Insulin Therapy and Outpatient Diabetes Management
Over the years since the completion of the Diabetes Control and Complications Trial (DCCT)1,2,3 the benefits for infants, children and youth with type 1 diabetes of following a system of diabetes management that allows for optimal glycemia has become increasingly apparent. Not only is there reduction in long-term diabetes complications, but there is normalization of growth and pubertal development and improvement in physical and psychosocial well-being. Unfortunately, coupled with these benefits is the risk of increased episodes of hypoglycemia that might have neurocognitive consequences, particularly for young children. Therefore, the systems of diabetes management that improve glycemic control must be well-defined and carefully taught to patients and families. Certain aspects of diabetes care must also be conveyed to school personnel and other caregivers if pediatric subjects with type 1 diabetes are to maximally benefit from an intensive management approach. To accomplish this, the family must work in concert with a multidisciplinary diabetes team as well as their primary care provider.
KeywordsCholesterol Zinc Catheter Carbohydrate Neuropathy
Unable to display preview. Download preview PDF.
- 13.ISPAD. Consensus Guidelines 2000, ed, International Society for Pediatric and Adolescent Diabetes, Medical Forum International, Zeist, Netherlands.Google Scholar
- 14.Skyler J Lancet 2001; 357: 331.Google Scholar
- 16.White JA, Hirsch IB. Acute complications of diabetes. Endocrinol Metab 2000.Google Scholar
- 17.American Diabetes Association. Medical management of type 1 diabetes, 3rd edition. American Diabetes Association, Alexandria, VA, 1998.Google Scholar
- 18.American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 1997; 20(Suppl 1): S5–S13.Google Scholar
- 27.Anderson B, Ho J, Brackett J, Finkelstein D, Laffel L. Parental involvement in diabetes management tasks: Relationships to blood glucose monitoring adherence and metabolic control in young adolescents with insulin-dependent diabetes mellitus. J Pediatr 1997; 130, 257–265.PubMedCrossRefGoogle Scholar
- 28.Nathan DM, McKitrick C, Larkin M, Schaffran R, Singer DE. Glycemic control in diabetes mellitus: Have changes in therapy made a difference? 1996; 100, 157–163.Google Scholar
- 45.Kaufman FR. (1997). Diabetes mellitus. Pediatr Res 1997; 18, 383–392.Google Scholar
- 49.Kaufman FR, Halvorson M. New trends in managing type 1 diabetes. Contemporary Pediatrics 1999; 16, 112–123.Google Scholar
- 56.American Diabetes Association. Care of children with diabetes in the school and day care setting. Diabetes Care 2000; 23 (Suppl 1), S100–103.Google Scholar