Gorrell Jennifer Justice, Williams Jennifer Schoelles, Powell Paula
Departments of Pharmacy Practice, West Virginia University, Charleston, West Virginia.
J Pediatr Pharmacol Ther. 2003 Oct;8(4):252-65. doi: 10.5863/1551-6776-8.4.252.
The purpose of this article is to provide the health care practitioner with a comprehensive review of the pathophysiology and treatment of Type 1 Diabetes Mellitus. Traditionally, insulin has been administered via an insulin syringe. In the recent past, diabetes research has focused on developing more convenient insulin delivery devices and longer acting insulin's in hopes of increasing compliance with insulin therapy and improving the management of Type 1 diabetes in both children and adults. Rapidly developing approaches to insulin delivery for Type 1 diabetes continue to be developed at a rapid rate, including administration via continuous subcutaneous insulin infusion in addition to other new approaches. With these advances in therapy, pediatric patients with Type 1 diabetes have been able to achieve strict glycemic control, although the treatment of hypoglycemia remains a burden. The objectives of this article are to the following: to review the epidemiology, risk factors, pathophysiology, clinical manifestations, and diagnostic criteria of Type 1 diabetes mellitus in children,; to discuss the management of these patients, including, insulin therapy, monitoring, diet and exercise, carbohydrate counting and treatment of hypoglycemia,; and to review insulin administration devices, including insulin pens, insulin jet injectors, insulin pumps, and novel insulin delivery systems.
本文旨在为医疗从业者提供有关1型糖尿病病理生理学及治疗方法的全面综述。传统上，胰岛素是通过胰岛素注射器给药的。近年来，糖尿病研究主要集中在开发更便捷的胰岛素给药装置以及长效胰岛素，以期提高胰岛素治疗的依从性，并改善儿童和成人1型糖尿病的管理。针对1型糖尿病的胰岛素给药方法仍在迅速发展，除其他新方法外，还包括持续皮下胰岛素输注。随着这些治疗方法的进步，1型糖尿病儿童患者已能够实现严格的血糖控制，不过低血糖的治疗仍是一项负担。本文的目标如下：回顾儿童1型糖尿病的流行病学、危险因素、病理生理学、临床表现及诊断标准；讨论这些患者的管理，包括胰岛素治疗、监测、饮食与运动、碳水化合物计数及低血糖治疗；回顾胰岛素给药装置，包括胰岛素笔、胰岛素喷射注射器、胰岛素泵及新型胰岛素给药系统。
