Type 1 diabetes mellitus (DM) is characterized by irreversible, autoimmune, pancreatic β-cell destruction. During the disease, some patients experience a phase of Partial Clinical Remission (PCR) known as “honeymoon.” This is a transitory period that is characterized by insulin production by residual β cells following DM diagnosis and initiating the insulin therapy. In this study, we aimed to evaluate the influence of insulin production on immune system after the onset of diabetes, and we showed that the duration of honeymoon period could be related to the onset of other autoimmune conditions. For this retrospective study, 159 children aged between 11 and 18 years with type 1 DM were eligible. They have been diagnosed diabetes at least 10 years ago and use exogenous insulin. Our results showed that younger age at the onset of Type 1 DM in children, predicts Celiac Disease. Female sex and low HCO3 levels at the onset of DM had a high predictive value on patients who did not experience longer Partial Clinical Remission phase. Patients with higher BMI at the diagnosis of DM experienced shorter honeymoon period than the average. Smaller of our patients who diagnosed just DM have more than 297 days honeymoon period with respect to patients with one associated autoimmune disease. This may be due to a continuous and prolonged stimulation of immune system during the period of honeymoon that predispose the patient to develop other TH1 diseases. The patients who experienced more than 297 days Partial Clinical Remission seem under risk of developing one other autoimmune disease more than the patients who experienced less than 297 days Partial Clinical Remission. We have to consider that this observation is very intriguing because many protocols spring-up to try prolonging the honeymoon period in patients with autoimmune DM. If this aim is important from a metabolic point of view, long follow-ups are needed to be sure that the risk of other autoimmune diseases does not increase.

Background Pandemics are states of disease that occur worldwide and sharply increase in populations. It causes life events which trigger anxiety, depression, anger, sleep deprivation, emotional distress and stress. World Health Organization (WHO) declared coronavirus disease 2019 (COVID‐19) a pandemic on March 11, pointing to the over 118,000 cases in over 110 countries. Many healthcare workers became ill during the pandemic and some among them died. In this study, we aimed to evaluate and compare level of stress against COVID‐19 pandemic among doctors from Turkey and Italy. Methods This research is a cross‐sectional study in which Perceived Stress Scale (PSS‐10) and Secondary Traumatic Stress Scale (STSS) are administered online via social networks. All data collection tools were delivered to individuals between 1 and 15 June 2020 and filled in online with Google Forms application. In total, 618 individuals were included in this study and all of them were medical doctors. Results Higher PS and STS levels were found related to female gender, being married, working in pandemic hospital and older ages. Stress levels were found statistically higher in Turkish doctors when compared to Italian doctors for both stress scales (Turkish/Italian PSS:20.18 ± 7.90/ 19.35 ± 6.71, STSS: 44.19 ± 13.29/ 38.83 ± 13.74). Conclusion The number of doctors per 1000 of population is lower and per capita visits to a physician are higher in Turkey when compared to Italy. Besides pandemic, these heavier working conditions, increased weekly working hours can cause stress for Turkish doctors. Reporting information such this study is important and international collaborations are essential to plan future prevention strategies. We need to strengthen international ties and build more international collaborations rather than staying within our national silos. Additionally, interventions to promote mental well‐being in health care professionals exposed to COVID‐19 need to be immediately implemented.

Wolfram Syndrome (WS) is a very rare genetic disorder characterized by several symptoms that occur from childhood to adulthood. Usually, the first clinical sign is non-autoimmune diabetes even if other clinical features (optic subatrophy, neurosensorial deafness, diabetes insipidus) may be present in an early state and may be diagnosed after diabetes’ onset. Prognosis is poor, and the death occurs at the median age of 39 years as a consequence of progressive respiratory impairment, secondary to brain atrophy and neurological failure. The aim of this paper is the description of the metabolic treatment of the WS. We reported the experience of long treatment in patients with this syndrome diagnosed in pediatric age and followed also in adult age. It is known that there is a correlation between metabolic control of diabetes, the onset of other associated symptoms, and the progression of the neurodegenerative alterations. Therefore, a multidisciplinary approach is necessary in order to prevent, treat and carefully monitor all the comorbidities that may occur. An extensive understanding of WS from pathophysiology to novel possible therapy is fundamental and further studies are needed to better manage this devastating disease and to guarantee to patients a better quality of life and a longer life expectancy.

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In pediatric diabetology, a precise diagnosis is very important because it allows early and correct clinical management of the patient. Monogenic diabetes (MD), which accounts for 1–6% of all pediatric–adolescent diabetes cases, is the most relevant example of precision medicine. The definitive diagnosis of MD, possible only by genetic testing, allows us to direct patients to more appropriate therapy in relation to the identified mutation. In some cases, MD patients can avoid insulin and be treated with oral hypoglycemic drugs with a perceptible impact on both the quality of life and the healthcare costs. However, the genetic and phenotypic heterogeneity of MD and the overlapping clinical characteristics between different forms, can complicate the diagnostic process. In recent years, the development of Next-Generation Sequencing (NGS) methodology, which allows the simultaneous analysis of multiple genes, has revolutionized molecular diagnostics, becoming the cornerstone of MD precision diagnosis. We report two cases of patients with clinical suspects of MD in which a genetic test was carried out, using a NGS multigenic panel, and it clarified the correct pathogenesis of diabetes, allowing us to better manage the disease both in probands and other affected family members.