Skip to main content
SpringerLink
Log in

Pharmacotherapy of Children and Adolescents with Type 1 Diabetes Mellitus

  • Chapter
  • First Online:
Book cover Pediatric Pharmacotherapy

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 261))

Abstract

Insulin treatment in children and adolescents with autoimmune type 1 diabetes has changed tremendously in the last 20 years with the knowledge of DCCT trial regarding near-normal glucose levels on the micro- and macrovascular outcome. Intensified insulin therapy is now standard of care. Carb counting however was introduced systematically only recently in several countries. In industrialized countries most patients in this age group are treated with continuous subcutaneous insulin injections. Nowadays this is combined with continuous subcutaneous glucose measurement commencing sensor-augmented pump therapy. Predictive low glucose suspend reduces the frequency of hypoglycemic events. Still not available for children is a commercially available closed loop system. However, treatment goals are still frequently not reached especially in the group of adolescents. Therefore several additive drugs are tested to improve treatment results. There are new insulins with faster and longer action profile in the pipeline to better mimic physiologic insulin profiles. Smart insulins may be able to mimic reaction on blood sugar levels. The broad facet of treatment modalities helps pediatric diabetes teams to individualize therapy and so improve patients’ health-related quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abali S, Turan S, Atay Z, Güran T, Haliloglu B, Bereket A (2015) Higher insulin detemir doses are required for the similar glycemic control: comparison of insulin detemir and glargine in children with type 1 diabetes mellitus. Pediatr Diabetes 16:361–366

    Article  CAS  PubMed  Google Scholar 

  • Anderson G, Meiffren G, Lamers D, DeVries JH, Ranson A, Seroussi C, Alluis B, Gaudier M, Soula O, Heise T (2018) Ultra-rapid BioChaperone Lispro improves postprandial blood glucose excursions vs lispro in a 14-day crossover treatment study in people with type 1 diabetes. Diabetes Obes Metab 20:2627–2632

    Article  Google Scholar 

  • Bachran R, Beyer P, Klinkert C, Heidtmann B, Rosenbauer J, Holl RW (2012) Basal rates and circadian profiles in continuous subcutaneous insulin infusion (CSII) differ for preschool children, prepubertal children, adolescents and young adults. Pediatr Diabetes 13:1–5

    Article  CAS  PubMed  Google Scholar 

  • Beato-Vibora PI, Quiros-Lopez C, Lazaro-Martin L, Martin-Frias M, Barrio-Castellanos R, Gil-Poch E, Arroyo-Diez FJ, Gimenez-Alvarez M (2018) Impact of sensor-augmented pump therapy with predictive low glucose suspend function on glycemic control and patient satisfaction in adults and children with type 1 diabetes. Diabetes Technol Ther 20:738–743

    Article  CAS  PubMed  Google Scholar 

  • Bendas A, Rothe U, Kiess W, Kapellen TM, Stange T, Manuwald U et al (2015) Trends in incidence rates during 1999-2008 and prevalence in 2008 of childhood type 1 diabetes mellitus in Germany-model based national estimates. PLoS One 16:10

    Google Scholar 

  • Bergenstal RM, Tamborlane W, Ahmann A, Buse JB, Dailey G, Davis SN, Joyce C, Peoples T, Perkins BA, Welsh JB, Willi SM, Wood MA, STAR 3 Study Group (2010) Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med 363:311–320

    Article  CAS  PubMed  Google Scholar 

  • Bergenstal RM, Bailey TS, Rodbard D, Ziemen M, Guo H, Muehlen-Bartmer I, Ahmann AJ (2017) Comparison of insulin glargine 300 units/mL and 100 units/m Lind adults with type 1 diabetes: continuous glucose monitoring profiles and variability using morning and evening injections. Diabetes Care 40:554–560

    Article  CAS  PubMed  Google Scholar 

  • Burdik P, Cooper S, Horner B, Cobry E, McFann K, Chase HP (2009) Use of a subcutaneous injection port to improve glycemic control in children with type 1 diabetes. Pediatr Diabetes 10:116–119

    Article  Google Scholar 

  • Danne T, Aman J, Schober E, Deiss D, Jacobsen JL, Friberg HH, Jensen LH, ANA 1200 Study Group (2003) A comparison of postprandial and preprandial administration of insulin aspart in children and adolescents with type 1 diabetes mellitus. Diabetes Care 26:2359–2364

    Article  CAS  PubMed  Google Scholar 

  • Danne T, Philotheou A, Goldman D, Guo X, Cali A, Johnston P (2013) A randomized trial comparing the rate of hypoglycemia – assessed using continuous glucose monitoring – in 125 preschool children with type 1 diabetes treated with insulin glargine or NPH insulin (the PRESCHOOL study). Pediatr Diabetes 14:593–601

    Article  CAS  PubMed  Google Scholar 

  • Danne T, Phillip M, Buckingham BA, Jarosz-Chobot P, Saboo B, Urakami T, Battelino T, Hanas R, Codner E (2018) ISPAD clinical practice guidelines 2018: insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 19(Suppl 27):115–135

    Article  PubMed  Google Scholar 

  • The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. N Engl J Med 329:977–986

    Article  Google Scholar 

  • Engwerda EE, Tack CJ, de Galan BE (2017) Pharmacokinetic and pharmacodynamic variability of insulin when administered by jet injection. J Diabetes Sci Technol 11:947–952

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fath M, Danne T, Biester T, Erichsen L, Kordonouri O, Haahr H (2017) Faster-acting insulin aspart provides faster onset and greater early exposure vs insulin aspart in children and adolescents with type 1 diabetes mellitus. Pediatr Diabetes 18:903–910

    Article  CAS  PubMed  Google Scholar 

  • Forlenza GP, Pinhas-Hamile O, Liljenquist DR, Shulman DI, Bailey TS, Bode BW, Wood MA, Buckingham BA, Kaiserman KB, Shin J, Huang S, Lee SW, Kaufman FR (2019) Safety evaluation of the MiniMed 670G system in children 7-13 years of age with type 1 diabetes. Diabetes Technol Ther 21:11–19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fullerton B, Siebenhofer A, Jeitler K, Horvath K, Semlitsch T, Berghold A, Plank J, Pieber TR, Gerlach FM (2016) Short acting insulin analogues versus regular human insulin for adults with type 1 diabetes. Cochrane Database Syst Rev:CD012161

    Google Scholar 

  • Heise T, Pieber TR, Danne T, Erichsen L, Haahr H (2017) Pharmacodynamic characteristics of fast-acting insulin aspart in adults with type 1 diabetes. Clin Pharmacokinet 56:551–559

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Holl RW, Prinz N (2019) Versorgung von Kindern und Jugendlichen mit Diabetes – aktuelle Situation und Veränderungen der letzten 23 Jahre. In: Deutscher Gesundheitsbericht Diabetes 2019. Herausgeber Deutsche Diabetesgesellschaft. Kirchheim Verlag, Mainz. ISSN 1614-824X

    Google Scholar 

  • Home PD (2012) The pharmacokinetics and pharmacodynamics of rapid-acting insulin analogues and their clinical consequences. Diabetes Obes Metab 14:780–788

    Article  CAS  PubMed  Google Scholar 

  • Kapellen TM, Dost A, Leludas C, Kiess W (1998) Patient acceptance and use of an emergency telephone hotline service in pediatric diabetes care. Diabetes Care 21:1365

    Article  CAS  PubMed  Google Scholar 

  • Kapellen TM, Gausche R, Dost A, Wiegand S, Flechtner-Mors M, Keller E, Kiess W, Holl RW, for the DPV-Science-Initiative of the German Competence Network Diabetes and the German Competence Network Obesity (Consortium LARGE) (2013) Children and adolescents with type 1 diabetes in Germany are more overweight than healthy controls: results comparing DPV database and CrescNet database. J Pediatr Endocrinol Metab 7:1–6

    Google Scholar 

  • Kapellen TM, Heidtmann B, Lilienthal E, Rami-Merhar B, Engler-Schmidt C, Holl RW (2015) Continuous subcutaneous insulin infusion in neonates and infants below 1 year: analysis of initial bolus and basal rate based on the experiences from the German working group for pediatric pump treatment. Diabetes Technol Ther 17:872–879

    Article  CAS  PubMed  Google Scholar 

  • Karges B, Schwandt A, Heidtmann B, Kordonouri O, Binder E, Schierloh U, Boettcher C, Kapellen T, Rosenbauer J, Holl RW (2017) Association of insulin pump therapy versus insulin injection therapy with severe hypoglycemia, ketoacidosis, and glycemic control among children, adolescents, and young adults with type 1 diabetes. JAMA 318:1358–1366

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Khalifah RA, Alnhdi A, Alghar H, Alanazi M, Florez ID (2017) The effect of adding metformin to insulin therapy for type 1 diabetes mellitus children: a systematic review and metaanalysis. Pediatr Diabetes 18:664–673

    Article  PubMed  Google Scholar 

  • Laranjeira FO, de Anrade KR, Figueiredo AC, Silva EN, Pereira MG (2018) Long acting insulin analogues for type 1 diabetes: an overview of systematic reviews and meta-analysis of randomized controlled trials. PLoS One 13:e0194801

    Article  PubMed  PubMed Central  Google Scholar 

  • Libman IM, Miller KM, DiMeglio LA, Bethin KE, Katz ML, Shah A, Simmons JH, Haller MJ, Raman S, Tamborlane WV, Coffey JK, Saenz AM, Beck RW, Nadeau KJ, for the T1D Exchange Clinic Network Metformin RCT Study Group (2015) Effect of metformin added to insulin on glycemic control among overweight/obese adolescents with type 1 diabetes. JAMA 314(21):2241–2250

    Article  CAS  PubMed  Google Scholar 

  • Lucidi P, Porcellati F, MarinelliAndreoli A, Carriero I, Cioli P, Bolli GB, Fanelli CG (2015) Pharmacokinetics and pharmacodynamics of NPH in Type 1 diabetes: the importance of appropriate resuspension before subcutaneous injection. Diabetes Care 38:2204–2210

    Article  CAS  PubMed  Google Scholar 

  • Meyer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX, Aschner P, Craig ME (2018) ISPAD clinical practice guidelines 2018: definition, epidemiology and classification of diabetes in children and adolescents. Pediatr Diabetes 19(Suppl 27):7–19

    Article  Google Scholar 

  • Mueller-Godeffroy E, Vonthein R, Ludwig-Seibold C, Heidtmann B, Boettcher C, Kramer M, Hessler N, Hilgard D, Lilienthal E, Ziegler A, Wagner VM, on behalf of the German working group for Pediatric Pump Therapy (agip) (2018) Psychosocial benefits of insulin pump therapy in children with type 1 diabetes and their families: the pumpkin multicenter randomized controlled trial. Pediatr Diabetes 19:1471–1480

    Article  CAS  PubMed  Google Scholar 

  • Neal B, Perkovic V, Mahaffey KW, CANVAS Program Collaborative Group et al (2017) Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med 377:644–657

    Article  CAS  PubMed  Google Scholar 

  • Päivärinta M, Tapainen P, Veijola R (2008) Basal insulin switch from NPH to glargine in children and adolescents with type 1 diabetes. Pediatr Diabetes 9:83–90

    Article  PubMed  Google Scholar 

  • Petrie JR, Chaturvedi N, Ford I, Brouwers MC, Greenlaw N, Tillin T, Hramiak I, Hughes AD, Jenkins AJ, Klein EK, Klein R, Ooi TC, Rossing P, Stehouwer CD, Sattar N, Colhoun HM, on behalf of REMOVAL Study Group (2017) Cardiovascular and metabolic effects of metformin in patients with type 1 diabetes (REMOVAL): a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 5:597–609

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Philotheou A, Arslanian S, Blatniczky L, Peterkova V, Souhami E, Danne T (2011) Comparable efficacy and safety of insulin glulisine and insulin lispro when given as part of basal bolus regimen in a 26-week trial in pediatric patients with type 1 diabetes. Diabetes Technol Ther 13:327–334

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Quianzon CC, Cheikh I (2012) History of insulin. J Community Hosp Intern Med Perspect 2(2). https://doi.org/10.3402/jchimp.v2i2.18701

  • Riddle MC, Cefalu WT (2018) SGLT inhibitors for type 1 diabetes: an obvious choice or too good to be true? Diabetes Care 41:2444–2447

    Article  CAS  PubMed  Google Scholar 

  • Sherr JL, Hermann JM, Campbell F, Foster NC, Hofer SE, Allgrove J, Maahs DM, Kapellen TM, Holman N, Tamborlane WV, Holl RW, Beck RW, Warner JT (2016) Use of insulin pump therapy in children and adolescents with type 1 diabetes and its impact on metabolic control: comparison of results from three large transatlantic paediatric registries. Diabetologia 59:87–91

    Article  CAS  PubMed  Google Scholar 

  • Tauschmann M, Thabit H, Bally L, Allen JM, Hartnell S, Wilinska ME, Ruan Y, Sibayan J, Kollman C, Cheng P, Beck RW, Acerini CL, Evans ML, Dunger DB, Elleri D, Campbell F, Bergenstal RM, Criego A, Shan VN, Leelaranthna L, Hovorka R, APCam11 Consortium (2018) Closed loop delivery in suboptimal controlled type 1 diabetes: a multicentre, 12 week randomized trial. Lancet 392:1321–1329

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Thalange N, Bereket A, Larsen J, Hiort LC, Peterkova V (2013) Insulin analogues in children with type 1 diabetes: a 52-week randomized clinical trial. Diabet Med 30:216–225

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Thelange N, Deeb L, Iotova V, Kawamura T, Klingensmith G, Philotheou A, Silverstein J, Tumini S, Ocampo Francisco A-M, Kinduryte O, Danne T (2015) Insulin degludec in combination with bolus insulin aspart is safe and effective in children and adolescents with type 1 diabetes. Pediatr Diabetes. 16:164–176

    Article  Google Scholar 

  • Tosur M, Redondo MJ, Lyons SK (2018) Adjuvant pharmacotherapies to insulin for the treatment of type 1 diabetes. Curr Diab Rep 18:79

    Article  PubMed  Google Scholar 

  • Unger J (2013) Rational use of GLP1 receptor agonists in patients with type 1 diabetes. Curr Diab Rep 13:663–668

    Article  CAS  PubMed  Google Scholar 

  • Zinman B, Wanner C, Lachin JM et al (2015) Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 373:2117–2128

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany

    Thomas M. Kapellen

Authors
  1. Thomas M. Kapellen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas M. Kapellen .

Editor information

Editors and Affiliations

  1. Hospital for Children and Adolescents Center of Paediatric Research Department of Women and Child Health, University of Leipzig, Leipzig, Germany

    Wieland Kiess

  2. Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Department of Clinical Pharmacology, University Hospital Tüebingen, Tüebingen, Germany, Robert Bosch Gesellschaft fuer medizinische Forschung mbH, Stuttgart, Germany

    Matthias Schwab

  3. Children’s Hospital, University of Basel Children’s Hospital, Basel, Switzerland

    Johannes van den Anker

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kapellen, T.M. (2019). Pharmacotherapy of Children and Adolescents with Type 1 Diabetes Mellitus. In: Kiess, W., Schwab, M., van den Anker, J. (eds) Pediatric Pharmacotherapy . Handbook of Experimental Pharmacology, vol 261. Springer, Cham. https://doi.org/10.1007/164_2019_245

Download citation

Publish with us

Policies and ethics

Search

Navigation