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

Bruno Bombaci1, Marta Bassi2, Valeria Castorani3

  • 1Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy.

Acta Diabetologica
|May 18, 2026
PubMed

Insights

Diabetic peripheral neuropathy screening is inconsistent in Italian pediatric diabetes centers, with many delaying diagnosis. Improved training and national protocols are needed for timely identification in children with type 1 diabetes.

Area of Science:

  • Pediatric Endocrinology
  • Neurology
  • Public Health

Background:

  • Diabetic peripheral neuropathy (DN) is a significant complication of type 1 diabetes (T1D), often presenting subclinically in pediatric populations.
  • International guidelines advocate for annual DN screening in youth with T1D, but adherence remains uncertain.
  • Early detection of DN is crucial for preventing long-term complications and ensuring optimal patient outcomes.

Purpose of the Study:

  • To evaluate the current practices and adherence to DN screening guidelines in Italian pediatric diabetes centers.
  • To identify organizational barriers and challenges hindering the implementation of consistent DN screening protocols.
  • To assess the level of professional training and awareness regarding DN screening among healthcare providers.

Main Methods:

  • A nationwide, cross-sectional survey was conducted among Italian pediatric diabetes centers affiliated with the ISPED Diabetes Study Group.
  • A 27-item questionnaire gathered data on organizational features, DN screening practices, and professional training.
  • Data were analyzed to determine the extent of adherence to recommended screening criteria and methods.

Main Results:

  • Only 18.6% of centers reported annual DN screening, with over 40% initiating screening only upon symptom onset.
  • Adherence to recommended screening criteria (age ≥ 11 years, 2-5 years diabetes duration) was observed in 31.3% of centers.
  • A significant majority (89.6%) of respondents lacked formal training in DN screening, and nerve conduction studies and the Michigan Neuropathy Screening Instrument were underutilized.

Conclusions:

  • DN screening practices in Italian pediatric diabetology are inconsistent and often delayed, potentially leading to underdiagnosis of early neuropathic changes.
  • There is a critical need to enhance professional awareness, implement structured training programs, and establish harmonized national protocols for DN screening.
  • These interventions are essential for ensuring timely identification and equitable management of DN in children and adolescents with T1D.
Abstract

Keywords:
AdolescentsChildrenDiabetes complicationsGuidelineMichigan neuropathy screening instrumentNeurophysiological tests

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