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Knowledge, Attitudes, and Practices in Neonatal Diabetes Mellitus Management: the JEnious-NeOnatal-DIabetes (JENODI)
Maurizio Delvecchio1, Claudia Piona2, Agata Chobot3,4
1Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. maurizio.delvecchio1@univaq.it.
Insights
This survey reveals varied knowledge and practices in neonatal diabetes mellitus (NDM) management among ISPAD members. Continuous education is crucial to enhance physician confidence and standardize NDM care globally.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Genetics
Background:
- Neonatal diabetes mellitus (NDM) is a rare condition requiring specialized management.
- Understanding current practices and knowledge gaps in NDM is essential for improving patient outcomes.
Purpose of the Study:
- To assess the knowledge, attitude, and management strategies for NDM among International Society for Pediatric and Adolescent Diabetes (ISPAD) members.
- To identify variations in NDM diagnosis and treatment across different geographic regions.
Main Methods:
- An online questionnaire was distributed to ISPAD members via the society's website.
- 108 responses were collected from 45 countries, with 103 participants involved in NDM management.
Main Results:
- Most participants initiate insulin (87.9%) and utilize continuous glucose monitoring (80.6%) and insulin pumps (54.6%) for NDM.
- Genetic testing is widely recommended (97.2%) and routinely performed (79.6%) to guide sulfonylurea (SU) treatment.
- A significant portion of physicians lack specific NDM training (63%) and confidence (55.5%) in managing these patients.
Conclusions:
- Survey results highlight diverse NDM management approaches globally, emphasizing the need for standardized protocols.
- Genetic testing is considered vital for identifying NDM patients responsive to sulfonylurea therapy.
- Enhanced continuous medical education is recommended to improve physician confidence and expertise in managing neonatal diabetes mellitus.
Introduction:
We aimed to explore the knowledge, attitude, and management of neonatal diabetes mellitus (NDM) among members of the International Society for Pediatric and Adolescent Diabetes (ISPAD).
Methods:
Members of the society were invited to complete an online questionnaire posted on the ISPAD website.
Results:
We received 108 responses from 45 different countries. Of these, 103 were involved in NDM management. 87.9% of participants would start insulin at diagnosis, and 11% would prefer sulfonylurea (SU); 54.6% would start with an insulin pump, and 80.6% would use continuous glucose monitoring. Genetic testing was suggested by 97.2% (50.9% when diagnosis occurs up to 6 months, 15.7% up to 9 months, and 30.6% up to 12 months of age), while 79.6% routinely request it in clinical practice. Of the participants, 96.3% consider genetic testing necessary to identify children who can be treated with SU, and 26.9% would try SU before testing/obtaining results. Only 37% received specific training on NDM, while 44.5% felt less confident in managing patients with NDM. Incidence in the country of practice, participant's age, years of experience in the field, number of patients registered in the clinic, and number of patients with NDM followed up were associated with differences in answers.
Conclusions:
This survey offers the possibility of informing health providers about the awareness of different aspects of NDM management. Our results provide the opportunity to compare various aspects of diagnosis and treatment of NDM in different geographic areas. Continuous education is needed to boost physicians' confidence in managing patients with this rare form of diabetes.
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