The gold standard for the treatment of Type 1 diabetes in children and adolescents is the intensified insulin therapy using either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) pump according to the basal-bolus-principle. Blood glucose measurement is the mainstay of diabetes management, guiding insulin dosing decisions and monitoring glycemic control. New technological advances including subcutaneous continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM) are of particular importance for children and adolescents due to the age-related metabolic fluctuations. They provide more information about intra- and interday glycemic excursions that may lead to acute events (such as hypoglycemia) or postprandial hyperglycemia, which have been linked to both microvascular and macrovascular complications. Both rtCGM and iCGM facilitate monitoring of time spent in- and outside the target glucose range (glycated hemoglobin (HbA1c), which has been the traditional method for assessing glycemic control so far. Furthermore, the combination of CSII and rtCGM in form of a sensor-augmented pump (SaP) treatment allows semi-automated insulin dosing with the aim of reduction of hypo- and hyperglycemia in patients with Type 1 diabetes. Current studies show that the implementation of modern technologies into diabetes treatment can help the optimization of metabolic control and also lead to improved quality of life both in patients with type 1 diabetes and in their families.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology