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Present and future perspectives on children with type 1 diabetes
1Kinderklinik der Charité, Campus Virchow-Klinikum, Humboldt University, Berlin, Germany.
Insights
Paediatric diabetes care needs improvement, as only one-third of young patients achieve target HbA1c levels. Establishing quality standards and exploring new therapies are crucial for better outcomes in childhood diabetes management.
Area of Science:
- Paediatric endocrinology
- Diabetes mellitus management
Background:
- Multidisciplinary care for paediatric diabetes yields suboptimal glycemic control in most young patients.
- A significant gap exists in achieving target HbA1c levels (below 8%), linked to reduced secondary complication risk.
Purpose of the Study:
- To review current advancements in paediatric diabetology.
- To discuss emerging therapeutic strategies and future directions for managing diabetes in children and adolescents.
Main Methods:
- Comprehensive literature review of recent multinational investigations and clinical practices.
- Analysis of current treatment protocols and their effectiveness in paediatric populations.
Main Results:
- Despite multidisciplinary efforts, only a third of young patients with diabetes achieve recommended HbA1c levels.
- Current treatment lacks standardized protocols, necessitating individualized, team-based approaches.
Conclusions:
- There is a critical need to establish quality standards for structure, process, and outcomes in paediatric diabetology.
- Future research should focus on curative options like transplantation and advanced pharmacological therapies, including novel insulins and beta cell peptides.
Abstract:
This review presents current achievements in paediatric diabetology and discusses potential new approaches. Recent multinational investigations have demonstrated that in spite of multidisciplinary diabetes care only one-third of young patients with diabetes have an HbA1c below 8%, which is associated with a lower risk for development of secondary complications. Since there is no standard protocol for the optimal treatment of diabetes in children and adolescents, the therapy has to be tailored to the individual child's needs, involving not only paediatricians, but also dieticians, diabetes educators, psychologists and social workers. To improve the current situation a major goal for the next few years appears to be the establishment of standards for structure, process and outcome quality in paediatric diabetology. Future perspectives include possibilities for a cure via islet- or pancreas transplantation or improved pharmacological therapy following the introduction of new types of insulin or other beta cell-related peptides as adjunctive therapy not currently used.