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Minerva Pediatrics 2021 Sep 16

DOI: 10.23736/S2724-5276.21.06545-9


lingua: Inglese

Long-term complications of type 1 diabetes: what do we know and what do we need to understand?

Claudia PIONA 1, Claudia VENTRICI 2, Loredana MARCOVECCHIO 3, Francesco CHIARELLI 4, Claudio MAFFEIS 1, Riccardo BONFANTI 5, Ivana RABBONE 6

1 Paediatric Diabetes and Metabolic Disorders Unit, Regional Center for Paediatric Diabetes, University City Hospital of Verona, Italy; 2 Paediatric Unit, Hospital of Polistena, Polistena, Reggio Calabria, Italy; 3 Department of Paediatrics, University of Cambridge, Cambridge, UK; 4 Department of Paediatrics, University of Chieti, Chieti, Italy; 5 Diabetes Research Institute, Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Milano, Italy; 6 Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy


Long-term complications of type 1 diabetes (T1D) include microvascular complications and macrovascular disease. Despite the important advances in the treatment of T1D of the last decades, these complications still represent the leading cause of morbidity and mortality in patients with T1D. Extensive evidence indicates that structural and functional alterations of the kidney, retina, nerves and large arteries occur already in the first years after the onset of diabetes. We performed a comprehensive review of the available evidence on screening, diagnosis, prevention and treatment of vascular complications of T1D. In particular, we focused on three major challenges related to long-term complications of T1D: 1) finding of new biomarkers and diagnostic methods able to identify early signs of complications; 2) identifying specific risk factors for the development of these complications; 3) identifying and implementing new therapeutic strategies able to prevent the development and progression of vascular complications.

KEY WORDS: Type 1 diabetes; Diabetic complications; Diagnosis; Risk factor; Biomarkers; Treatment

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