Biester Torben, Kordonouri Olga, Danne Thomas
Diabetes Centre for Children and Adolescents, AUF DER BULT, Janusz-Korczak-Allee 12, 30173 Hannover, Germany.
Diabetes Centre for Children and Adolescents, Hannover, Germany.
Ther Adv Endocrinol Metab. 2018 May;9(5):157-166. doi: 10.1177/2042018818763247. Epub 2018 Mar 19.
For paediatric patients with type 1 diabetes, intensified insulin therapy with either multiple daily injection or insulin pump therapy is currently the only method of treatment. To optimize this therapy, insulin analogues are fixed parts of all therapy regimens. New ultra-rapid insulins seem to be beneficial not only in adults but also in this age group. New developments in long-acting analogues have demonstrated safety and will be regular in paediatrics, we hope, soon. Furthermore, the psychosocial approach for consideration of real-life aspects becomes more the focus of therapeutic regimens and is implemented into international guidelines. Technical improvements, such as continuous glucose monitoring, particularly in combination with pump therapy, support the great success of rapid-acting analogues by reducing hypoglycaemias. Non-insulin agents such as SGLT2-inhibitors show beneficial aspects in people with type 1 diabetes. For outpatient care with these currently off-label-used drugs, special training for measurement of ketones should be imperative.
对于1型糖尿病儿科患者，目前强化胰岛素治疗（每日多次注射或胰岛素泵治疗）是唯一的治疗方法。为优化这种治疗，胰岛素类似物是所有治疗方案的固定组成部分。新型超短效胰岛素似乎不仅对成人有益，对该年龄组也有益。长效类似物的新进展已证明其安全性，我们希望很快能在儿科常规使用。此外，考虑现实生活方面的社会心理方法越来越成为治疗方案的重点，并已纳入国际指南。技术改进，如持续葡萄糖监测，特别是与泵治疗相结合，通过减少低血糖症支持了速效类似物的巨大成功。非胰岛素药物如SGLT2抑制剂在1型糖尿病患者中显示出有益的方面。对于目前使用这些未获批药物的门诊治疗，酮体测量的特殊培训应该是必要的。
