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Chapter 9: Insulin treatment in children and adolescents with diabetes
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Dear Members,
Dear Friends,

Type 1 diabetes (T1D) is all about insulin. Since 1922, when this life-saving medicine was discovered, T1D has become a chronic, not fatal condition. After almost 100 years everything has changed – the dawn of diabetes technology made new opportunities, but insulin still remains at the core of all recent advances in the treatment of children (people!) with diabetes.

This ISPAD 2018 Guidelines chapter Insulin treatment in children and adolescents with diabetes is a compendium of insulin treatment. It summarizes current pediatric recommendations for insulin injection and devices for insulin delivery. It gives updated advice for pediatric insulin dose adjustments and guidance on approaches for persistent deviations of glucose levels from target. It details how to use traditional insulins and new insulin analogs appropriately in each individual based on factors including age, duration of diabetes, lifestyle (dietary patterns, exercise schedules, school, work commitments etc.), targets of metabolic control and particularly individual patient/family preferences.



It recommends what treatments to use and highlights the importance of intensive regimes. Insulin treatment that mimics normal physiological patterns as closely as possible remains the cardinal principle of treatment for type 1 diabetes. Overall, there has been a paradigm shift toward multiple daily injections and insulin pumps over the last decades. While previously therapies have focused on avoiding painful injections in children, leading to regimens with little flexibility and dietary restrictions, currently intensive regimens with differential substitution of basal and prandial insulin have become the gold standard in pediatric diabetology.

This chapter also highlights that every child diagnosed with diabetes is dependent on insulin for survival and therefore should have access to adequate amounts of at least regular and long-acting (NPH) insulin. ISPAD, through cooperation with Life for a Child are working toward making insulin available for all children and adolescents with diabetes and promoting universal insulin labeling. You can support Life for a Child throug Facebook donation or through their website (above). Inequalities in accessing insulin for people of all ages are also being tackled by T1International - you can support them by clicking the link to their website.

If you would like to learn even more about this lifesaving medicine, whose discovery has been awarded Nobel Prize, check the ISPAD online resource platform:

Diverse views of the coming of insulin, by Michael Bliss (author of the book “The discovery of insulin”).
New and smart insulins, by Neale Cohen.


The Conference Resource Platform has been made possible thanks to an independent educational sponsorship from
,
If you have any questions, please contact:

ISPAD Conference Secretariat
K.I.T. Group GmbH
Association & Conference Management
Tel.: +49 30 24 60 3-270
Fax: +49 30 24 60 3-200
 
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© 2019 International Society for Pediatric and Adolescent Diabetes (ISPAD)

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