[Could oral antidiabetic agents be useful in the management of different types of diabetes and syndromes of insulin resistance in children and adolescents?].

Various pharmacological approaches can be used to improve glucose homeostasis. These pharmacological treatments may be used individually for certain types of patients, or may be combined to provide a more ideal glycaemic control. Metformin is widely used in pediatric patients and is considered to be the most effective oral agent. Addition of metformin to insulin in pediatric patients with type 1 diabetes mellitus improves metabolic control. Metformin acts by promoting glucose utilization and reducing hepatic glucose production. In many patients with type 2 diabetes, hyperglycemia can be reduced with appropriate changes in diet and exercise, however, some patients with type 2 diabetes and insulin resistance syndromes need pharmacological therapy to improve their metabolic control. The first oral agent used should be metformin. More severe pancreatic beta-cell dysfunction in the group of children requires insulin therapy. Some forms of monogenic diabetes can be successfully managed by sulphonylurea agents.