Managing Children and Adolescents with Type 1 Diabetes and Coexisting Celiac Disease: Real-World Data from a Global Survey.

IF 2.6 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Maja Raicevic, Francesco Maria Rosanio, Tiago Jeronimo Dos Santos, Agata Chobot, Claudia Piona, Laura Cudizio, Hussain Alsaffar, Katja Dumic, Sommayya Aftab, Meera Shaunak, Enza Mozzillo, Rade Vukovic
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Abstract

Introduction: Celiac disease (CD) is among the diseases most commonly associated with type 1 diabetes (T1D). This study aimed to evaluate the worldwide practices and attitudes of physicians involved in pediatric diabetes care regarding diagnosing and managing CD in children with T1D.

Methods: The 30-item survey was conducted between July and December 2023 aimed at targeting pediatricians with special interest in T1D and CD. It was shared by the JENIOUS - young investigators group of the International Society of Pediatric and Adolescent Diabetes (ISPAD) - and the YES - early career group of the European Society for Pediatric Endocrinology (ESPE).

Results: Overall, 180 physicians (67.8% female) from 25 countries responded. Among respondents, 62.2% expected sustaining optimal glycemic control in children with T1D and CD (T1D + CD) to be more difficult than in children with T1D alone. Majority (81.1%) agreed that more specific guidelines are needed. The follow-up routine for patients with T1D + CD differed, and one-quarter of physicians scheduled more frequent follow-up checkups for these patients. Seventy percent agreed multidisciplinary outpatient clinics for their follow-up is needed. In the multivariate ordinal logistic regression model, a statistically significant predictor of a higher degree of practice according to ISPAD 2022 guidelines was a higher level of country income (OR = 3.34; p < 0.001).

Conclusions: These results showed variations in physicians' practices regarding managing CD in children with T1D, emphasizing the need for more specific guidelines and intensive education of physicians in managing this population, especially in lower-income countries. Our data also suggest the implementation of multidisciplinary outpatient clinics for their follow-up.

管理同时患有 1 型糖尿病和乳糜泻的儿童和青少年:来自全球调查的真实数据。
目的:乳糜泻(CD)是最常见的 1 型糖尿病(T1D)相关疾病之一。本研究旨在评估全球从事儿科糖尿病护理的医生在诊断和管理 T1D 儿童乳糜泻方面的做法和态度:这项包含 30 个项目的调查于 2023 年 7 月至 12 月间进行,调查对象是对 T1D 和 CD 特别感兴趣的儿科医生。该调查由国际儿童和青少年糖尿病学会(ISPAD)的JENIOUS--年轻研究者小组和欧洲儿科内分泌学会(ESPE)的YES--早期职业小组共同进行:来自 25 个国家的 180 名医生(67.8% 为女性)做出了答复。结果:来自 25 个国家的 180 名医生(67.8% 为女性)做出了答复。在答复者中,62.2% 的人认为,与单纯 T1D 患儿相比,T1D 合并 CD(T1D+CD)患儿维持最佳血糖控制更为困难。大多数人(81.1%)同意需要更具体的指南。对 T1D+CD 患者的常规随访有所不同,四分之一的医生为这些患者安排了更频繁的随访检查。70%的医生认为需要多学科门诊对他们进行随访。在多变量序数逻辑回归模型中,国家收入水平越高,根据ISPAD 2022指南开展的诊疗活动就越多,这在统计学上具有显著预测意义(OR=3.34;p<0.001):这些结果表明,医生在管理 T1D 儿童 CD 方面的做法存在差异,强调需要制定更具体的指南并对医生进行强化教育,以管理这一人群,尤其是在低收入国家。我们的数据还建议对他们实施多学科门诊随访。
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来源期刊
Hormone Research in Paediatrics
Hormone Research in Paediatrics ENDOCRINOLOGY & METABOLISM-PEDIATRICS
CiteScore
4.90
自引率
6.20%
发文量
88
审稿时长
4-8 weeks
期刊介绍: The mission of ''Hormone Research in Paediatrics'' is to improve the care of children with endocrine disorders by promoting basic and clinical knowledge. The journal facilitates the dissemination of information through original papers, mini reviews, clinical guidelines and papers on novel insights from clinical practice. Periodic editorials from outstanding paediatric endocrinologists address the main published novelties by critically reviewing the major strengths and weaknesses of the studies.
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