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Type 1 diabetes: new pediatric screenings and innovative tools to manage blood sugar levels

September 13, 2023 is a date that marked an important milestone in the fight against type 1 diabetes. On that day, in fact, the Law n.130/2023 which establishes in our country, the first in the world, the screening of the pediatric population For type 1 diabetes and celiac disease.

The Law, promoted by Italian Diabetes Foundationaims to identify early, in the age range between 1 and 17, children and young people affected by these pathologies or at risk of developing them.

The great advantage? Scientific research conducted around the world shows that timely diagnosis and interventions strongly reduce both risks acute that the long-term consequences of these diseases in people who suffer from them. In the cases of type 1 diabetesin fact, still too often the diagnosis occurs following an episode of ketoacidosisi.e. a serious metabolic imbalance which requires rapid admission to the emergency room and which, in the most serious cases, can endanger the child's life.

The pilot project

After the approval of the law, the Ministry of Health and the Istituto Superiore di Sanità signed an agreement for the creation of a pilot project which will be conducted in 4 Regions: Lombardy, Marche, Campania and Sardinia. In these territories, the Free Choice Paediatricians (PLS) participating in the study will recruit children aged 2, 6 and 10 on a voluntary basis. Auto-antibodies related to type 1 diabetes and celiac disease will be measured and the presence of two genetic variants associated with these pathologies will be evaluated.

Cropped view of doctor holding cotton and syringe near hand of girl isolated on white

The importance of promoting correct information

The incidence, and consequently the prevalence, of type 1 diabetes have constantly grown over the last decades throughout the world, so much so that today type 1 diabetes is the most widespread chronic disease of childhood and adolescence.

If the screening law actually represents an important step forward, we cannot forget that There are still many clichés and false myths about the pathology to be debunked. As demonstrated by the initiative of Matthiasa young rugby player from a small club in the Milanese hinterland who recently decided to gather his teammates to explain to them how it is managed and what are the key things to know about type 1 diabetes.

The meeting was wanted by the boy himself and his parents to ensure that – as is in the spirit of rugby – the team is aware and in case of need his teammates can be ready to help Mattia.

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Type 1 diabetes: let's clarify

The new law approved also provides for periodic carrying out information and awareness campaigns by the Ministry of Health. Despite the data relating to the incidence, in fact, the People's knowledge of the disease is not yet adequate.

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Type 1 diabetes, also called juvenile or insulin-dependent diabetesit's a chronic, autoimmune diseasedependent on aalteration of the immune system, which involves the destruction of cells of the organism recognized as foreign and towards which antibodies are produced that attack them. In the case of type 1 diabetes, they come pancreatic cells are destroyed that they produce insulinhormone that regulates blood glucose levels, a sort of key that allows sugar to enter cells to be used as energy. Type 1 diabetes accounts for approximately 10% of diabetes cases. It generally develops during the teenage yearsbut can also appear in newborn children or in young adults and lasts a lifetime.

Disease management

A crucial and delicate aspect concerns the disease management since patients with type 1 diabetes, to maintain normal blood sugar levels, must take insulin for life via injections (in the form of tablets it would be neutralized in the stomach and would not be able to enter the blood to carry out its function).

Fortunately, progress has been made on this front too in recent years important steps forward. A turning point was marked by the introduction of insulin pumps (or insulin pumps), electronic instruments – explains the Italian Society of Diabetology – which control the activity of a small pump that delivers insulin subcutaneously via a small plastic catheter that is positioned under the skin of the abdomen and replaced periodically. Another important innovation were the sensors which allow the continuous glucose monitoring (CGM – Continuous Glucose Monitoring). More recently, these tools have also been added so-called «hybrid systems»through which sensors and insulin pumps they work in synergy: the former providing information on blood sugar trends and the latter automatically regulating insulin delivery based on this information.

Close Up Of Diabetic Girl On Bed In At Home Using Insulin Pen To Measure To Check Blood Sugar Level
Close Up Of Diabetic Girl On Bed In At Home Using Insulin Pen To Measure To Check Blood Sugar Level

New technologies available to patients

“THE AID systems (automated insulin delivery systems) have been introduced into clinical practice since 2020 and they have it quickly improved metabolic outcomes and quality of life – explains the professor Valentino CherubiniPresident of Italian Society of Pediatric Endocrinology and Diabetology. – They also allow you to use telematics as a tool for their optimization. There technology has revolutionized diabetes care not only for the improvement of outcomes but also because it has assigned a primary role to telemedicine. In pediatrics, the use of devices that allow remote controls has progressively increased. The devices are connected to the cloud that allow remote controls both to the doctor and to the family members who care for the children. However, it is good to remember that not everything can be solved remotelyThe child with diabetes and his family they need a personal relationship that cannot be overlooked».

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«It's about tools that concretely improve the state of health of people with diabetes, because they allow more effective glycemic controlreducing the risk of complications related to diabetic disease – the professor also underlines Riccardo Candido, President ofAssociation of Diabetes Doctors. – Plus, they deliver significant advantages in terms of quality of lifegranting greater practicality, greater freedom and discretion in managing your illness. The most recent ones devices for continuous glucose monitoring they are equipped with apps through which you can control on your smartphone your blood sugar levels. Since the app can be shared on your phone more people, the parent can also remotely monitor the child's data who wears the CGM while at school or playing sports.”

Device for diabetes management: where are we at in Italy?

But if thetechnological innovation promises to revolutionize the approach to careIn practice, there still seems to be some obstacles to overcome.

“These solutions are still underemployed in Italyas demonstrated, for example, by the case of microinsulants: according to the AMD Annals only just over 18% of people with type 1 diabetes uses them – underlines Professor Riccardo Candido. – Furthermore, given the different models and specific prescriptive indications That at a regional level regulate the availability of these devices, we also assist to a problem of inequality Of access to care».


Source: Vanity Fair

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