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Published on: June 11, 2012
Knowledge, attitudes, and practices in pediatric hypoglycemia in Italy (KAPPHy study)
Arianna Maiorana1, Roberta Pajno2, Francesco Tagliaferri3,4
1Division of Metabolic Diseases and Hepatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy.
Insights
Pediatric hypoglycemia management in Italy shows variability in diagnostic thresholds and technology use. Harmonized national guidelines are needed for consistent diagnosis and treatment of childhood hypoglycemia.
Area of Science:
- Pediatric Endocrinology
- Metabolic Diseases
- Clinical Practice Guidelines
Background:
- Childhood hypoglycemia presents significant morbidity and potential long-term neurological issues.
- Current diagnostic and management strategies for pediatric hypoglycemia are inconsistent, especially post-neonatal period.
Purpose of the Study:
- To assess current diagnostic and therapeutic practices for pediatric hypoglycemia in Italy.
- To evaluate practices among members of the Italian Society of Pediatric Endocrinology and Diabetology (SIEDP) and the Italian Society of Metabolic Diseases and Newborn Screening (SIMMESN).
Main Methods:
- An anonymous electronic survey with 43 questions was distributed to SIEDP and SIMMESN members.
- Descriptive statistics and comparative analyses were performed on the survey data.
Main Results:
- 118 respondents participated, most with direct experience in pediatric hypoglycemia.
- Significant heterogeneity was observed in diagnostic thresholds (50, 60, or 70 mg/dL).
- Differences noted in the use of genetic testing (more by SIMMESN) and continuous glucose monitoring (more by SIEDP).
Conclusions:
- Pediatric hypoglycemia management in Italy generally aligns with international standards.
- Variability in diagnostic thresholds, molecular testing, and technology adoption persists.
- There is a clear need for unified national recommendations and diagnostic definitions.
Purpose:
Childhood hypoglycemia is associated with relevant morbidity and likely long-term neurological sequelae. Diagnostic thresholds and management strategies remain quite heterogeneous, particularly beyond the neonatal period. We aimed to evaluate current diagnostic and therapeutic practices for pediatric hypoglycemia management in Italy among members of the Italian Society of Pediatric Endocrinology and Diabetology (SIEDP) and the Italian Society of Metabolic Diseases and Newborn Screening (SIMMESN).
Methods:
An anonymous electronic survey including 43 questions about management of pediatric hypoglycemia was sent to SIEDP and SIMMESN members. Descriptive statistics and comparative statistical analysis between respondents of the two societies were run.
Results:
A total of 118 respondents participated. Most of them reported direct clinical experience in pediatric hypoglycemia and routinely used critical sampling during hypoglycemic episodes. Diagnostic thresholds were heterogeneous: 34.7% reported 50 mg/dL, 33.1% 60 mg/dL, and 22.0% 70 mg/dL. Comparative analysis between societies showed no differences in most diagnostic procedures, but significant differences emerged in diagnostic thresholds (p = 0.005), with SIMMESN members selected 60 mg/dL more frequently (adjusted p = 0.020), and SIEDP members more frequently 70 mg/dL (adjusted p = 0.013). SIMMESN members reported more frequent use of genetic testing for etiological diagnosis. SIEDP respondents showed a frequent used of continuous glucose monitoring in the follow-up.
Conclusion:
Management of pediatric hypoglycemia in Italy is largely aligned with international recommendations. Clinically relevant variability persists, particularly in diagnostic thresholds, adoption of molecular analysis, and technologies, likely reflecting different clinical focus and patient populations. Our findings highlight the need for harmonized national recommendations and shared diagnostic definitions across scientific societies.
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