title: Organization and regional distribution of centers for the management of children and adolescents with diabetes in Italy.
abstract: BACKGROUND
  The incidence of type 1 diabetes in childhood is increasing by 3 % per year, placing growing demands on healthcare professionals and medical expenditures. Aim of this study wars to assess the organization of care to children with diabetes in Italy.
  
  
  METHODS
  During 2012 a structured questionnaire was sent to all of the members of Italian Society of Paediatric Endocrinology and Diabetology (ISPED). Questions examined organizational structure of Centers, personnel dedicated to the care of children with diabetes, number of subjects followed, local legal legislation supporting centres.
  
  
  RESULTS
  A total of 68 centers taking care to 15,563 children and adolescents with diabetes under 18 years of age were identified with a prevalence of 1.4 per 1,000 people. A wide variation in the organizational background was also reported. Fourty-four centers were organized as outpatient departments, 17 as simple units, 5 as complex units and 2 as simple departmental structures. Most centers had a multidisciplinary team. Ten out of twenty Italian regions had introduced supportive regional legislation, but it was fully applied only in six of them.
  
  
  CONCLUSIONS
  Great differences between regions were found in organizational structures, staffing levels and supportive legislation. The national legislation on diabetes was broadly implemented throughout the country regions. Further efforts are needed to improve standards and consistency of pediatric diabetes care in Italy.
authors.affiliation: S.O.D. Pediatric Diabetes, Department of Women's and Children's Health, Salesi Hospital, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Ancona, Presidio "G. Salesi", Via Corridoni 11, 60100, Ancona, Italy. giorgetti_chiara@yahoo.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Giorgetti
authors.affiliation: S.O.D. Pediatric Diabetes, Department of Women's and Children's Health, Salesi Hospital, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Ancona, Presidio "G. Salesi", Via Corridoni 11, 60100, Ancona, Italy. lucia.ferrito@gmail.com.
authors.forename: Lucia
authors.initials: L
authors.lastname: Ferrito
authors.affiliation: S.O.D. Pediatric Diabetes, Department of Women's and Children's Health, Salesi Hospital, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Ancona, Presidio "G. Salesi", Via Corridoni 11, 60100, Ancona, Italy. federica.zallocco@gmail.com.
authors.forename: Federica
authors.initials: F
authors.lastname: Zallocco
authors.affiliation: S.O.D. Pediatric Diabetes, Department of Women's and Children's Health, Salesi Hospital, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Ancona, Presidio "G. Salesi", Via Corridoni 11, 60100, Ancona, Italy. antonioiannilli@alice.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Iannilli
authors.affiliation: S.O.D. Pediatric Diabetes, Department of Women's and Children's Health, Salesi Hospital, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Ancona, Presidio "G. Salesi", Via Corridoni 11, 60100, Ancona, Italy. v.cherubini@univpm.it.
authors.forename: Valentino
authors.initials: V
authors.lastname: Cherubini
mesh_terms: D000293:Adolescent; D002648:Child; D003695:Delivery of Health Care / Q000458:organization & administration*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D010818:Practice Patterns, Physicians' / Q000592:standards*; D015995:Prevalence; D012041:Regional Medical Programs / Q000458:organization & administration*; D011795:Surveys and Questionnaires