How is pediatric type 1 diabetes mellitus (DM) treated?

Updated: Jul 03, 2019
  • Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

All children with type 1 diabetes mellitus require insulin therapy. The following are also required in treatment:

  • Blood glucose testing strips

  • Urine ketone testing tablets or strips

  • Blood ketone testing strips

Strategies to help patients and their parents achieve the best possible glycemic management are crucial. A 2-year randomized clinical trial found that a practical, low-intensity behavioral intervention delivered during routine care improved glycemic outcomes. [49]

A well-organized diabetes care team can provide all necessary instruction and support in an outpatient setting. The only immediate requirement is to train the child or family to check blood glucose levels, to administer insulin injections, and to recognize and treat hypoglycemia. The patient and/or family should have 24-hour access to advice and know how to contact the team. Children should wear some form of medical identification, such as a medic alert bracelet or necklace. [5, 50]

Awareness of hypoglycemia becomes impaired over time, and severe hypoglycemia can occur without warning. Hypoglycemia is more likely to affect people who maintain low blood sugar levels and who already suffer frequent hypoglycemic attacks. Overzealous or inadequate treatment of hypoglycemia can lead to serious consequences.

Failure to regularly examine for diabetic complications in patients with type 1 diabetes mellitus, especially renal and ophthalmic ones, can be detrimental.


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