Marcovecchio M Loredana, Chiarelli Francesco
University of Chieti, Department of Paediatrics , Via dei Vestini 5, 66100 Chieti , Italy +0039 0871 358015 ; +0039 0871 574538 ;
Expert Opin Biol Ther. 2014 Mar;14(3):355-64. doi: 10.1517/14712598.2014.874413. Epub 2014 Jan 6.
Diabetes mellitus is a frequent endocrine disease during childhood and adolescence. Achieving a good glycemic control is of paramount importance to avoid short- and long-term complications and to allow a normal growth and quality of life.
This review offers an update on current available treatment strategies for type 1 and type 2 diabetes approved for use in children and adolescents.
Although many progresses have been made in the field of diabetes management in children and adolescents, there are still several problems to deal with. With regard to type 1 diabetes, insulin remains the main and essential therapeutic strategy. However, the main issue is to develop a system that allows more physiological insulin coverage and reduces the risk of hypoglycemia and weight gain. Adjunct therapies would be invaluable for patients struggling to achieve an acceptable glycemic control. Treatment of type 2 diabetes is based on lifestyle interventions and metformin is the first-line drug for children older than 10 years. As for type 1 diabetes, there is a strong need for developing new drugs to be used alone or in combination.
糖尿病是儿童和青少年时期常见的内分泌疾病。实现良好的血糖控制对于避免短期和长期并发症以及保证正常生长和生活质量至关重要。
本综述提供了目前已批准用于儿童和青少年的1型和2型糖尿病现有治疗策略的最新信息。
尽管儿童和青少年糖尿病管理领域已取得许多进展,但仍有几个问题需要解决。对于1型糖尿病,胰岛素仍然是主要且必不可少的治疗策略。然而,主要问题是开发一种能够实现更符合生理状态的胰岛素覆盖并降低低血糖和体重增加风险的系统。辅助治疗对于难以实现可接受血糖控制的患者将非常宝贵。2型糖尿病的治疗基于生活方式干预,二甲双胍是10岁以上儿童的一线药物。与1型糖尿病一样,迫切需要开发单独使用或联合使用的新药。