Furthermore, the description of cutaneous sensations associated with itch, the emotional burden of itch, sleep impairment, certain factors influencing itch intensity and itch impact on psyche were noted. Īdditionally, the 4-Item Itch Questionnaire (4IIQ), previously used by our group in many studies on different types of itch, was employed to assess CI extensity, severity, frequency and associated sleep impairment. NRS cutoff points are as follows: 1– < 3 points represent mild itch, 3–7 points moderate itch, ≥ 7–9 points severe itch and ≥ 9 points very severe itch. A numerical rating scale (NRS 0: no itch 10 points: worst imaginable itch) was utilized to assess maximal values of itch intensity in both the last 3 days and last 24 h. The main clinical parameter, the presence of chronic itch (CI), was documented, including the affected anatomical locations. If multiple laboratory tests were available, the results closest to the day of dermatologic examination would be chosen. The results of routine laboratory blood tests were also noted with particular emphasis on glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG). SD standard deviation, BMI body mass indexĪfter inclusion, detailed information on demographics, clinical history, comorbidities and physical findings was recorded. Therefore, the final study group constituted 100 pediatric patients with T1D (Table (Table1 1). Among 102 patients, 2 subjects suffered from dermatologic disorders (one patient had atopic dermatitis and one suffered from psoriasis). Exclusion criteria included: mental status changes making the patient unable to make a detailed assessment of itch known severe renal or liver disease a history of chronic dermatologic disease. The inclusion criteria were diagnosis of T1D according to internationally accepted criteria and an informed written participation agreement signed by the parent. The mother of one child refused participation in the study because of the severe course of T1D (hospitalization due to diabetic ketoacidosis) the mother of another child refused participation in the study without specifying the reasons (response rate: 98%). We approached 104 consecutive patients aged 6–18 years who were treated in the Department of Endocrinology and Diabetology for Children and Adolescents. Written informed consent to participate was obtained from all children and their carers before enrollment, they were also informed of their right to leave the study at any time. The study procedures were carried out in agreement with the Helsinki Declaration of 1964 and its later amendments, and good clinical practice guidelines. The project was approved by the local Ethical Committee (ST.C260.18.019). This prospective cross-sectional study was performed between April 2019 and December 2019. Therefore, we set up a prospective study among pediatric patients with T1D, using standardized methods for itch assessment to investigate the prevalence of itch, to provide itch characteristics and to explore the potential underlying causes. Studies on itch in T1D, employing currently accepted methodology, are scarce. However, these studies used inconsistent definitions and various tools for itch evaluation and included heterogeneous diabetic populations. Only a few studies investigated the occurrence of itch in DM, reporting a wide prevalence ranging from 18.4–27.5%. Most researchers classify itch in diabetes, according to the International Forum for the Study of Itch (IFSI), as systemic itch however, some authors suggested mixed etiology of diabetic itch with the additional involvement of both dermatologic and neurologic components. It is a frequent and distressing symptom occurring not only in dermatologic conditions but also in chronic systemic diseases, posing a high burden and decrease in quality of life (QoL) of patients. Itch is defined as an unpleasant sensation that leads to intensive scratching. Approximately 2–3 teenagers per 1000 are currently diagnosed with this type of diabetes, and this ratio is rising by 3% per annum in European children, with an increasing number being diagnosed in early childhood. More than 90% of patients with T1D are diagnosed before the age of 30. Type 1 diabetes (T1D) is reported to be one of the most common medical conditions in school-age youth, and it is ranked third in the prevalence of pediatric conditions. The International Diabetes Federation estimated that 1 in 11 adults aged 20–79 years (which amounts to 415 million adults) had DM globally in 2015. Diabetes mellitus (DM) and its complications are a growing problem worldwide.
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