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Management of type 1 diabetes mellitus in children and adolescents

INTRODUCTION

Type 1 diabetes mellitus, one of the most common chronic diseases in childhood, is caused by insulin deficiency resulting from the destruction of insulin-producing pancreatic beta cells. (See "Pathogenesis of type 1 diabetes mellitus".)

There are unique challenges in caring for children and adolescents with diabetes that differentiate pediatric from adult care. These include the obvious differences in the size of the patients, developmental issues such as the unpredictability of a toddler's dietary intake and activity level, and medical issues such as the increased risk of hypoglycemia and diabetic ketoacidosis. Because of these considerations, the management of a child with type 1 diabetes must take into account the age and developmental maturity of the child.

Although most children with type 1 diabetes present with the classic signs and symptoms of hyperglycemia without accompanying acidosis, approximately 30 percent of children in the United States present with diabetic ketoacidosis [1]. The management of these patients is discussed in detail separately. (See "Treatment and complications of diabetic ketoacidosis in children".)

The management of the child or adolescent with type 1 diabetes, who either did not present with ketoacidosis or who has recovered from ketoacidosis, will be reviewed here. The term parent will be used throughout the discussion, with recognition that the primary caregiver may not be a parent.

The presentation, diagnosis, and complications of childhood-onset type 1 diabetes are discussed separately. (See "Epidemiology, presentation, and diagnosis of type 1 diabetes mellitus in children and adolescents" and "Complications and screening in children and adolescents with type 1 diabetes mellitus".)

                                        

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Literature review current through: Apr 2012. | This topic last updated: Mar 1, 2012.
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