Modern insulin therapy in children and adolescents.
Clear evidence exists that near-normal blood glucose control will prevent serious late diabetic complications. This review summarizes the targets for blood glucose control and discusses why insulin replacement therapy is so complicated in children and adolescents. It is important that diabetes treatment teams have excellent knowledge of insulin preparations, insulin pharmacokinetics and action profiles and the limitations and pitfalls of therapy. This is necessary to be able to optimize and individualize treatment. A detailed summary of different insulin regimens is given and discussed to help treatment teams choose a suitable regimen for the individual patient. The use of home blood glucose measurement is necessary to reach the targets of treatment. If economic resources are limited, alternative strategies are suggested. In wealthy countries the lifestyle of adolescents demands great flexibility and a suggestion for systematic training to increase flexibility in daily life is presented.
Dahl-Jørgensen
K
K
Aker Diabetes Research Centre, Paediatric Department, Ullevål University Hospital, Oslo, Norway.
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008991:Monitoring, Physiologic; D011379:Prognosis; D011788:Quality of Life
D001786:Blood Glucose; D007328:Insulin