The International Society for Pediatric and Adolescent Diabetes Clinical Practice Consensus Guideline 2018 for management of diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state provide comprehensive guidance for management of DKA in young people. Intravenous (IV) infusion of insulin remains the treatment of choice for treating DKA; however, the policy of many hospitals around the world requires admission to an intensive care unit (ICU) for IV insulin infusion. During the coronavirus 2019 (COVID-19) pandemic or other settings where intensive care resources are limited, ICU services may need to be prioritized or may not be appropriate due to risk of transmission of infection to young people with type 1 or type 2 diabetes.
View Article and Find Full Text PDFJ Pediatr Endocrinol Metab
March 2015
Background: The epidemiology of type 1 diabetes mellitus may provide insights into the pathogenesis of the disease.
Objective: The aim of this work was to characterize the trend of the incidence of type 1 diabetes mellitus in Romanian children aged from 0 to 17 years over a 10-year interval.
Subjects And Methods: Data regarding new cases were obtained from two sources: (1) The Romanian Childhood Diabetes Registry and (2) Records of the Medical Center "Cristian Serban", Buzias.
On behalf of the Global Pediatric Endocrinology and Diabetes group, the authors provide a perspective on the rights of a child as enshrined in the United Nations Convention on the Rights of the Child (1989) concerning the care of pediatric endocrine disorders and diabetes mellitus, throughout the world, with particular reference to care in resource-constrained settings. In this article, we define the spectrum of health care needs of the child with an endocrine disorder and how they may be addressed, in terms of education, research, and development of sustainable programs for improved health outcomes. We emphasize the responsibilities of medical communities, the pharmaceutical industry, and relevant governments in promoting and supporting such concepts.
View Article and Find Full Text PDF"Monsieur Le Professor Harry Dorchy is retiring". He has had a brilliant 40 year career since receiving his medical degree from the Free University of Brussels in 1969 and his PhD--entitled " Contribution a l'etude du diabète de l'enfant et de l'adolescent "--in 1981 from the same illustrious university. He had the great fortune to connect with his mentor, Professor Helmut Jean Loeb, and for many years, the two of them cared for young people with diabetes in Brussels and worked closely to establish a remarkable legacy of clinical care, research and innovative thinking about how young children in Belgium--in fact, around the world--, ought to be considered and treated.
View Article and Find Full Text PDFType 1 diabetes is one of the most frequent chronic diseases in childhood. As in other chronic diseases (asthma, cystic fibrosis, rheumatoid arthritis, epilepsy) children and their families become the focus of self-treatment and the directors of their own care; thus, the health care team should be the guides who set the stage, provided advice and oversight and helped to re-focus efforts when goals were not being met all centered around the patient and family. Rather than the diabetes health care team being the only ones to initiate treatment, patient and parents have to be empowered to analyze their own data, identify patterns, problem solve with food and activity and do so based upon actual blood glucose results.
View Article and Find Full Text PDFJ Pediatr Endocrinol Metab
March 2003
The DCCT scientifically established the basis for optimizing blood glucose control in type 1 diabetes mellitus around the world using a multidisciplinary team approach and patient-centered adjustments of food and insulin based upon blood glucose data generated by the patient. Pediatric diabetologists no longer believe that it is prudent to allow higher blood glucose levels in prepubertal children but much educational emphasis must be placed upon minimizing serious episodes of hypoglycemia. Individualized treatment should be determined by a close working relationship between highly trained diabetes nurses, educators and dieticians with the patient as the focus of self-care decisions, and a pediatric diabetologist ideally setting the philosophical and medical goals.
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