Adolescent And Type 1 Diabetes

Adolescent And Type 1 Diabetes


Type 1 diabetes in one in 500 children and adolescents, as well as vascular complications remains an important reason for mortality and morbidity in adult life. Blood sugar level dropped, since the confirmation of a clear relationship between glycemic control and microvascular complications, on the issue Craig and the others proposed a population-based, cross-sectional study of 1190 children and adolescents with type 1 diabetes patients, in the New South Wales and Australian Capital territory.3 its median glycosylated hemoglobin level of 8.2%, probably reflecting some selection bias, because the 571 (33%) of the population did not participate adolescent and type 1 diabetes. However, this degree of glucose control is still a considerable improvement over the past 10 years and comparable to the level of International Studies in Children with Type 1 diabetes. this trend along with the increasing use and intensive management in the children and youth, but also an alarming increase in the incidence of severe hypoglycemia.

There are compelling reasons, the proposed intensive treatment in adolescents with type 1 diabetes - whether multiple daily injections or continuous subcutaneous insulin infusion. Strengthen the effectiveness of the treatment, to improve and maintain good blood glucose control have been identified in young people is the basis of test conditions.6 more recent data also shows that the benefits of intensive treatment and improved blood glucose control, persist even when the glycosylated hemoglobin level rise. Upon completion, in the Diabetes Control and Complications Test (dcct), youth from the former intensive therapy and conventional treatment group returned to routine care, and maximize the use of intensive therapy. Although there is no difference in their blood sugar control, four years after the end of the dcct, before benefits more effectively to strengthen the control treatment group persisted. They are sick of progress to the proliferation or serious non-proliferation retinopathy reduced by 78 per cent in four years. Suboptimal control in adolescent and type 1 diabetes seems to be a long-lasting adverse effects, even when better blood glucose control is achieved.

Those caring for children and adolescents with type 1 diabetes may be concerned that demands on the family and children achieve good blood glucose control and intensive therapy. However, good blood glucose control, and a better quality of life scores (quality of life), the adolescent and type 1 diabetes and less burden on its perceived strength parents. insulin regimen does not affect quality of life. Clearly, the requirements to achieve good control less than the consequences of poor control.

Constraints, the achievement of the desired blood glucose control is still low blood sugar, but do not rule out other problems persist or family function. Dcct young people in the higher interest rate of hypoglycemia than their adult counterparts, despite higher glycosylated hemoglobin levels.6 glucagon secretion, which stimulates hepatic glycogenolysis, weak early in the process, type 1 diabetes, patients increase the vulnerability of hypoglycemia. In addition, blood glucose threshold levels of catecholamine release is the response to hypoglycemia can be reduced with better blood glucose control, anti-regulatory response is the most weak in recent sleep. continuous glucose monitoring devices, low blood sugar at night Children are frequent. However, both the new insulin analogues, continuous subcutaneous insulin therapy and a commitment to improve the control, without the attendant risk of hypoglycemia. In Western Australia, adolescent and type 1 diabetes have more hypoglycemia in conjunction with the fall glycosylated hemoglobin level until 1995 Thereafter further improve their control, but did not increase the hypoglycemia.

Can dcct suggested that young people receive intensive treatment, reproduced in routine care? The hvidore Study Group followed more than 2,500 children and adolescents more than three years, in Europe, Canada and japan.5 despite the use of more intensive therapy, to improve glycemic control is not necessarily a broad differences Pediatric Center. Intensive Therapy intensive follow-up, education and support, as well as resources, many Australian paediatric diabetes units, and the majority of patients do not have access to support in the case. Dcct the most successful implementation of the proposed report, make full use of resources from diabetes clinical care units consultant for the job.

Although it was suggested that adolescents with type 1 diabetes patients received intensive treatment, the timetable must be personal. For example, some students need insulin afternoon tea, most adolescent and type 1 diabetes need long-acting insulin at night before bed control, the management of many preschool children, brokering insulin in the morning and the small dose of insulin analogues to cover hyperglycemia , in one day. Insulin pump, can provide the best solution, some patients, especially those with frequent hypoglycemia or hypoglycemia do not know, but if there is no government subsidies, they are not affordable for most families. All of these choices are easy for children and their families, for some people, the intensive therapy is impossible. Insulin omission and chronic poor glycemic control is still a problem in adolescence and the need to constantly intervention.