Background Frequent use of modern diabetes technologies increases the chance for optimal type 1 diabetes (T1D) control. Limited reimbursement influences the access of patients with T1D to these modalities and could worsen their prognosis. We aimed to describe the situation of reimbursement for insulins, glucometers, insulin pumps (CSII) and continuous glucose monitoring (CGM) for children with T1D in European countries participating in the SWEET Project and to compare data from EU countries with data from our previous study in 2009. Methods The study was conducted between March 2017 and August 2017. First, we approached diabetes technology companies with a survey to map the reimbursement of insulins and diabetic devices. The data collected from these companies were then validated by members of the SWEET consortium. Results We collected data from 29 European countries, whereas all types of insulins are mostly fully covered, heterogeneity was observed regarding the reimbursement of strips for glucometers (from 90 strips/month to no limit). CSII is readily available in 20 of 29 countries. Seven countries reported significant quota issues or obstacles for CSII prescription, and two countries had no CSII reimbursement. CGM is at least partially reimbursed in 17 of 29 countries. The comparison with the 2009 study showed an increasing availability of CSII and CGM across the EU. Conclusions Although innovative diabetes technology is available, a large proportion of children with T1D still do not benefit from it due to its limited reimbursement.

OBJECTIVES: We aimed to study the prevalence of the early onset Type 1 diabetes in Slovakia during the years 1996-2017. BACKGROUND: Prevalence of Type 1 diabetes in young children is increasing worldwide. However, recent data from Slovakia are missing. METHODS: All children with newly diagnosed Type 1 diabetes included in the study were diagnosed in the Children Diabetes Centre in Bratislava during the years 1996-2017. The incidence of T1D in children aged below 3 and below 5 years was calculated and compared to the T1D incidence in older children. Incidence trends were calculated with the Poissed regression. RESULTS: Gender-adjusted incidence of T1D annually increased by 5.4 % (CI: 3.9-6.8; p < 0.001) in children <3 years, and by 3.4 % (95 % CI 2.2-4.6; p < 0.001) in children < 5 years during the last two decades. Moreover, the proportion of young children < 3 years of age among all newly diagnosed children and adolescents increased over time (4.

Little is known about complete remission in Type 1 diabetes mellitus (T1D) with the discontinuance of insulin treatment for a period of time. In this retrospective study we analysed the frequency and factors of onset and duration of 1. remission and 2. complete remission in children and adolescents with T1D from the Children Diabetes Centre in Bratislava, Slovakia. A total of 529 individuals with T1D, aged < 19 years (8.5 ± 4.3 years) at diabetes onset were included in the study. Remission was defined by HbA1c < 7.0% (53 mmol/mol) and an insulin daily dose < 0.5 IU/kg (and 0 IU/kg for complete remission). Remission occurred in 210 (39.7%) participants, and 15 of them had complete remission (2.8% from all participants). We have identified a new independent factor of complete remission onset (higher C-peptide). Complete remitters had a longer duration of remission compared with other remitters and also differed in lower HbA1c levels. No association was seen with autoantibodies or genetic risk score for T1D. Thus, not only partial but also complete remission is influenced by factors pointing toward an early diagnosis of T1D, which is important for better patient outcome.

detská klinika, lekárska fakulta univerzity komenského a národný ústav detských chorôb, Bratislava diaBGene a oddelenie výskumu porúch metabolizmu, Ústav experimentálnej endokrinológie, Biomedicínske centrum slovenskej akadémie vied, Bratislava

The implementation of modern technology into standard of care of type 1 diabetes lenka petruželková, lukáš plachý, marie kajprová, Vítek neuman, Barbora obermannová, Štěpánka průhová, Jan lebl, stanislava koloušková, Zdeněk Šumník pediatrická klinika Fn Motol a 2. lF uk, praha souhrn petruželková l, plachý l, kajprová m, neuman V, obermannová B, průhová Š, lebl J, koloušková s, Šumník Z. technologická revoluce v léčbě diabetu 1. typu diabetes 1. typu je chronické autoimunitní onemocnění vyžadující doživotní aplikaci inzulinu. Vzhledem k nárůstu počtu onemocnění především v nejmladší věkové kategorii je potřeba počítat s nárůstem celkového počtu pacientů a z toho plynoucí zvýšenou zátěží zdravotního systému. neuspokojivá kompenzace diabetu je spojena s rozvojem dlouhodobých mikro-a makrovaskulárních komplikací, které výrazně ovlivňují kvalitu a délku života pacientů. cílem léčby u dětských pacientů je dosáhnout optimální kontroly glykemie, tedy normoglykemie, která by měla výskyt sekundárních komplikací diabetu zcela eliminovat. k dosažení normoglykemie přispělo zařazení moderních technologií do standardní terapie diabetu 1. typu. Jejich přehled a cestu k našim pacientům přiblíží tento článek. klíčová slova: diabetes 1. typu, technologie, uzavřená smyčka summary petruželková l, plachý l, kajprová m, neuman V, obermannová B, průhová Š, lebl J, koloušková s, Šumník Z. the implementation of modern technology into standard of care of type 1 diabetes type 1 diabetes is a chronic autoimmune condition that requires life-long insulin administration. an increasing prevalence of diabetes, especially in youngest children, results in significant burden on the healthcare system. unsatisfactory disease control is associated with the development of long-term micro-and macrovascular complications, which significantly affect the quality of life and life expectancy of our patients. the current treatment goal in paediatric patients is to achieve normoglycemia and to completely eliminate the occurrence of secondary complications of diabetes. Modern technologies have been successfully implemented as the standard of care for people with type 1 diabetes and have improved the glycaemic control by reducing time spent both in hyper-and hypoglycaemia, while improving quality of life of our patients. their overview and their pathway to our patients are presented in this review.