Traitement du diabète de l'enfant et de l'adolescent

P. Boileau (Chef de clinique-assistant), B. Merle (Diététicienne), P.-F. Bougnères (Professeur, chef de service)
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Abstract

In most cases, the diabetes found in children and adolescents is type 1 diabetes, an autoimmune disease. The treatment of diabetes aims at achieving glucose control, with levels as close to normal as possible, to reduce the risk of long-term complications. Subcutaneous insulin therapy is a cornerstone in the treatment of patients with type 1 diabetes; its regimen and dose must be individualized, depending on the concerned child. Diet is essential for achieving optimal metabolic control. The risk of long-term microvascular complications is related to the mean level of hemoglobin A1C (HbA1C). Therefore, the regular and frequent assessment of HbA1C combined with the monitoring of blood glucose is critical in terms of individual management. Diabetic ketoacidosis (in newly diagnosed patients or due to insulin omission) and severe hypoglycemia are the two major acute complications in children with type 1 diabetes. Both are theoretically preventable.

儿童和青少年糖尿病的治疗
在大多数情况下,儿童和青少年的糖尿病是1型糖尿病,一种自身免疫性疾病。糖尿病的治疗目标是控制血糖,使血糖水平尽可能接近正常水平,以减少长期并发症的风险。皮下胰岛素治疗是1型糖尿病患者治疗的基石;它的方案和剂量必须个体化,取决于有关儿童。饮食是达到最佳代谢控制的必要条件。长期微血管并发症的风险与糖化血红蛋白(HbA1C)的平均水平有关。因此,定期和频繁地评估HbA1C并结合监测血糖在个体化管理方面至关重要。糖尿病酮症酸中毒(在新诊断患者或由于胰岛素遗漏)和严重低血糖是儿童1型糖尿病的两大急性并发症。这两种情况在理论上都是可以预防的。
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