Quality of care and clinical characteristics of adults with type 1 diabetes in Italy: insights from the 2025 AMD Annals initiative

Aims: The Italian Association of Medical Diabetologists (AMD) has monitored the quality of diabetes care nationwide since 2006. We describe the clinical characteristics, quality of care, and use of technologies among adults with type 1 diabetes (T1D) attending 343 Italian diabetes clinics in 2025. Methods: Anonymous data were extracted from electronic medical records using standardized software. Process, treatment, and outcome indicators, together with the validated Q-score, were evaluated. Results: Overall, 51,013 adults with T1D were included (mean age 49.3 ± 17.1 years; 19.4% aged >65 years). HbA1c ≤7.0% was achieved by 37.2% of patients, whereas only 4.3% simultaneously achieved HbA1c ≤7.0%, LDL-cholesterol <70 mg/dL, and blood pressure <130/80 mmHg. Obesity was present in 14.7% of individuals. Diabetic retinopathy affected 29.5% of patients, albuminuria 20.8%, and 11.3% had eGFR <60 mL/min/1.73 m2. Continuous subcutaneous insulin infusion (CSII) was used by 21.3% of patients and was associated with better glycemic control, more favorable glucometric indices, and a lower prevalence of chronic complications than multiple daily injections. Only 3.1% of patients had a Q-score <15. Conclusions: Adults with T1D are increasingly older and frequently affected by obesity. Although overall quality of care is satisfactory, substantial gaps remain in cardiovascular risk-factor control and technology adoption.