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Browsing by Author "Schiaffini, R"

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  • Diabetes-Related Antibody-Testing is a Valuable Screening Tool for Identifying Monogenic Diabetes – A Survey from the Worldwide SWEET Registry
    Publication . Limbert, C; Lanzinger, S; deBeaufort, C; Iotova, V; Pelicand, J; Prieto, M; Schiaffini, R; Šumnik, Z; Pacaud, D
    Aims: To evaluate access to screening tools for monogenic diabetes in paediatric diabetes centres across the world and its impact on diagnosis and clinical outcomes of children and youth with genetic forms of diabetes. Methods: 79 centres from the SWEET diabetes registry including 53,207 children with diabetes participated in a survey on accessibility and use of diabetes related antibodies, c-peptide and genetic testing. Results: 73, 63 and 62 participating centres had access to c-peptide, antibody and genetic testing, respectively. Access to antibody testing was associated with higher proportion of patients with rare forms of diabetes identified with monogenic diabetes (54 % versus 17 %, p = 0.01), lower average whole clinic HbA1c (7.7[Q1,Q2: 7.3-8.0]%/61[56-64]mmol/mol versus 9.2[8.6-10.0]%/77[70-86]mmol/mol, p < 0.001) and younger age at onset (8.3 [7.3-8.8] versus 9.7 [8.6-12.7] years p < 0.001). Additional access to c-peptide or genetic testing was not related to differences in age at onset or HbA1c outcome. Conclusions: Clinical suspicion and antibody testing are related to identification of different types of diabetes. Implementing access to comprehensive antibody screening may provide important information for selecting individuals for further genetic evaluation. In addition, worse overall clinical outcomes in centers with limited diagnostic capabilities indicate they may also need support for individualized diabetes management.
    2022Journal article Open access Show more
  • The COVID-19 Pandemic Affects Seasonality, With Increasing Cases of New-Onset Type 1 Diabetes in Children, From the Worldwide SWEET Registry
    Publication . Reschke, F; Lanzinger, S; Herczeg, V; Prahalad, P; Schiaffini, R; Mul, D; Clapin, H; Zabeen, B; Pelicand, J; Phillip, M; Limbert, C; Danne, T; Alonso, GT; Rhodes, ET; Davis, E; Veeze, HJ; Maahs, D; Cardona-Hernandez, R; Sumnik, Z; Corathers, S; Bratina, N; Danne, T; Gevers, E; Imane, Z; Piccini, B; Forsander, G; Pacaud, D; Maffeis, C; Campbell, F; Bonfanti, R; de Sanctis, L; Krone, RE; Toth-Heyn, P; Witsch, M; Arsanoglu, I; Jefferies, C; Landry, A; Beltrand, J; Amed, S; Rami-Merhar, B; Barat, P; Szypowska, A; Zabeen, B; Casteels, K; Savova, R; Cherubini, V; de Bock, M; Todorovic, S; Limbert, C; Moravej, H; Pozgaj Sepac, M; Mazur, A; Gerasimidou-Vazeou, A; Iotova, V; O’Riordan, S; Chobot, A; Herbst, A; Ngwu, U; Cody, D; Birkebæk, NH; Hanas, R; Goksen, D; Sarda, A; Chobot, J; Mirante, A; Richmond Padilla, E; Tsiroukidou, K; Saboo, B; Kanaka-Gantenbein, C; Schiaffini, R; Foskett, D; Jali, S; Verkauskiene, R; Castro-Correia, C; Kumar Guness, P; Pelicand, J; Cotterill, A; Kumari Mohan, M; Spehar Uroic, A; Goss, P; Svensson, J; Ramchandani, GD; Coutant, R; Mantilla, L; Sima, A; Hyun Kim, J; Galli-Tsinopoulou, A; Ribeiro, R; O’Gorman, C; Fonna, H; Bratke, H; El Habashy, S; Gokalani, R; Scharf Pinto, M; Chavda, V
    Objective: To analyze whether the coronavirus disease 2019 (COVID-19) pandemic increased the number of cases or impacted seasonality of new-onset type 1 diabetes (T1D) in large pediatric diabetes centers globally. Research design and methods: We analyzed data on 17,280 cases of T1D diagnosed during 2018-2021 from 92 worldwide centers participating in the SWEET registry using hierarchic linear regression models. Results: The average number of new-onset T1D cases per center adjusted for the total number of patients treated at the center per year and stratified by age-groups increased from 11.2 (95% CI 10.1-12.2) in 2018 to 21.7 (20.6-22.8) in 2021 for the youngest age-group, <6 years; from 13.1 (12.2-14.0) in 2018 to 26.7 (25.7-27.7) in 2021 for children ages 6 to <12 years; and from 12.2 (11.5-12.9) to 24.7 (24.0-25.5) for adolescents ages 12-18 years (all P < 0.001). These increases remained within the expected increase with the 95% CI of the regression line. However, in Europe and North America following the lockdown early in 2020, the typical seasonality of more cases during winter season was delayed, with a peak during the summer and autumn months. While the seasonal pattern in Europe returned to prepandemic times in 2021, this was not the case in North America. Compared with 2018-2019 (HbA1c 7.7%), higher average HbA1c levels (2020, 8.1%; 2021, 8.6%; P < 0.001) were present within the first year of T1D during the pandemic. Conclusions: The slope of the rise in pediatric new-onset T1D in SWEET centers remained unchanged during the COVID-19 pandemic, but a change in the seasonality at onset became apparent.
    2022Journal article Open access Show more