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

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 A_1C (HbA_1C). Therefore, the regular and frequent assessment of HbA_1C 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.