Marcovecchio Maria Loredana, Chiarelli Francesco
aDepartment of Paediatrics, University of Cambridge, Cambridge, UK bDepartment of Paediatrics, University of Chieti, Chieti, Italy.
Curr Opin Pediatr. 2017 Aug;29(4):481-487. doi: 10.1097/MOP.0000000000000504.
Type 1 diabetes (T1D) and type 2 diabetes (T2D) are frequent conditions during childhood and adolescence. The present review offers an update on current available treatment strategies for T1D and T2D approved for use in children and adolescents.
Insulin remains the main and essential therapeutic strategy in youth with T1D. A second generation of insulin analogues is being evaluated and could help in improving glycemic control. Over the last decades advances in technology have allowed the implementation of insulin pump therapy and continuous glucose monitoring, and are now leading the way towards the development of an artificial pancreas or closed loop system.Treatment of T2D is based on lifestyle interventions and metformin as the first-line drug to be used. Little evidence is available for other oral hypoglycemic drugs, currently used in adults.
Although much progress has been made in the field of diabetes management, there are still several unmet goals. One of the main issues is to develop a system allowing more physiological insulin coverage. For both T1D and T2D, there is a strong need of new drugs to be used alone or in combination, mainly in patients struggling to achieve good glycemic control.
1型糖尿病（T1D）和2型糖尿病（T2D）是儿童和青少年时期的常见病症。本综述提供了目前已批准用于儿童和青少年的T1D和T2D现有治疗策略的最新信息。
胰岛素仍然是青少年T1D的主要和基本治疗策略。第二代胰岛素类似物正在进行评估，可能有助于改善血糖控制。在过去几十年中，技术进步使得胰岛素泵治疗和持续血糖监测得以实施，目前正引领着人工胰腺或闭环系统的发展。T2D的治疗基于生活方式干预和二甲双胍作为一线用药。目前在成人中使用的其他口服降糖药的证据很少。
尽管在糖尿病管理领域已经取得了很大进展，但仍有几个未实现的目标。主要问题之一是开发一种能够实现更生理性胰岛素覆盖的系统。对于T1D和T2D，都迫切需要单独或联合使用的新药，主要用于难以实现良好血糖控制的患者。
