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Pediatric Type 1 Diabetes: Mechanisms and Impact of Technologies on Comorbidities and Life Expectancy
Flavia Urbano1, Ilaria Farella2, Giacomina Brunetti3
1Giovanni XXIII Pediatric Hospital, 70126 Bari, Italy.
Insights
Automated insulin delivery systems significantly improve blood glucose control and quality of life for children with type 1 diabetes (T1D). These advanced technologies help manage T1D, reducing long-term complications.
Area of Science:
- Pediatric Endocrinology
- Biomedical Engineering
- Diabetes Technology
Background:
- Type 1 diabetes (T1D) is a growing childhood chronic disease requiring lifelong management.
- Strict blood glucose control is crucial to prevent T1D-related complications and mortality.
- Current T1D management impacts children's quality of life due to constant monitoring and insulin administration.
Purpose of the Study:
- To review current technologies for T1D management in children.
- To explore the impact of these technologies on diabetes-related comorbidities.
- To assess effects on quality of life and life expectancy in pediatric T1D patients.
Main Methods:
- Literature review of automated insulin delivery (AID) systems.
- Analysis of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) integration.
- Examination of technological advancements in pediatric diabetes care.
Main Results:
- AID systems, including smartphone-connected CSII and CGM, enhance metabolic control in T1D children.
- These technologies show promise in mitigating short- and long-term diabetes-related comorbidities.
- Improved glycemic control positively affects the quality of life for young patients.
Conclusions:
- Advanced AID systems offer a therapeutic advantage for pediatric T1D.
- Technological integration is key to optimizing T1D management in children.
- Further research should focus on long-term outcomes and life expectation with these evolving technologies.
Abstract:
Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood, with a progressively increasing incidence. T1D management requires lifelong insulin treatment and ongoing health care support. The main goal of treatment is to maintain blood glucose levels as close to the physiological range as possible, particularly to avoid blood glucose fluctuations, which have been linked to morbidity and mortality in patients with T1D. Indeed, the guidelines of the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommend a glycated hemoglobin (HbA1c) level < 53 mmol/mol (<7.0%) for young people with T1D to avoid comorbidities. Moreover, diabetic disease strongly influences the quality of life of young patients who must undergo continuous monitoring of glycemic values and the administration of subcutaneous insulin. In recent decades, the development of automated insulin delivery (AID) systems improved the metabolic control and the quality of life of T1D patients. Continuous subcutaneous insulin infusion (CSII) combined with continuous glucose monitoring (CGM) devices connected to smartphones represent a good therapeutic option, especially in young children. In this literature review, we revised the mechanisms of the currently available technologies for T1D in pediatric age and explored their effect on short- and long-term diabetes-related comorbidities, quality of life, and life expectation.
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