[The selection of insulin and adjustment of the dosage in diabetic children and adolescents: personal experiences].
The principal aims of therapeutic management of the child, adolescent and adult with type 1 diabetes are to allow good quality of life and to avoid long-term complications (retinopathy, neuropathy, nephropathy, etc.) by maintaining blood glucose concentrations close to the normal range. Repeated determinations of glycated hemoglobin levels (HbA1c) provide a good criterion of overall control. They must be under 7%. The number of daily insulin injections, (2 or 4), by itself does not necessarily give better results, but the 4-injection regimen allows greater freedom, taking into account that the proper insulin adjustment is difficult before adolescence. Successful glycemic control in young patients depends mainly on the quality and intensity of diabetes education. The aim of this paper is to propose some "recipes", concerning the choice of the insulin regimens and the criteria for insulin adjustments, in order obtain good HbA1c levels. Because medical literature shows that treatment of type 1 diabetic patients is inadequate in general and that levels of HbA1c are often too high, diabetes treatment teams should individually explore the reasons for failure, without any prejudice or bias.
Dorchy
H
H
Clinique de Diabétologie, H.U.D.E.R.F., U.L.B.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002985:Clinical Protocols; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000145:classification*; D010349:Patient Compliance; D010353:Patient Education as Topic; D011788:Quality of Life
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin