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. 2025 Mar 13;51(1):77.
doi: 10.1186/s13052-025-01854-7.

Unmet needs of Italian centers for pediatric diabetes care: analysis of a survey among pediatric diabetologists facing the national screening program for Type 1 Diabetes

Marco Marigliano #  1   2 , Roberto Franceschi #  3 , Enza Mozzillo #  4 , Valentina Tiberi #  5 , Monica Marino  5 , Giada Boccolini  5 , Malgorzata Wasniewska  6 , Maria Elizabeth Street  7 , Maria Rosaria Licenziati  8 , Riccardo Bonfanti  9 , Felice Citriniti  10 , Giuseppe D'Annunzio  11 , Maria Carolina Salerno  4 , Valentino Cherubini  5 ; Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED)
Collaborators, Affiliations

Unmet needs of Italian centers for pediatric diabetes care: analysis of a survey among pediatric diabetologists facing the national screening program for Type 1 Diabetes

Marco Marigliano et al. Ital J Pediatr. .

Abstract

Backgrounds: The incidence of Type 1 Diabetes (T1D) in children and adolescents is increasing by 3-4% per year. Children and adolescents with T1D (CwD) should receive person-centered, specialized treatment from a multidisciplinary team to ensure appropriate care. Italy is the first to implement a countrywide T1D screening program, which will raise the need for funding for specialized pediatric care. The study aims to update the organization of the Italian Centers for pediatric diabetes care.

Methods: In 2022, members of the 59 Italian Centers following CwD were invited to complete an email survey regarding the Centers' organization, characteristics, and activities. The questionnaire included information on responders, department organization, team composition, activities, and the organizational structures: department, ambulatory care services (AC), simple operational units (UOS), simple departmental operational units (UOSd), and complex operational units (UOC).

Results: The data collected referred to the year 2022. According to the results, 21,318 people with diabetes were treated. Of these, 19,643 subjects (92.1%) have T1D (16,672 were CwD), 387 (1,8%) have Type 2 Diabetes, and 1,288 (6,1%) have other forms of diabetes. Compared to the 2012 survey, a 13% decrease (from 68 to 59 Centers) in the number of pediatric Centers caring for CwD was observed with a parallel increase of total (+ 6.6%) and average (+ 22%) number of CwD per Center. The estimated prevalence of T1D has increased (1.4 vs. 1.7 per 1,000 CwD-2012 vs. 2022). A reduction in numbers for AC (-22%) and UOS (-35%) was observed, whereas UOSd/UOC increased by 50%. Almost 35% of the dietitians and 40% of the psychologists were not permanent members of the multidisciplinary diabetes team.

Conclusions: The observed decrease in the overall number of pediatric diabetes Centers, the reduction in specialized and dedicated HCPs, and the concurrent increase in the number of treated CwD in the last ten years indicate an alarming situation for pediatric diabetes treatment in Italy. Furthermore, the projected rise in CwD due to the National T1D screening program emphasizes the need for increased resources for specialized pediatric care of CwD at all stages.

Keywords: Adolescents; Benchmarking; Care; Children; Screening; Team; Technology; Type 1 diabetes.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors state there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Classification of Italian Centers for the Treatment of Pediatric Diabetes in June 2022
Fig. 2
Fig. 2
The numerosity of the Center (%) is determined by their geographical position (North, Center, and South + Islands)
Fig. 3
Fig. 3
Percentages of Centers with 0, 1, 2, or ≥ 3 Healthcare Professionals (HCP: physicians, nurses, dietitians, and psychologists) working with children and adolescents with T1D
Fig. 4
Fig. 4
Distribution of the different pediatric Centers for treating pediatric diabetes in 2012 and 2022
Fig. 5
Fig. 5
Distribution of mean HCPs Full Time Equivalent (FTE) stratified by quartiles of children and adolescents (< 18 years) with T1D treated in 2012 and 2022. Physicians (Panel A), Nurses (Panel B), Dietitians (Panel C), and Psychologists (Panel D). The dotted lines represent the minimum value of the recommended optimal FTE/100 CwD according to SWEET and ISPAD [6, 8]
See this image and copyright information in PMC

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