Materiały źródłowe

• #1 Outpatient Management of Pediatric Type 1 Diabetes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4596120/

  The incidence of both type 1 and type 2 diabetes (T1DM and T2DM) continues to rise within the pediatric population. However, T1DM remains the most prevalent form diagnosed in children. It is critical that health-care professionals understand the types of diabetes diagnosed in pediatrics, especially the distinguishing features between T1DM and T2DM, to ensure proper treatment. […] Similar to all individuals with T1DM, lifelong administration of exogenous insulin is necessary for survival. However, children have very distinct needs and challenges compared to those in the adult diabetes population. Accordingly, treatment, goals, and age-appropriate requirements must be individually addressed. The main objectives for the treatment of pediatric T1DM include maintaining glucose levels as close to normal as possible, avoiding acute complications, and preventing long-term complications. In addition, unique to pediatrics, facilitating normal growth and development is important to comprehensive care. To achieve these goals, a careful balance of insulin therapy, medical nutrition therapy, and exercise or activity is necessary. Pharmacological treatment options consist of various insulin products aimed at mimicking prior endogenous insulin secretion while minimizing adverse effects. This review focuses on the management of pediatric T1DM in the outpatient environment, highlighting pharmacotherapy management strategies.

• #2 Children and diabetes | Diabetes UK

  https://www.diabetes.org.uk/living-with-diabetes/life-with-diabetes/children-and-diabetes

  Your child will probably have to take insulin to treat it. They’ll either use a pen or a pump and will eventually be able to do this by themselves with your help. […] We can provide you with different tools to make sure your child is getting the care they need and deserve. […] We’ve created our Type 1 bag filled with resources, guidance and stories, to help you make your child’s first year with diabetes as simple as possible.

• #3 Type 1 diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017

  Treatment for type 1 diabetes includes: Taking insulin, Counting carbohydrates, fats and protein, Monitoring blood sugar often, Eating healthy foods, Exercising regularly and keeping a healthy weight. […] The goal is to keep the blood sugar level as close to normal as possible to delay or prevent complications. Generally, the goal is to keep the daytime blood sugar levels before meals between 80 and 130 mg/dL (4.44 to 7.2 mmol/L). After-meal numbers should be no higher than 180 mg/dL (10 mmol/L) two hours after eating. […] Anyone who has type 1 diabetes needs insulin therapy throughout their life. […] You’ll probably need several daily injections that include a combination of a long-acting insulin and a rapid-acting insulin. These injections act more like the body’s normal use of insulin than do older insulin regimens that only required one or two shots a day. A combination of three or more insulin injections a day has been shown to improve blood sugar levels.

• #4 Pediatric Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Diet, Activity

  https://emedicine.medscape.com/article/919999-treatment

  All children with type 1 diabetes mellitus will eventually require insulin therapy. Those who are diagnosed during an early stage (stage I or stage II) will not require insulin immediately but will progress to insulin dependence. The timing and tempo of progression varies from individual to individual. […] The following are also required in treatment: Glucometer and blood glucose testing strips – Blood glucose levels should be monitored up to 6-10 times daily, Urine or blood ketone testing strips, Continuous glucose monitoring supplies, Glucagon for treatment of severe hypoglycemia, Injection supplies and/or insulin pump therapy. […] The ADA recommends assessing glycemic control using HbA1c and/or appropriate continuous glucose monitoring metrics every 3 months in pediatric patients who are growing.

• #5 Outpatient Management of Pediatric Type 1 Diabetes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4596120/

  Pediatric patients, regardless of diabetes type, must be treated and educated differently from adults with diabetes. Diabetes is a lifelong disease that requires constant vigilance and adjustments as pediatric patients progress through childhood. […] Goals of therapy are to maintain normal growth and development and avoid both short- and long-term complications. Striving for an A1c goal of less than 7.5% is currently recommended for all pediatric patients. However, individualization is critical, specifically minimizing risk of hypoglycemia or hyperglycemia based on the unique needs of the patient. Children with T1DM should be assessed initially and followed until adulthood by a comprehensive multidisciplinary team and center experienced in addressing the special needs of this population.

• #6 Type 1 Diabetes: Causes, Symptoms, Complications & Treatment

  https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes

  Type 1 diabetes requires daily management with insulin injections and blood sugar monitoring. […] People with Type 1 diabetes need synthetic insulin every day, multiple times a day in order to live and be healthy. […] Three of the main components of Type 1 diabetes management include: Insulin, Blood glucose (sugar) monitoring, Carbohydrate counting. […] There are several different types of synthetic insulin. […] You can take insulin in the following ways: Multiple daily injections (MDI), Pen, Pump, Rapid-acting inhaled insulin. […] People with Type 1 diabetes need to monitor their blood sugar closely throughout the day. […] A large part of Type 1 diabetes management is counting carbohydrates (carbs) in the food and drinks you consume in order to give yourself proper doses of insulin.

• #7 Type 1 diabetes mellitus in children and adolescents: Insulin therapy – UpToDate

  https://www.uptodate.com/contents/insulin-therapy-for-children-and-adolescents-with-type-1-diabetes-mellitus

  Type 1 diabetes mellitus in children and adolescents: Insulin therapy […] Insulin therapy is the mainstay of treatment for type 1 diabetes mellitus (T1DM), which is characterized by insulin deficiency. The goal of treatment is to maintain blood glucose within age-appropriate glycemic targets to minimize short- and long-term complications of chronic hyperglycemia. However, this goal remains elusive because of the difficulty in replicating the minute-to-minute variations of endogenous (physiologic) insulin secretion directly into the portal vein versus delivery of exogenous insulin, which is absorbed from the site of subcutaneous injection or infusion into the systemic circulation. […] Many different insulin preparations and delivery systems are available. The specific insulin regimen selected for any child and family/caregiver is based on their individual lifestyle needs, cost considerations, local medication availability, and provider preference, while also optimizing the ability to maintain the child’s blood glucose within target ranges. As a result, the preferred insulin formulation and regimen will vary among children and can change for any individual child over time. […] This topic review will focus on the details of insulin therapy, including dosing, dose adjustment based on blood glucose monitoring, and options for insulin administration.

• #8 Treatment of diabetes in children

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4812517/

  Type 1 diabetes mellitus (T1D) and type 2 diabetes (T2D) mellitus are on the increase in children and adolescents. […] Usually, in both children and adults, T1D is treated with insulin while T2D is treated with metformin. […] In this review, we outline the current pathology and treatment and future therapies of T1D mellitus and T2D mellitus in children. […] In the present review, we provide the current guidelines on treating T1D and T2D mellitus. […] The primary way to treat T1D is to administer insulin while metformin is used to treat T2D. […] Insulin is used in the majority of cases of children with T1D. […] Unlike children diagnosed with T2D, children with T1D need insulin treatment to survive. Oral insulin is not an option for patients with diabetes as gastric enzymes impede oral insulin.

• #9 Treatment of diabetes in children

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4812517/

  There are many types of insulin that are available for the treatment of T1D. […] When prescribing insulin, doctors take into account a child’s age and his/her needs and therefore, may prescribe a mixture of these insulin types. […] Insulin is delivered using a fine needle and syringe or pen, which looks similar to an ink pen but is instead filled with insulin. […] Insulin may also be used in treating childhood T2D. […] Insulin treatment in type 2 diabetes is also important, especially in cases where patients are ketotic. […] Clinical trials have been conducted to determine the effectiveness of other drugs for treatment. […] Amylin analog pramlintide is a promising drug that can be used in the treatment of diabetes.

• #10 Type 1 diabetes in children – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/diagnosis-treatment/drc-20355312

  Treatment for type 1 diabetes includes: Taking insulin, Monitoring blood sugar, Eating healthy foods, Exercising regularly. […] You’ll work closely with your child’s diabetes treatment team health care provider, certified diabetes care and education specialist, and registered dietitian. The goal of treatment is to keep your child’s blood sugar within certain numbers. This target range helps to keep your child’s blood sugar level as close to normal as possible. […] Anyone who has type 1 diabetes needs lifelong treatment with one or more types of insulin to survive. […] Insulin delivery options include: Fine needle and syringe, Insulin pen with fine needle, An insulin pump. […] You or your child will need to check and record your child’s blood sugar at least four times a day. […] Continuous glucose monitoring (CGM) devices measure your blood sugar every few minutes using a temporary sensor inserted under the skin.

• #11 Pediatric Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Diet, Activity

  https://emedicine.medscape.com/article/919999-treatment

  The ADA recommends insulin pump therapy be offered to all pediatric patients with type 1 diabetes mellitus who have the ability for and are in agreement with use of the technology. […] The ADA’s Standards of Care in Diabetes-2024 recommend that if it can be safely used by either the patient or the patients caregivers, youths with type 1 diabetes who are taking multiple daily injections or on insulin pump therapy should be offered, at diagnosis or as soon as possible afterwards, real-time or intermittently scanned continuous glucose monitoring. […] A hybrid closed-loop system (insulin pump with continuous glucose monitoring) is used to improve glycemic control in type 1 diabetes. These systems include a CGM that is in constant communication with an infusion pump and will adjust insulin delivery to maintain glucose within a pre-set range. […] There are several ongoing trials on potential treatments to prevent type 1 diabetes. As of now, only one medication (teplizumab) has been approved for use in stage II type 1 diabetes to prevent progression to stage III.

• #12 Outpatient Management of Pediatric Type 1 Diabetes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4596120/

  Continuous subcutaneous insulin infusion (CSII), also known as insulin pump therapy, is considered a form of intensive insulin therapy that uses one of the rapid-acting insulin analogs. CSII therapy has been shown to provide reductions in A1c. […] Education with subsequent implementation of the diabetes care plan is paramount to the long-term success of pediatric diabetes management and outcomes. While education can be delivered in a variety of ways, the optimal approach involves multidisciplinary pediatric teams, including CDE, experienced in the treatment and care of this population.

• #13 Pediatric Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Diet, Activity

  https://emedicine.medscape.com/article/919999-treatment

  Goals of glycemic control (regardless of age) is HbA1c of less than 7% for most patients. If using continuous glucose monitoring, this should be interpreted over a 14-day period and used in addition to HbA1c monitoring. […] Individualization of the HbA1c goal may be appropriate for certain pediatric patients, such as those with limited ability to articulate hypoglycemia or at risk for severe hypoglycemia (younger children or pre-verbal infants), those with a history of severe hypoglycemia, or those with limited life expectancy. […] A well-organized diabetes care team can provide all necessary instruction and support in an outpatient setting. […] All children with type 1 diabetes mellitus require insulin therapy with either multiple daily dosing of subcutaneous injections (MDI) or continuous insulin infusion/insulin pumps.

• #14 Pediatric Type 1 Diabetes Mellitus Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/919999-guidelines

  The majority of children with type 1 diabetes should be treated with intensive insulin regimens using multiple daily injections of prandial insulin and basal insulin or continuous subcutaneous insulin infusion. […] Continuous glucose monitors (CGM) should be considered in all children and adolescents with type 1 diabetes; the benefits of CGM correlate with adherence to ongoing use of the device. […] Individualized medical nutrition therapy is recommended for children and adolescents. […] Exercise is recommended, with a goal of 60 minutes a day of moderate to vigorous aerobic activity, along with vigorous muscle-strengthening and bone-strengthening activities at least 3 days a week. […] All individuals with type 1 diabetes should have access to an uninterrupted supply of insulin; lack of access and insulin omissions are major causes of diabetic ketoacidosis.

• #15 Diabetes Mellitus (DM) in Children and Adolescents – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/hormonal-disorders-in-children/diabetes-mellitus-dm-in-children-and-adolescents

  In type 1 diabetes, parents and older children are taught how to gauge the carbohydrate content of food and to develop a meal plan. […] To control blood glucose, children with type 1 diabetes take injections of insulin. […] When type 1 diabetes is first diagnosed, children are usually hospitalized. Children with type 1 diabetes are given fluids (to treat dehydration) and insulin. They always require insulin because nothing else is effective. […] After diagnosis, children must take insulin regularly. Doctors work with children and their family to determine which insulin regimen is best. […] Most children who have type 1 diabetes should be treated with MDI regimens or with insulin pump therapy. […] Insulin pump therapy is increasingly being used in children. Potential benefits include better glucose control, safety, and user satisfaction compared to MDI regimens.

• #16 Diabetes Canada | Clinical Practice Guidelines

  https://guidelines.diabetes.ca/cpg/chapter34

  Children with new-onset diabetes who present with DKA require a short period of hospitalization to stabilize the associated metabolic derangements and to initiate insulin therapy. Outpatient education for children with new-onset diabetes has been shown to be less expensive than inpatient education and associated with similar or slightly better outcomes when appropriate interprofessional resources to provide outpatient education on basic diabetes management are available. […] Insulin therapy is the mainstay of medical management of type 1 diabetes. A variety of insulin regimens can be used, but few have been studied specifically in children with new-onset diabetes. […] The choice of insulin regimen depends on many factors, including the child’s age, duration of diabetes, family lifestyle, school support, socioeconomic factors, and family, patient, and physician preferences.

• #17 Treating Type 1 Diabetes (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/treating-type1.html

  In type 1 diabetes, special cells in the pancreas that make insulin (beta cells) are destroyed. The body needs insulin to help glucose (sugar) get from the blood into the cells for energy. Without insulin, a persons blood sugar rises and they get sick. […] If your child or teen is diagnosed with type 1 diabetes, the next step is to start treatment. Treating diabetes means keeping blood sugar levels in a healthy range. Your childs diabetes care team will treat your child using a personalized diabetes care plan made for them. […] Treating type 1 diabetes also includes checking blood sugar levels every day. […] All kids and teens with type 1 diabetes need to take insulin so that glucose can get from their blood into their cells for energy. The care team will make an insulin schedule specifically for your child.

• #18 Treating Type 1 Diabetes (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/treating-type1.html

  Kids with type 1 diabetes need to find the right balance of food, insulin, and exercise to keep their blood sugars in the healthy range. […] Exercise strengthens your childs muscles and bones, helps them feel good, and controls blood sugar levels. In fact, being active makes insulin work better. Kids with type 1 diabetes can and should exercise. […] Following the plan and staying in touch with the care team is the best way to keep your child healthy.

• #19 Type 1 diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017

  An insulin pump is a device about the size of a cellphone that’s worn on the outside of your body. A tube connects the reservoir of insulin to a catheter that’s inserted under the skin of your abdomen. Insulin pumps are programmed to dispense specific amounts of insulin automatically and when you eat. […] Depending on the type of insulin therapy you select or need, you may have to check and record your blood sugar level at least four times a day. […] Continuous glucose monitoring (CGM) monitors blood sugar levels. It may be especially helpful for preventing low blood sugar. These devices have been shown to lower A1C. […] A closed loop system is a device implanted in the body that links a continuous glucose monitor to an insulin pump. The monitor checks blood sugar levels regularly. The device automatically delivers the right amount of insulin when the monitor shows that it’s needed.

• #20 Type 1 diabetes – Wikipedia

  https://en.wikipedia.org/wiki/Type_1_diabetes

  To achieve this, people with diabetes often monitor their blood glucose levels at home. […] Around 83% of type 1 diabetics monitor their blood glucose by capillary blood testing: pricking the finger to draw a drop of blood, and determining blood glucose with a glucose meter. […] The American Diabetes Association recommends testing blood glucose around 6-10 times per day: before each meal, before exercise, at bedtime, occasionally after a meal, and any time someone feels the symptoms of hypoglycemia. […] Around 17% of people with type 1 diabetes use a continuous glucose monitor, a device with a sensor under the skin that constantly measures glucose levels and communicates those levels to an external device. […] Continuous glucose monitoring is associated with better blood sugar control than capillary blood testing alone; however, continuous glucose monitoring tends to be substantially more expensive.

• #21 Pediatric Type 1 Diabetes Mellitus Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/919999-guidelines

  Glucagon should be prescribed for all individuals with type 1 diabetes, and caregivers or family members should be instructed regarding administration. […] The majority of children and adolescents with type 1 diabetes should be treated with intensive insulin regimens, either via multiple daily injections or continuous subcutaneous insulin infusion. […] Continuous glucose monitoring should be considered in children and adolescents with type 1 diabetes, whether they are using injections or continuous subcutaneous insulin infusion, as an additional tool to help improve glycemic control; benefits of continuous glucose monitoring correlate with adherence to ongoing use of the device. […] Automated insulin delivery systems improve glycemic control and reduce hypoglycemia in adolescents and should be considered in adolescents with type 1 diabetes.

• #22 Pediatric Diabetes Treatment Center

  https://www.nicklauschildrens.org/programs/diabetes-treatment-center

  Nicklaus Children’s is dedicated to the treatment and management of diabetes in babies, children and adolescents. […] The treatment of diabetes in children has evolved from just one or two injections per day to multiple injections or constant insulin infusion through a diabetes insulin pump, often referred to as „The Pump.” […] The advantages of „The Pump” are to increase flexibility of lifestyle while improving blood sugar control. […] Nicklaus Children’s Hospital has designed a program to help you and your child make the transition from injections to the diabetes insulin pump. […] This program is specifically designed to be less intrusive in your lifestyle and get you and your child back into your routine as soon as possible. […] Nicklaus Childrens Palm Beach Gardens Outpatient Center kicked off National Diabetes Month by introducing a new treatment option for children with Type 1 diabetes, the Medtronic MiniMed 670G system, sometimes called an artificial pancreas, consistently measures blood sugar, predicts when a rise or fall is going to occur, and adjusts itself to deliver precise doses of insulin, requiring minimal interaction from the patient.

• #23 Type 1 diabetes in children – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/diagnosis-treatment/drc-20355312

  A closed loop system is a device implanted in the body that links a continuous glucose monitor to an insulin pump. […] Food is a big part of any diabetes treatment plan, but that doesn’t mean your child has to follow a strict „diabetes diet.” […] Your child’s registered dietitian can help you create a meal plan that fits your child’s food preferences and health goals, as well as help you plan for occasional treats. […] Everyone needs regular aerobic exercise, and children who have type 1 diabetes are no exception. […] Your child will need regular appointments to ensure good diabetes management. […] The American Diabetes Association generally recommends an A1C of 7% or lower for all children and teens with diabetes. […] If managing your child’s diabetes seems overwhelming, take it one day at a time. […] The habits you teach your child today will help him or her enjoy an active and healthy life with type 1 diabetes.

• #24 Outpatient Management of Pediatric Type 1 Diabetes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4596120/

  Specific treatment and education for T1DM will vary based on the type of diabetes. However, for most children with diabetes, T1DM is the most prevalent form. There are 3 main components for the treatment of T1DM: medical nutrition therapy (MNT), exercise or activity, and medication management. Each component can influence overall outcomes. All 3 components must be evaluated by the healthcare practitioner when making medication changes. […] MNT is a critical component of diabetes management regardless of type of diabetes. Overall goals of MNT are near normalization of glucose, blood pressure, lipids, and weight. Consultation with a registered dietician trained in pediatric diabetes, preferably a certified diabetes educator (CDE), is recommended. […] Insulin therapy in T1DM is essential for survival. Insulin therapy should most closely mimic normal physiological insulin secretion based on age, weight, and stage of growth and development. Insulin treatment recommendations can be achieved by using various insulin regimens from a variety of insulin products, pens, or pumps.

• #25 Type 1 diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017

  Other medications also may be prescribed for people with type 1 diabetes, such as: High blood pressure medications, Aspirin, Cholesterol-lowering drugs. […] Your registered dietitian will recommend that you eat fewer animal products and refined carbohydrates, such as white bread and sweets. This healthy-eating plan is recommended even for people without diabetes. […] Everyone needs regular aerobic exercise, including people who have type 1 diabetes. […] Certain life activities may be of concern for people who have type 1 diabetes. […] The risk of complications during pregnancy is higher for people with type 1 diabetes. […] With a successful pancreas transplant, you would no longer need insulin. […] Researchers are experimenting with islet cell transplantation. This provides new insulin-producing cells from a donor pancreas.

• #26 Type 1 diabetes in children: What you need to know

  https://blog.walgreens.com/health/diabetes/type-1-diabetes-in-children.html

  Blood glucose monitoring: Typically, a child with type 1 diabetes will need to check their blood sugar levels several times per day, either by collecting a drop of blood and putting it in a glucometer or with a continuous glucose monitor, normally worn on the upper arm. Monitoring blood sugar levels throughout the day can help you determine how much insulin your child needs to take and what foods they should eat. […] Dietary changes: Children with diabetes often benefit from limiting simple carbohydrates without fiber or nutrients, such as candy, table sugar, cookies, pastries, juices, soda and cereal. These types of foods can cause blood sugar to rise quickly and can make it harder to manage diabetes. […] Exercise: Regular physical activity can help your child better manage blood sugar levels.

• #27 Diabetes Canada | Clinical Practice Guidelines

  https://guidelines.diabetes.ca/cpg/chapter34

  Insulin therapy should be individualized to reach A1C targets, minimize hypoglycemia and optimize quality of life. […] Self-monitoring of blood glucose (SMBG) is an essential part of management of type 1 diabetes, and increased frequency has been associated with better clinical outcomes. […] The closed-loop pancreas system, also known as the artificial or bionic pancreas system, is one of the most rapidly evolving areas of clinical care for type 1 diabetes. […] All children with type 1 diabetes should receive counselling from a registered dietitian experienced in pediatric diabetes. […] Hypoglycemia is a major obstacle for children with type 1 diabetes and can affect their ability to achieve glycemic targets. […] Severe hypoglycemia should be treated with pediatric doses of intravenous dextrose in the hospital setting or glucagon in the home setting.

• #28 Type 1 Diabetes in Children, Teens, and Young Adults: Treatments

  https://mydoctor.kaiserpermanente.org/mas/structured-content/Treatment_Type_1_Diabetes_in_Children_Teens_and_Young_Adults_Treatments_-_Pedi_Endocrinology.xml?co=%2Fregions%2Fmas

  Being physically active lowers your child’s blood sugar. So you should coordinate what and when your child eats with insulin doses and physical activity. We’ll help you find the right balance, based on your child’s daily schedule and favorite activities. […] Teaching daily diabetes management skills and strategies helps children learn what they need to do to stay healthy and feel their best throughout life. Young children may be scared about this, at first. Teens may be angry that diabetes keeps them from having an unstructured, carefree lifestyle.

• #29 3 Ways to Help Manage Your Child’s Type 1 Diabetes | Diabetes | CDC

  https://www.cdc.gov/diabetes/caring/3-ways-help-manage-childs-type-1.html

  Treatment options, blood sugar highs and lows, carb counting, ketones, dealing with sick days, managing diabetes at school. […] Ask your child’s doctor to refer you to diabetes self-management education and support services when your child is first diagnosed. You’ll meet with a diabetes education and care specialist to learn how to use knowledge, skills, and tools to manage diabetes. […] Taking insulin is a necessary part of treating type 1 diabetes. It can be delivered in different waysby syringe, insulin pen, or insulin pump. A diabetes education and care specialist can help you understand the pros and cons of different devices. […] If you have questions or concerns, reach out to your child’s health care team. They’re there to help!

• #30

  https://drmohans.com/care-of-children-and-adolescents-with-type-1-diabetes/

  Type 1 diabetes requires regular blood sugar monitoring and treatment with insulin. Insulin is vital for the survival of people with Type 1 diabetes. Treatment, lifestyle adjustments, and self-care can control blood sugar levels and minimize the risk of disease-related complications. […] Diabetes education is mandatory in the management of type 1 diabetes in children/ adolescents. […] The management of diabetes in children and adolescents with Type 1 diabetes must take into account the age and developmental maturity of the child. […] Diabetes management in children and adolescents becomes more effective when the entire family gets involved. […] Thus, the education about how to care for a child and adolescent with diabetes must be provided to the entire family unit, emphasizing age and developmentally appropriate self-care and integrating this into the child’s diabetes management.

• #31

  https://drmohans.com/care-of-children-and-adolescents-with-type-1-diabetes/

  Educating the child with diabetes and his/her about healthy eating habits, exercise, and dosage management of insulin is the most important part of the initial management of the disease. […] Infants and toddlers present unique challenges for the treatment of Type 1 diabetes. […] Most children in this age-group can participate in their self-management by testing blood glucose, helping to keep records, and in some cases counting carbohydrates. […] Children with diabetes can take care of their daily diabetes management tasks, such as insulin injections and blood glucose testing with supervision and support from caring and knowledgeable parents. […] Adolescents can perform the tasks of diabetes management, however, they still need help with decision-making about insulin adjustments. […] Self-monitoring of blood glucose (SMBG) using glucose meters has been shown to be associated with improved glycemic control. […] For children with type 1 diabetes, four or more tests per day are generally necessary.

• #32 Where to begin when your child is diagnosed with type 1 diabetes | HealthPartners Blog

  https://www.healthpartners.com/blog/where-to-begin-when-your-child-is-diagnosed-with-type-1-diabetes/

  Your child with diabetes will still do what all children do: grow. […] When you have a strong diabetes care team, making these changes is easy. […] Your childs diabetes care team will include: Pediatric endocrinologist, Pediatrician or family medicine doctor, Certified diabetes care and education specialists (CDCES), School nurse, Mental health specialist. […] Diet can be a challenging aspect of your childs diabetes care plan. […] Children can handle different diabetes care tasks depending on their age, but they should feel involved in their care from a very young age. […] Effectively managing type 1 diabetes doesnt require perfection, only effort. Your childs blood sugar level may not always be exactly where you want it, but its about finding a balance that works for them, and one that lets them be a kid.

• #33 Type 1 Diabetes in Children, Teens, and Young Adults: Treatments

  https://mydoctor.kaiserpermanente.org/mas/structured-content/Treatment_Type_1_Diabetes_in_Children_Teens_and_Young_Adults_Treatments_-_Pedi_Endocrinology.xml?co=%2Fregions%2Fmas

  When first diagnosed with type 1 diabetes, a child or teen may need to be treated in a hospital. We start giving insulin and other care as needed. You’ll meet your child’s pediatric endocrinologist and other members of your care team. When your child’s condition is stable, the team will: Teach you how to manage your child’s diabetes at home. Share the management plan with your child’s pediatrician. Follow up with your family after your child leaves the hospital. […] Your child’s diabetes management plan is built on 3 key lifestyle choices. Your child needs to: Eat healthily every day, using meal planning. Be physically active every day. Maintain a healthy weight. For a child with type 1 diabetes, healthy eating takes planning. A dietitian or other specialist will help you make a plan that includes when, what, and how much your child should eat.

• #34 Diabetes

  https://www.rch.org.au/kidsinfo/fact_sheets/Diabetes_/

  Type 1 diabetes is the most common type of diabetes affecting children and teenagers in Australia. Type 1 diabetes is caused by the body not having enough insulin. Without insulin, glucose levels will build up in the blood. Type 1 diabetes is treated by replacing the insulin and managing blood glucose levels. […] The treatment of type 1 diabetes involves the replacement of insulin. Insulin can be replaced in the body either via insulin injections or with insulin pump therapy. […] The treatment of type 1 diabetes involves the replacement of insulin and checking blood glucose levels. […] Managing diabetes involves balancing insulin, food, and exercise. […] Follow-up care involves appointments every three to four months with an endocrinologist.

• #35 Type 1 Diabetes Mellitus in Children and Adolescents – Society of Pediatric Psychology

  https://pedpsych.org/fact_sheets/diabetes_mellitus/

  Type 1 diabetes mellitus (T1D) is a lifelong autoimmune disorder of glucose metabolism that destroys insulin-producing beta cells in the pancreas. Effective treatment requires insulin replacement via multiple daily injections (MDI) or an insulin pump, blood glucose monitoring, regulated carbohydrate intake and exercise, and active prevention or correction of abnormally high or low blood glucose levels. […] Managing diabetes requires the child and parents to share responsibility and collaborate effectively on daily tasks. […] Diabetes care is best provided via a multidisciplinary team who can target the medical needs and the mental health of youth and their parents through initial screenings, ongoing assessment, and treatment. […] There have been rigorous randomized controlled trials of psychological interventions targeting youth coping skills and family-focused interventions targeting parent-youth teamwork, T1D-related communication, problem solving, and conflict resolution. Most of these trials have yielded stronger treatment effects on behavioral outcomes than on metabolic outcomes. More recently, several digital health interventions have shown preliminary efficacy, including studies employing video-based telehealth, mHealth, and web-based interventions.

• #36 Type 1 Diabetes: Signs and Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/diabetes-type-1

  Better therapies are being developed, such as insulin pumps with continuous glucose monitors that check blood glucose every few minutes automatically. A new development is a combination continuous monitor and insulin pump. It adjusts the pump automatically to give insulin and keep the blood glucose level as close to normal as possible. […] Insulin is produced by beta cells in the pancreas, and beta cell transplants are used in certain patients. These transplants can keep the glucose level more normal without taking insulin. There are risks associated with beta cell transplants. They are not for everyone yet.

• #37 Diabetes Treatment | Children’s Hospital Los Angeles

  https://www.chla.org/center-endocrinology-diabetes-and-metabolism/diagnosis-and-treatment/diabetes-treatment

  Type 1 diabetes occurs when the pancreas does not make insulin (a hormone that helps regulate blood sugar). […] The primary treatment for Type 1 diabetes is insulin. Children with Type 1 diabetes don’t produce insulin, so their bodies need to get it another way. […] Insulin pumps are small devices that stay attached to your child’s body. […] A continuous glucose monitor (CGM) keeps track of your child’s blood sugar level through a small sensor placed under the skin, usually on the arm or belly. […] Some children may benefit from diabetes medications other than insulin. […] Diet and exercise are important for managing all types of diabetes. […] A dietitian may teach your child how to count carbohydrates (carbs). […] Children who come to CHLA have access to promising new therapies through clinical trials. […] The providers in our Diabetes Program arm your family with all the necessary tools to live a high quality of life with diabetes.

• #38 Type 1 Diabetes Treatment and Therapy – Breakthrough T1D

  https://www.breakthrought1d.org/t1d-basics/treatments/

  Therapies such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), statins, and other lipid-lowering drugs may be prescribed to manage cardiovascular disease and reduce the risk of cardiovascular complications. […] The U.S. Food and Drug Administration (FDA) approved Tzield™ (teplizumab-mzwv) in November 2022, making it the first approved disease-modifying therapy for delaying T1D onset in people at risk of developing the disease. […] Though not approved for T1D, these drugs have tremendous promise as a type 1 diabetes treatment in terms of glucose and metabolic control, weight loss, and more. […] For a treatment, drug, or device to make it into the hands of people with type 1 diabetes, it must first complete a vital step—a clinical trial.

• #39 New treatment to delay type 1 diabetes in children available at UCLA Health | UCLA Health

  https://www.uclahealth.org/news/article/new-treatment-delay-type-1-diabetes-children-available-ucla

  Teplizumab can help kids who are at risk of getting type 1 diabetes, says Dr. Christina Reh of UCLA Mattel Children’s Hospital. […] UCLA Health and UCLA Mattel Children’s Hospital now treat kids who are at risk of getting type 1 diabetes with a new drug called teplizumab. The FDA-approved medicine can help kids ages 8 and older put off symptoms for up to two years. […] Today, doctors can help before a child has symptoms and delay the need for insulin. A screening blood test can see if a child is at higher risk for the disease. If they are, they can receive the drug. […] The medicine helps combat the immune cells that are attacking the pancreas beta cells that make insulin, says Christina Reh, MD, associate professor at UCLA, clinical director of the pediatric diabetes program for UCLA Westwood and surrounding clinics. […] If we can catch people sooner, thats when this medication works best, she says. This is not a cure, but its a step toward one.

• #40 Breakthrough Drug Helps Children with New-Onset Type 1 Diabetes | UC San Francisco

  https://www.ucsf.edu/news/2023/10/426396/breakthrough-drug-helps-children-new-onset-type-1-diabetes

  Children who were recently diagnosed with type 1 diabetes need less supplemental insulin to keep their blood sugar in a healthy range if they use the immunotherapy drug teplizumab, a new study reports. […] Teplizumab, an immunotherapy drug, was approved by the FDA in 2022 thanks to a UCSF study showing that a 14-day dose of the drug delayed the onset of type 1 diabetes in at-risk children and adults by an average of three years. […] The teplizumab group of 217 patients preserved more of their remaining insulin-producing beta cells and trended toward needing lower doses of supplemental insulin to keep their glucose levels in a near-normal range, compared to the 111 children who received placebo. […] Many more of the teplizumab-treated patients experienced a clinical remission the ability to achieve tight blood sugar control using less supplemental insulin than those in the placebo group, Gitelman said. A full remission would mean not needing insulin at all.

• #41

  https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Diabetes-Mellitus-Type-1-Diabetes.aspx

  For those at high risk who show early signs of blood sugar abnormalities (stage 2 type 1 diabetes), an FDA-approved medication is available that can delay the progression to full-blown (stage 3) type 1 diabetes by an average of 2 years. It works by targeting specific immune cells responsible for attacking insulin-producing cells in the pancreas, helping to slow progression of the disease. […] With early detection, timely treatment and the support of primary care providers and pediatric endocrinologists, the management and prognosis of type 1 diabetes continues to improve. This means families can navigate the disease more effectively and embrace a healthier future.

• #42 Type 1 diabetes – Wikipedia

  https://en.wikipedia.org/wiki/Type_1_diabetes

  The goal of insulin therapy is to mimic normal pancreatic insulin secretion: low levels of insulin constantly present to support basic metabolism, plus the two-phase secretion of additional insulin in response to high blood sugar, then an extended phase of continued insulin secretion. […] This is accomplished by combining different insulin preparations that act with differing speeds and durations. […] The standard of care for type 1 diabetes is a bolus of rapid-acting insulin 10-15 minutes before each meal or snack, and as-needed to correct hyperglycemia. […] In addition, constant low levels of insulin are achieved with one or two daily doses of long-acting insulin, or by steady infusion by an insulin pump. […] A non-insulin medication approved by the U.S. Food and Drug Administration for treating type 1 diabetes is the amylin analog pramlintide, which replaces the beta-cell hormone amylin.

• #43 Type 1 Diabetes Treatment and Therapy – Breakthrough T1D

  https://www.breakthrought1d.org/t1d-basics/treatments/

  Insulin is the primary type 1 diabetes treatment. People with type 1 diabetes (T1D) must take insulin to survive because their body does not make enough of it. Insulin is administered by injection, inhalation, or insulin pump. […] Managing type 1 diabetes involves three main steps: checking blood sugar, administering insulin, and counting carbohydrates. […] There are four primary methods for administering insulin: injections with syringe or pen, inhaler, insulin pump, or artificial pancreas system/automated insulin delivery system. […] Adjunctive therapies complement insulin to achieve better glucose control. […] Pramlintide is a synthetic amylin analog administered via syringe. It is approved for people with T1D who use mealtime insulin and do not achieve their glycemic targets despite optimal insulin therapy.

• #44 Finding hope and help for kids with type 1 diabetes | Cardinal Glennon

  https://www.ssmhealth.com/newsroom/blogs/ssm-health-matters/august-2024/finding-hope-and-help-for-kids-with-type-1-diabetes

  Type 1 diabetes requires careful dietary planning, blood sugar monitoring, and daily doses of insulin to remain healthy. […] Unfortunately, there is no cure for type 1 diabetes, but treatments have progressed to allow those with diabetes to live long, healthy lives, and new, transformative therapies have recently been introduced on a small scale. […] The development of the insulin pump has been one of the most dramatic breakthroughs of the last few decades. These are small external devices that provide insulin through a small tube and needle (or directly through the skin) as the person needs it, replacing multiple injections each day. […] And although an actual cure has yet to be found, recent advances using stem cell therapy to replace the missing insulin-producing cells have shown great promise. Currently only recommended for those unable to control blood sugar levels with traditional treatments, these techniques can reduce or eliminate the need for daily insulin. Additional variations of those treatments are expected within the next several years, and will hopefully be a game-changer for all those with type 1 diabetes.

• #45 Type 1 Diabetes Mellitus in Children

  https://www.nationwidechildrens.org/conditions/health-library/type-1-diabetes-mellitus-in-children

  Your child’s healthcare provider will tell you how to prevent these problems. […] Balancing insulin, diet, and activity can help keep blood sugar levels in the target range and help prevent complications such as: Eye problems, Kidney disease, Nerve damage, Tooth and gum problems, Skin and foot problems, Heart and blood vessel disease. […] With daily insulin injections and other management activities, children with type 1 diabetes can lead active, healthy lives.

• #46 Type 1 Diabetes: Causes, Symptoms, Complications & Treatment

  https://my.clevelandclinic.org/health/diseases/21500-type-1-diabetes

  The main side effect of diabetes treatment through insulin is low blood sugar (hypoglycemia). […] There is currently no cure for Type 1 diabetes, but scientists are working on ways to prevent or slow down the progression of the condition through studies such as TrialNet. […] If you or your child are experiencing symptoms of Type 1 diabetes, such as extreme thirst and frequent urination, see your healthcare provider as soon as possible. […] If you or your child have been diagnosed with diabetes, you’ll need to see your endocrinologist multiple times a year throughout your life to make sure your diabetes management is working well for you.

• #47 Pediatric Type 1 Diabetes Mellitus Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/919999-guidelines

  Annual screening for albuminuria with a random spot urine sample for albumin-to-creatinine ratio should be performed at puberty or at age 10 years or older, whichever is earlier, once the child has had diabetes for 5 years. […] An initial dilated and comprehensive eye examination is recommended once a youth has had type 1 diabetes for 3-5 years, provided that he/she is age 10 years or older or puberty has started, whichever is earlier.

• #48 Diabetes Mellitus (DM) in Children and Adolescents – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/hormonal-disorders-in-children/diabetes-mellitus-dm-in-children-and-adolescents

  Type 1 diabetes occurs when the pancreas produces little or no insulin. Type 1 diabetes is the most common type among children, causing about two thirds of all cases of diabetes. It is one of the most common chronic childhood diseases. By age 18, 1 in 300 children has developed type 1 diabetes. […] In type 1 diabetes, the pancreas does not produce enough insulin because the immune system attacks and destroys the cells in the pancreas that make insulin (islet cells). […] Children who have type 1 diabetes are at higher risk of some other disorders in which the body’s immune system attacks itself (autoimmune disorders), particularly certain types of thyroid disease, and celiac disease. […] The main goal of diabetes treatment is to keep blood glucose levels as close to the normal range as can be done safely. However, no treatment completely maintains blood glucose at normal levels.

• #49 Type 1 diabetes in children – Diabetes Living

  https://www.tapatalk.com/groups/diabetesliving/type-1-diabetes-in-children-t6162.html

  Type 1 diabetes is a serious disease. Helping your child follow his or her diabetes treatment plan takes round-the-clock commitment and will initially require some significant lifestyle changes. But your efforts are worthwhile. Careful management of type 1 diabetes can reduce your child’s risk of serious even life-threatening complications. […] Encourage him or her to take an increasingly active role in diabetes management. […] Stress the importance of lifelong diabetes care. […] Teach your child how to test his or her blood sugar and inject insulin. […] Help your child make wise food choices. […] Encourage your child to remain physically active. […] Foster a relationship between your child and his or her diabetes treatment team. […] Make sure your child wears a medical identification tag.

• #50 Type 1 diabetes in children – Diabetes Living

  https://www.tapatalk.com/groups/diabetesliving/type-1-diabetes-in-children-t6162.html

  Along with at-home care, you’ll also need to work with your child’s school nurse and teachers to make sure they know what the symptoms of high and low blood sugar levels are, and in some cases, the school nurse may need to administer insulin or check your child’s blood sugar levels. […] Good diabetes management requires a lot of time and effort, especially in the beginning. […] Talking to a counselor or therapist may help your child or you to cope with the dramatic lifestyle changes that come with a type 1 diabetes diagnosis. Your child may find encouragement and understanding in a type 1 diabetes support group for children. […] The American Diabetes Association also offers diabetes camp programs that provide children and teens with diabetes education and support. […] If you and your child work with your child’s doctor and do your best to control blood sugar levels, your child will likely live a long and normal life.

• #51

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=uq1405abc

  Type 1 diabetes is a lifelong disease that currently has no cure. Your child needs to take insulin injections. […] If your child doesn’t want to feel the insulin needle, your child’s doctor can prescribe an indwelling subcutaneous cannula. […] It is also important that you meet with your child’s teacher, school nurse, and school administrators to discuss diabetes care at school. […] Encourage your child to play sports and be physically active, because it positively contributes to his or her diabetes treatment. […] As children with type 1 diabetes grow, encourage them to take more control over their treatment. […] Such settings can help children learn about their disease and about how to manage it. […] Your diabetes team coordinator can direct you to local support groups as well as many resources on online and publications from organizations such as Diabetes Canada.

• #52 Diabetes – issues for children and teenagers | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-issues-for-children-and-teenagers

  People living with type 1 diabetes must inject insulin multiple times a day, as must some people with type 2 diabetes. […] Children with diabetes will need help from parents and loved ones to establish a routine to manage their diabetes. This includes: blood glucose monitoring, injecting insulin, learning how to count carbohydrates, seeing diabetes health professionals regularly, cope with fluctuating blood glucose levels. […] Emotional support offered by friends, family and a diabetes healthcare team can be very helpful during this time and can improve the way children or teenagers cope with their diabetes. […] Parents of young children with diabetes are usually highly involved in their child’s diabetes management. As children get older, it is important that they develop the skills and confidence to manage their diabetes independently.

• #53

  https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=uq1405abc

  Type 1 diabetes is a lifelong disease that currently has no cure. Your child needs to take insulin injections. […] If your child doesn’t want to feel the insulin needle, your child’s doctor can prescribe an indwelling subcutaneous cannula. […] School can also present a particular challenge for a child with type 1 diabetes. […] It is also important that you meet with your child’s teacher, school nurse, and school administrators to discuss diabetes care at school. […] Encourage your child to play sports and be physically active, because it positively contributes to his or her diabetes treatment. […] As children with type 1 diabetes grow, encourage them to take more control over their treatment. […] Such settings can help children learn about their disease and about how to manage it. […] Your diabetes team coordinator can direct you to local support groups as well as many resources on online and publications from organizations such as Diabetes Canada.

• #54 Type-1 diabetes in children and teenagers | Raising Children Network

  https://raisingchildren.net.au/guides/a-z-health-reference/type-1-diabetes

  Theres currently no cure for type-1 diabetes. […] If your child has type-1 diabetes, your child can manage their condition successfully and live a healthy life by keeping their blood sugar levels within a target range. […] Your child can keep their blood sugar within this target range by: injecting insulin 2-4 times a day or by using a 24-hour insulin pump, eating certain foods in the right amounts and at the right times, doing regular physical activity. […] Your child will have a team of diabetes health professionals to care for them and help them learn how to manage their diabetes. […] Theyll teach you and your child how to measure your childs blood sugar, explain what to do when the blood sugar goes outside the target range, teach you and your child how to inject insulin or use an insulin pump, teach you and your child about healthy eating and exercise, talk about your childs diagnosis and ongoing treatment. […] You can lower your childs risk of complications from type-1 diabetes by keeping your childs blood sugar levels within the target range most of the time.

• #55 Spotting the Signs of Pediatric Type 1 Diabetes | Children’s Healthcare of Atlanta

  https://www.choa.org/parent-resources/diabetes/signs-of-type-1-diabetes

  While there is no cure for type 1 diabetes, the condition is manageable with the right care. Your child will need to replace the missing insulin with daily insulin injections or by using an insulin pump. […] With proper insulin therapy, plus the development of healthy diet and exercise habits, kids with type 1 diabetes are able to live long, fulfilling lives, says Andrew Muir, MD, System Medical Director of Endocrinology and Diabetes. […] The key is to address diabetes head on. If poorly managed, type 1 diabetes can cause long-term complications into adulthood, including heart disease, stroke, vision impairment, kidney damage, skin problems and nerve damage. […] With lots of support and supervision from you and your child’s care team, eventually managing their disease will become just another part of your child’s daily routine.

• #56 Breakthrough Drug Helps Children with New-Onset Type 1 Diabetes | UC San Francisco

  https://www.ucsf.edu/news/2023/10/426396/breakthrough-drug-helps-children-new-onset-type-1-diabetes

  Gitelman is already thinking about next steps. His team continues to follow the PROTECT patients to see how long the effects of the current therapy may last, and sees potential for studying whether these patients, or future ones, might benefit from additional teplizumab infusions at later time points.

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