the development of T2DM and future cardiovascular events. For this reason these w omen deserve a careful follow - up
    50th Scientific Session, European Association for the Study of Diabetes, Vienna; 09/2014
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    ABSTRACT: Background: Sclerostin is an osteocyte derived inhibitor of the Wnt/β Catenin signaling pathway which acts as a negative regulator of bone formation. Published data on sclerostin levels in type 1 diabetes mellitus (T1DM) are few. Objective: To evaluate gender differences in sclerostin serum levels, and the association between sclerostin, bone mass, bone metabolism and the main clinical characteristics of subjects with T1DM. Design and methods: Sixty-nine patients with T1DM (mean age 33.7± 8.1; 49% males) were enrolled in this study cross-sectional study in a clinical research center. Bone mineral density was measured by phalangeal quantitative ultrasound (QUS); bone turnover markers (urinary PYR, D-PYR, OH-PRO to evaluate bone resorption; serum B-ALP and BGP to evaluate bone formation) and sclerostin were assessed. Results: D-PYR and sclerostin were significantly higher in women in comparison to men (P=0.04). A disease duration greater than 15 years was associated to higher sclerostin levels (P=0.03). Bone turnover markers and QUS parameters were not correlated to sclerostin. A significant negative correlation was observed between QUS parameters, BMI and OH-PRO. Sclerostin serum levels correlated with homocysteine (r=-0.34; P=0.005) and vitamin B12 (r=-0.31; P=0.02). Generalized linear model showed that macroangiopathy was the only predictor of sclerostin serum levels (beta=-11.8, 95%CI from -21.9 to -1.7; P=0.02). Conclusions: Our data demonstrate that women with T1DM exhibit higher sclerostin levels than men, and that circulating sclerostin is not associated with bone turnover markers and phalangeal QUS measurements. Macroangiopathy was associated with sclerostin levels.
    European Journal of Endocrinology 06/2014; 171(3). DOI:10.1530/EJE-14-0106 · 3.69 Impact Factor
  • 25° Congresso Nazionale - Società Italiana Diabetologia, Bologna, Bologna; 05/2014
  • 2nd Congress IGEA: integrated model of care for people with chronic diseases., Istituto Superiore di Sanità. Rome; 03/2014
  • 7th International Conference on Advanced Technologies & Treatments for Diabetes, Vienna, Austria; 02/2014
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    ABSTRACT: RIASSUNTO La chetoacidosi diabetica (diabetic ketoacidosis, DKA) è una complicanza del diabete di tipo 1, particolarmente grave quando si manifesta nei bambini; se non diagnosticata e trattata ade-guatamente può associarsi a edema cerebrale, danno neurolo-gico permanente e può perfino mettere a rischio la vita del paziente. Fino a oggi gli studi su questo fenomeno in Italia sono stati molto limitati. Nel periodo gennaio-maggio 2014, nell'ambito del GdS di Dia-betologia Pediatrica, è stata effettuata un'indagine osservazio-nale retrospettiva sulla DKA all'esordio, su base nazionale, che ha coinvolto complessivamente 76 centri. La DKA è stata definita mediante i criteri dell'ISPAD. Sono stati esaminati 7457 casi di diabete di tipo 1 di nuovo esordio nella popolazione dell'Italia Pe-ninsulare e Sicilia e 770 della Sardegna, diagnosticati nel decen-nio 2004-2013. Nella prima popolazione in media la DKA era presente all'esordio nel 32,9% dei casi (intervallo di confidenza [IC] al 95% 31,8-34,0%), mentre le forme gravi erano presenti nel 6,6% dei casi (IC al 95% 6,02-7,20%). Nei bambini della fascia d'età più piccola, 0-4 anni, la DKA all'esordio era più frequente, sia per le forme moderate sia per quelle gravi. Non erano pre-senti variazioni temporali. La popolazione sarda e quella in cui era presente un familiare di primo grado con diabete di tipo 1 ave-vano un rischio minore di DKA. Durante il periodo dello studio sono stati individuati tre decessi per DKA, mentre quattro bam-bini hanno riportato lesioni neurologiche permanenti. Nel periodo novembre 2011-aprile 2012 il GdS di Diabetologia ha condotto un'indagine retrospettiva sulla DKA in un campione di 2025 pazienti, di età compresa tra 0 e 18 anni con diabete di tipo 1 già noto, che ha riguardato 29 centri nazionali. L'incidenza di questa complicanza riguardava il 2,4% della popolazione per anno (IC al 95% 1,8-3,1), con un rischio più elevato nelle fasce d'età 10-14 anni e 15-18 anni, verosimilmente associato alla omissione delle somministrazioni d'insulina. L'analisi evidenziava un rischio più elevato in chi usava l'analogo rapido dell'insulina rispetto alla regolare, e nei pazienti che avevano un valore di emo-globina glicata più elevato. La giovane età della madre e il basso livello di scolarizzazione erano altri due fattori di rischio.
    Giornale Italiano di Diabetologia e Metabolismo 01/2014; 34:110-116.
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    ABSTRACT: In the context of the DAWN-2 initiatives, the BENCH-D Study aims to test a model of regional benchmarking to improve not only the quality of diabetes care, but also patient-centred outcomes. As part of the AMD-Annals quality improvement program, 32 diabetes clinics in 4 Italian regions extracted clinical data from electronic databases for measuring process and outcome quality indicators. A random sample of patients with type 2 diabetes filled in a questionnaire including validated instruments to assess patient-centred indicators: SF-12 Health Survey, WHO-5 Well-Being Index, Diabetes Empowerment Scale, Problem Areas in Diabetes, Health Care Climate Questionnaire, Patients Assessment of Chronic Illness Care, Barriers to Medications, Patient Support, Diabetes Self-care Activities, and Global Satisfaction for Diabetes Treatment. Data were discussed with participants in regional meetings. Main problems, obstacles and solutions were identified through a standardized process, and a regional mandate was produced to drive the priority actions. Overall, clinical indicators on 78,854 patients have been measured; additionally, 2,390 patients filled-in the questionnaire. The regional mandates were officially launched in March 2012. Clinical and patient-centred indicators will be evaluated again after 18 months. A final assessment of clinical indicators will take place after 30 months. In the context of the BENCH-D study, a set of instruments has been validated to measure patient well-being and satisfaction with the care. In the four regional meetings, different priorities were identified, reflecting different organizational resources of the different areas. In all the regions, a major challenge was represented by the need of skills and instruments to address psychosocial issues of people with diabetes. The BENCH-D study allows a field testing of benchmarking activities focused on clinical and patient-centred indicators.
    SpringerPlus 01/2014; 3:83. DOI:10.1186/2193-1801-3-83
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    ABSTRACT: Abstract There is a debate about whether universal or risk factors based screening is most appropriate for gestational diabetes diagnosis. The aim of our retrospective study was to compare in our population the universal screening test recommended by the International Association of Diabetes in Pregnancy Study Group (IADPSG) panel and the American Diabetes Association (ADA) versus the selective screening proposed by the United Kingdom National Institute for Health and Clinical Excellence guidelines (NICE) but modified by the Italian National Institute of Health. From May 2010 to October 2011 all consecutive pregnant women were screened for gestational diabetes according to the IADPSG's panel criteria, while all the risk factors for each patient were registered. Of the 1015 pregnant women included in the study 113 (11%) were diagnosed with gestational diabetes, and 26 (23%) of them wouldn't have been identified by the selective screening proposed by the Italian National Institute of Health. However, all the risk factors considered by the selective screening revealed a good predictive role except for maternal age ≥ 35 years (OR: 0.98). In the group without the risk factors considered it was reported the predictive role for gestational diabetes of prepregnancy BMI and nulliparity. The selective risk factors based screening proposed by the Italian National Institute of Health has detected 77% of gestational diabetes cases in our population, sparing the oral glucose tolerance test for more than 40% of pregnant women at the same time. More information on the clinical impact of this choice could be obtained by a strict analysis of treatment, perinatal outcome and follow-up of an adequate sample size of "missed" gestational diabetes.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 11/2013; 27(14). DOI:10.3109/14767058.2013.860961 · 1.21 Impact Factor
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    ABSTRACT: To assess the predictive value of the risk factors (RF) for gestational diabetes (GDM) considered by the selective screening (SS), and to identify subgroups of women at higher risk for GDM. Retrospective, single-center study. Data of 1015 women, screened for GDM at 24-28 weeks gestation and diagnosed according to IADPSG criteria, were evaluated. Information on the RF considered by SS was also collected, and their association with GDM was tested. To identify distinct and homogeneous subgroups of patients at higher risk, the RECPAM (RECursive Partitioning and AMalgamation) method was used. Overall, 113 (11.1%) women were diagnosed as having GDM. The application of SS would lead to the performance of an OGTT in 58.3% of women, and 26 (23.0%) cases of GDM would not be detected due to the absence of any RF. RECPAM analysis identified high risk subgroups characterized by fasting plasma glucose >5.1mmol/L (OR=26.5;95%CI 14.3-49.0) and pre-gestational BMI (OR=7.0;95%CI 3.9-12.8 for overweight women). In a final logistic model including RECPAM classes, previous macrosomia (OR=3.6;95%CI 1.1-11.6) and family history of diabetes (OR=1.8;95%CI 1.1-2.8), but not maternal age, were also associated with an increased risk of GDM. A screening approach based on the RECPAM model would reduce by over 50% (23.0% vs. 10.6%) the number of undiagnosed GDM cases as compared with the current SS approach, at the expense of 50 additional OGTTs needed. A screening approach based on our RECPAM model allows a significant reduction of undetected GDM cases compared to current SS procedure.
    European Journal of Endocrinology 10/2013; DOI:10.1530/EJE-13-0759 · 3.69 Impact Factor
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    ABSTRACT: The aim of this study was to demonstrate that neutrophil gelatinase-associated lipocalin (NGAL) increased before the onset of microalbuminuria in patients with type 1 diabetes mellitus (T1DM), representing an important biochemical parameter with high sensitivity and specificity to make a precocious diagnosis of "normoalbuminuric" diabetic nephropathy (DN). Serum NGAL (sNGAL) and urinary NGAL (uNGAL) levels were evaluated in a cohort of fifty patients affected by T1DM. They had no signs of clinical nephropathy. Thirty-five healthy subjects (HS) were recruited. sNGAL levels were significantly higher compared with those measured in HS [193.7 (103.2-405.4) vs. 46.4 (39.8-56.2) ng/ml; p < 0.0001], as were uNGAL levels [25.5 (14.2-40.2) vs. 6.5 (2.9-8.5) ng/ml; p < 0.0001]. sNGAL was found to be directly correlated with glycated hemoglobin. uNGAL also positively correlated with albuminuria, whereas an inverse correlation was found with uric acid. After multivariate analysis, significance was maintained for the correlation between uNGAL and microalbuminuria. In ROC analysis, sNGAL showed a good diagnostic profile such as uNGAL. NGAL increases in patients with T1DM, even before diagnosis of microalbuminuria representing an early biomarker of "normoalbuminuric" DN with a good sensitivity and specificity. NGAL measurement could be useful for the evaluation of early renal involvement in the course of diabetes.
    Acta Diabetologica 06/2013; DOI:10.1007/s00592-013-0485-7 · 3.68 Impact Factor
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    ABSTRACT: Objectives of this study were to assess diastolic function in pregnant women with abnormal glucose tolerance (AGT), compared with normal glucose tolerance (NGT) women, and to evaluate the insulin resistance status and its association with Doppler-echocardiographic indexes. Echocardiograms of 108 consecutive Caucasian women with singleton pregnancies were performed. Insulin resistance status was estimated by the homeostasis model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI). All the studied women showed normal diastolic patterns. Patients with AGT (50.9%), as compared with NGT women, had higher HOMA-IR (1.70 ± 1.30 versus 1.01 ± 0.81, P = 0.003), lower QUICKI (0.36 ± 0.005 versus 0.40 ± 0.06, P = 0.004), higher lateral mitral annulus late diastolic velocity (13.6 ± 4.9 versus 11.9 ± 4.9, P = 0.03), and higher A-wave velocity, the wave responsible for the active atrial contraction component (75.2 ± 14.2 versus 67.7 ± 16.2, P = 0.01). At multivariate regression analysis HOMA-IR was the only parameter associated with A-wave velocity. In conclusion, women with AGT had an increased subclinical diastolic active participation, which is associated with higher levels of insulin resistance. For the increased risk of deterioration of cardiac diastolic function, earlier and more seriously than normal pregnancy, AGT women may have a careful followup to detect the early signs of cardiac alteration and to prevent cardiovascular diseases.
    Journal of Diabetes Research 01/2013; 2013:486593. DOI:10.1155/2013/486593 · 3.54 Impact Factor
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    ABSTRACT: Background and aims Evaluation of incidence and correlates of severe hypoglycemia (SH) and diabetes ketoacidosis (DKA) in children and adolescents with T1DM. Methods and Results Retrospective study conducted in 29 diabetes centers from November 2011 to April 2012. The incidence of SH and DKA episodes and their correlates were assessed through a questionnaire administered to parents of patients aged 0-18 years. Incidence rates and incident rate ratios (IRRs) were estimated through multivariate Poisson regression analysis and multilevel analysis. Overall, 2025 patients were included (age 12.4±3.8 years; 53% males; diabetes duration 5.6±3.5 years; HbA1c 7.9±1.1%). The incidence of SH and DKA were of 7.7 and 2.4 events/100 py, respectively. The risk of SH was higher in females (IRR=1.44; 95%CI 1.04-1.99), in patients using rapid acting analogues as compared to regular insulin (IRR=1.48; 95%CI 0.97-2.26) and lower for patients using long acting analogues as compared to NPH insulin (IRR=0.40; 95%CI 0.19-0.85). No correlations were found between SH and HbA1c levels. The risk of DKA was higher in patients using rapid acting analogues (IRR=4.25; 95%CI 1.01-17.86) and increased with insulin units needed (IRR=7.66; 95%CI 2.83-20.74) and HbA1c levels (IRR=1.63; 95%CI 1.36-1.95). Mother’s age was inversely associated with the risk of both SH (IRR=0.95; 95%CI 0.92-0.98) and DKA (IRR=0.94; 95%CI 0.88-0.99). When accounting for center effect, the risk of SH associated with the use of rapid acting insulin analogues was attenuated (IRR=1.48; 95%CI 0.97-2.26); 33% and 16% of the residual variance in SH and DKA risk was explained by center effect. Conclusion The risk of SH and DKA is mainly associated with treatment modalities and strongly depends on the practice of specialist centers.
    Nutrition, metabolism, and cardiovascular diseases: NMCD 01/2013; DOI:10.1016/j.numecd.2013.11.004 · 3.88 Impact Factor
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    ABSTRACT: Background: Several studies have reported increased fracture risk in Type 1 Diabetes Mellitus (T1DM). Quantitative Ultrasound (QUS) provides information on the structure and elastic properties of bone, which are important determinants of fracture risk, along with bone mineral density. Aim: To study phalangeal sites by QUS, examine bone turn-over markers and analyze association between these factors with metabolic control in a population of premenopausal women with T1DM. Material and methods: Thirty-five T1DM premenopausal women (mean age 34.5±6.8 years) attending the Diabetic Outpatients Clinic in the Department of Internal Medicine, University of Messina, were consecutively enrolled and divided into two groups, taking into account the mean value of glycated hemoglobin in the last three years. Twenty healthy age-matched women served as controls. Phalangeal ultrasound measurements (AD-SoS, UBPI, T-Score, Z-Score) were performed using a DBM Sonic Bone Profiler. Osteocalcin and deoxypyridinoline served as markers of bone formation and bone resorption, respectively. Results: T1DM women with poor metabolic control showed lower phalangeal QUS values compared to healthy controls (p<0.01) and T1DM women with good metabolic control (p<0.05). No significant differences in QUS measurements were detected between T1DM women with good metabolic control and healthy controls. Lower bone formation and increased bone resorption, although not statistically significant, were observed in patients with poor metabolic control in comparison to patients with good metabolic control.
    Journal of endocrinological investigation 10/2012; 36(5). DOI:10.3275/8646 · 1.55 Impact Factor
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    ABSTRACT: AIM: To evaluate the correspondence between first-trimester fasting glycaemia and the results of the OGTT in diagnosing gestational diabetes (GDM). METHODS: The medical records of all consecutive women who had undergone a diagnostic OGTT, performed according to the IADPSG, during the past year were retrospectively reviewed. All first-trimester fasting glucose values greater or equal to 5.1mmol/L (92mg/dL), recommended as a diagnostic value, were also verified for each patient in this cohort. Moreover, a ROC curve and a multiple logistic-regression model were constructed to calculate the predictive capability of this cut-off value in diagnosing GDM. RESULTS: In our population of 738 eligible pregnant women, an 11.9% prevalence of GDM was revealed by OGTT. However, when the first-trimester fasting glucose value for each patient was retrospectively considered, there were a further 29 patients who should have been diagnosed as GDM cases (glycaemia≥5.1mmol/L), although their OGTT was normal. Yet, when the value of fasting glucose was considered not diagnostic, but only predictive, an AUC of 0.614 (95% CI: 0.544-0.684) and an aOR of 7.1 (95% CI: 3.8-13.1) was obtained in these patients compared with the reference group (fasting glucose<5.1mmol/L). CONCLUSION: There was no complete correspondence in diagnosing GDM between the first-trimester fasting glucose value and the results of a 2-h 75-g OGTT performed early in the third trimester. However, albeit not diagnostic, a fasting glucose value greater or equal to 5.1mmol/L may be considered a highly predictive risk factor for GDM.
    Diabetes & Metabolism 05/2012; 38(5). DOI:10.1016/j.diabet.2012.03.006 · 2.85 Impact Factor

Publication Stats

51 Citations
55.46 Total Impact Points

Institutions

  • 2015
    • Azienda Ospedaliera Niguarda Ca' Granda
      Milano, Lombardy, Italy
  • 2013–2014
    • CMNS Consorzio Mario Negri Sud
      • Department of Clinical Pharmacology and Epidemiology
      Chieta, Abruzzo, Italy
  • 2011–2013
    • Università degli Studi di Messina
      • Dipartimento di Medicina Clinica e Sperimentale
      Messina, Sicily, Italy