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Aims <p>Diabetic peripheral neuropathy (DN) is a major complication of type 1 diabetes (T1D), frequently subclinical in youth. Although international pediatric guidelines recommend annual screening, adherence in pediatric care is uncertain. This study aimed to assess DN screening practices in Italian pediatric diabetes centers and identify barriers to implementation.</p> Methods <p>Between December 2024 and May 2025, we conducted a nationwide, cross-sectional survey among Italian centers affiliated with the ISPED Diabetes Study Group. One respondent per center completed a 27-item questionnaire exploring organizational features, DN screening practices, and professional training.</p> Results <p>Forty-eight centers responded to the survey. Written internal protocols for DN screening were available in 22.9% of centers. Only 18.6% reported annual screening, while more than 40% initiated screening only in the presence of symptoms. Recommended criteria (age ≥ 11&#xa0;years and 2–5&#xa0;years diabetes duration) were applied by 31.3% of centers. Clinical neurological examination was widely adopted (95.8%), whereas nerve conduction studies (29.2%) and the Michigan Neuropathy Screening Instrument (14.6%) were rarely used. Notably, 89.6% of respondents had never received formal training in DN screening. Centers where pediatric diabetologists personally conducted the assessment were more likely to adhere to annual screening (<i>p</i> = 0.010).</p> Conclusions <p>Screening for DN in Italian pediatric diabetology is inconsistent and frequently delayed, contributing to probable underrecognition of early neuropathic changes. Strengthening professional awareness, promoting structured training, and implementing harmonized national protocols are essential steps to ensure timely identification and equitable care for children and adolescents with T1D.</p>

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Screening practices for diabetic peripheral neuropathy in pediatric type 1 diabetes: a nationwide survey by the ISPED Diabetes Study Group

  • 期刊论文

  • 发表日期：

    2026年5月18日

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  • Bruno Bombaci,
  • Marta Bassi,
  • Valeria Castorani,
  • Francesca Di Candia,
  • Marta Ferrari,
  • Mariangela Martino,
  • Luca Zagaroli,
  • Marco Marigliano,
  • Riccardo Bonfanti,
  • Claudia Accursia Albino,
  • Monica Aloe,
  • Maria Teresa Anzelotti,
  • Claudia Arnaldi,
  • Fabrizio Barbetti,
  • Marta Bassi,
  • Maria Giulia Berioli,
  • Luca Bernardini,
  • Enrica Bertelli,
  • Martina Biagioni,
  • Adriana Bobbio,
  • Bruno Bombaci,
  • Riccardo Bonfanti,
  • Clara Bonura,
  • Giulia Patrizia Bracciolini,
  • Mariella Bruzzese,
  • Patrizia Bruzzi,
  • Pietro Buono,
  • Piera Buscarino,
  • Francesco Cadario,
  • Valeria Calcaterra,
  • Elena Calzi,
  • Marco Cappa,
  • Roberta Cardani,
  • Francesca Cardella,
  • Giuliana Marcella Cardinale,
  • Alberto Casertano,
  • Valeria Castorani,
  • Vittoria Cauvin,
  • Valentina Cenciarelli,
  • Franco Ceruti,
  • Valentino Cherubini,
  • Francesco Chiarelli,
  • Giovanni Chiari,
  • Stefano Cianfarani,
  • Mario Cicchetti,
  • Paola Cipriano,
  • Dante Cirillo,
  • Felice Citriniti,
  • Maria Susanna Coccioli,
  • Santino Confetto,
  • Giovanna Contreas,
  • Anna Coro,
  • Antonella Correddu,
  • Elisa Corsini,
  • Antonino Crino′,
  • Giuseppe d′Annunzio,
  • Fiorella De Berardinis,
  • Valeria De Donno,
  • Gianpaolo De Filippo,
  • Rosaria De Marco,
  • Luisa De Sanctis,
  • Elisabetta Del Duca,
  • Maurizio Delvecchio,
  • Annalisa Deodati,
  • Procolo Di Bonito,
  • Francesca Di Candia,
  • Elena Faleschini,
  • Valentina Fattorusso,
  • Anna Favia,
  • Giovanni Federico,
  • Barbara Felappi,
  • Mara Ferrari,
  • Lucia Ferrito,
  • Graziella Fichera,
  • Franco Fontana,
  • Elena Fornari,
  • Roberto Franceschi,
  • Francesca Franco,
  • Adriana Franzese,
  • Anna Paola Frongia,
  • Giulio Frontino,
  • Alberto Gaiero,
  • Sabrina Maria Galassi,
  • Francesco Gallo,
  • Luigi Gargantini,
  • Elisa Giani,
  • Anna Jolanda Gortan,
  • Vanna Graziani,
  • Caterina Grosso,
  • Antonella Gualtieri,
  • Monica Guasti,
  • Lucia Paola Guerraggio,
  • Chiara Guzzetti,
  • Dario Iafusco,
  • Gennaro Iannicelli,
  • Maria Laura Iezzi,
  • Maria Giovanna Ignaccolo,
  • Stefania Innaurato,
  • Elena Inzaghi,
  • Brunella Iovane,
  • Lorenzo Iughetti,
  • Peter Kaufmann,
  • Alfonso La Loggia,
  • Anna Giulia Lambertini,
  • Rosa Lapolla,
  • Anna Lasagni,
  • Nicola Lazzaro,
  • Pietro Lazzeroni,
  • Lorenzo Lenzi,
  • Riccardo Lera,
  • Gabriella Levantini,
  • Marilea Lezzi,
  • Rosanna Lia,
  • Alice Liguori,
  • Donatella Lo Presti,
  • Fortunato Lombardo,
  • Antonella Lonero,
  • Silvia Longhi,
  • Antonella Lorubbio,
  • Sonia Lucchesi,
  • Rosella Maccioni,
  • Maddalena Macedoni,
  • Patrizia Cristiana Macellaro,
  • Simona Filomena Madeo,
  • Claudio Maffeis,
  • Benedetta Mainetti,
  • Giulio Maltoni,
  • Chiara Mameli,
  • Francesco Mammì,
  • Maria Luisa Manca Bitti,
  • Valentina Mancioppi,
  • Melania Manco,
  • Marco Marigliano,
  • Monica Marino,
  • Alberto Marsciani,
  • Maria Cristina Matteoli,
  • Elena Mazzali,
  • Marta Minute,
  • Nicola Minuto,
  • Sara Monti,
  • Anita Morandi,
  • Gianfranco Morganti,
  • Elisa Morotti,
  • Enza Mozzillo,
  • Gianluca Musolino,
  • Francesca Olivieri,
  • Federica Ortolani,
  • Valentina Pampanini,
  • Daniela Pardi,
  • Filomena Pascarella,
  • Bruno Pasquino,
  • Stefano Passanisi,
  • Ippolita Patrizia Patera,
  • Annalisa Pedini,
  • Maria Cristina Pennati,
  • Sonia Peruzzi,
  • Paola Peverelli,
  • Giulia Pezzino,
  • Barbara Piccini,
  • Elvira Eugenia Rosaria Piccinno,
  • Claudia Piona,
  • Gavina Piredda,
  • Alessia Piscopo,
  • Carmelo Pistone,
  • Erica Pozzi,
  • Elena Prandi,
  • Barbara Predieri,
  • Sabrina Prudente,
  • Anna Pulcina,
  • Ivana Rabbone,
  • Emioli Randazzo,
  • Novella Rapini,
  • Petra Reinstadler,
  • Sara Riboni,
  • Maria Rossella Ricciardi,
  • Andrea Rigamonti,
  • Carlo Ripoli,
  • Virginia Rossi,
  • Paolo Rossi,
  • Irene Rutigliano,
  • Alberto Sabbion,
  • Alessandro Salvatoni,
  • Caterina Salvo,
  • Giuseppina Salzano,
  • Mariateresa Sanseviero,
  • Silvia Savastio,
  • Rosanna Savini,
  • Mariapiera Scanu,
  • Andrea Enzo Scaramuzza,
  • Riccardo Schiaffini,
  • Maurizio Schiavone,
  • Eleonardo Schieven,
  • Mirella Scipione,
  • Andrea Secco,
  • Francesca Silvestri,
  • Giulia Siri,
  • Paola Sogno Valin,
  • Silvia Sordelli,
  • Daniele Spiri,
  • Stefano Stagi,
  • Filomena Andreina Stamati,
  • Tosca Suprani,
  • Valentina Talarico,
  • Valentina Tiberi,
  • Tiziana Antonia Lucia Timpanaro,
  • Davide Tinti,
  • Antonina Tirendi,
  • Letizia Grazia Tomaselli,
  • Sonia Toni,
  • Cataldo Torelli,
  • Gianluca Tornese,
  • Michela Trada,
  • Adolfo Andrea Trettene,
  • Stefano Tumini,
  • Marilena Tumminelli,
  • Giuliana Valerio,
  • Sara Vandelli,
  • Claudia Ventrici,
  • Maria Zampolli,
  • Manuela Zanatta,
  • Angela Zanfardino,
  • Clara Zecchino,
  • Silvia Zonca,
  • Stefano Zucchini

摘要

Aims

Diabetic peripheral neuropathy (DN) is a major complication of type 1 diabetes (T1D), frequently subclinical in youth. Although international pediatric guidelines recommend annual screening, adherence in pediatric care is uncertain. This study aimed to assess DN screening practices in Italian pediatric diabetes centers and identify barriers to implementation.

Methods

Between December 2024 and May 2025, we conducted a nationwide, cross-sectional survey among Italian centers affiliated with the ISPED Diabetes Study Group. One respondent per center completed a 27-item questionnaire exploring organizational features, DN screening practices, and professional training.

Results

Forty-eight centers responded to the survey. Written internal protocols for DN screening were available in 22.9% of centers. Only 18.6% reported annual screening, while more than 40% initiated screening only in the presence of symptoms. Recommended criteria (age ≥ 11 years and 2–5 years diabetes duration) were applied by 31.3% of centers. Clinical neurological examination was widely adopted (95.8%), whereas nerve conduction studies (29.2%) and the Michigan Neuropathy Screening Instrument (14.6%) were rarely used. Notably, 89.6% of respondents had never received formal training in DN screening. Centers where pediatric diabetologists personally conducted the assessment were more likely to adhere to annual screening (p = 0.010).

Conclusions

Screening for DN in Italian pediatric diabetology is inconsistent and frequently delayed, contributing to probable underrecognition of early neuropathic changes. Strengthening professional awareness, promoting structured training, and implementing harmonized national protocols are essential steps to ensure timely identification and equitable care for children and adolescents with T1D.