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Intensive insulin treatment in diabetic children
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
Univ Perugia, Dept Internal Med, I-06126 Perugia, Italy Linkoping Univ, Div Pediat, Dept Hlth & Environm, S-58183 Linkoping, Sweden.
2001 (English)In: Diabetes, Nutrition and Metabolism. Clinical and Experimental, ISSN 0394-3402, Vol. 14, no 5, 292-304 p.Article, review/survey (Refereed) Published
Abstract [en]

Intensification of insulin therapy which maintains long-term near-normoglycaemia (HbA(1c)<7.0%) strongly protects against onset and/or progression of diabetic microangiopathy in Type 1 diabetes mellitus of adults. Similar intensification of insulin therapy is needed in diabetic children as well, in order to prevent complications a few years after diabetes onset, ie very often in young age. Provided adequate psychosocial support and education are available, children should be treated with multiple daily injections of insulin or, when necessary, with continuous subcutaneous insulin infusion, along with blood glucose monitoring. Insulin regimens may differ from child to child and vary from day to day in the same child, depending on lifestyle and considering all the available insulin preparations. These include the short-acting insulin (both human regular and short-acting insulin analogues), the intermediate-acting insulin (NPH and Lente), as well as the new long-acting insulin analogue glargine. The latter seems a promising candidate to substitute of basal insulin. The concern that intensified insulin therapy increases the risk of hypoglycaemia, as indicated by the Diabetes Control and Complications Trial (DCCT), is no longer tenable. On the contrary, a physiological, flexible insulin regimen better than a fixed insulin regimen, usually the twice daily split-mixed regimen, protects against the risk of hypoglycaemia in relation to food ingestion, physical exercise and sleep. Thus, appropriate education should be delivered at diabetes onset to the child and parents in order to start the strategy of intensified insulin therapy as early as possible. (C) 2001, Editrice Kurtis.

Place, publisher, year, edition, pages
2001. Vol. 14, no 5, 292-304 p.
Keyword [en]
intensive insulin therapy, hypoglycaemia, children, adolescents, metabolic control, self-control, life quality
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-49048OAI: diva2:269944
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2011-01-13

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Ludvigsson, Johnny
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