Abstract
BackgroundThe incidence of type 1 diabetes in childhood is increasing by 3 % per year, placing growing demands on healthcare professionals and medical expenditures. Aim of this study wars to assess the organization of care to children with diabetes in Italy.MethodsDuring 2012 a structured questionnaire was sent to all of the members of Italian Society of Paediatric Endocrinology and Diabetology (ISPED). Questions examined organizational structure of Centers, personnel dedicated to the care of children with diabetes, number of subjects followed, local legal legislation supporting centres.ResultsA total of 68 centers taking care to 15,563 children and adolescents with diabetes under 18 years of age were identified with a prevalence of 1.4 per 1,000 people. A wide variation in the organizational background was also reported. Fourty-four centers were organized as outpatient departments, 17 as simple units, 5 as complex units and 2 as simple departmental structures. Most centers had a multidisciplinary team. Ten out of twenty Italian regions had introduced supportive regional legislation, but it was fully applied only in six of them.ConclusionGreat differences between regions were found in organizational structures, staffing levels and supportive legislation. The national legislation on diabetes was broadly implemented throughout the country regions. Further efforts are needed to improve standards and consistency of pediatric diabetes care in Italy.
Highlights
Type 1 diabetes (T1D) is one of the most common endocrine and metabolic conditions in childhood, showing an increasing incidence rate of about 3 % per year during the last two decades
A center for pediatric diabetes was defined as a place where a child with T1D can be diagnosed and followed by pediatricians with experience in diabetes care, independently of the number of patients followed in that center
44 centers were classified as an Ambulatory care services (AC), 17 as a Simple operational units (UOS), 5 as a Complex operational units (UOC), and 2 as a Simple departmental operational units (UOSd)
Summary
Type 1 diabetes (T1D) is one of the most common endocrine and metabolic conditions in childhood, showing an increasing incidence rate of about 3 % per year during the last two decades. A further burden for the health care system derives from the growing number of immigrant children living in Italy, as they usually have a Giorgetti et al Italian Journal of Pediatrics (2015) 41:74 each region with the act “Provisions for the prevention and the cure of diabetes mellitus” [10]. This law predates, by about 5 years, the recognition of special needs of children and adolescents with diabetes by the International Diabetes Federation (IDF).
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