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.
KeywordsCeliac Disease Insulin Glargine Severe Hypoglycemia Insulin Aspart Insulin Lispro
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