Does high blood glucose mean more insulin? Type 1 diabetes management in children and adolescents.

Background: The growth and development occurring in children and adolescents with type 1 diabetes contributes to many medical and nonmedical factors that may affect diabetic control.

Objective: This article discusses the assessment of high blood sugar levels in children and adolescents with type 1 diabetes.

Discussion: Traditionally, diet, exercise and insulin dose are seen as the determinants of blood glucose levels in type 1 diabetic patients. While these factors are important, other practical, medical and psychosocial factors need to be considered. Appropriate management requires more than just alteration of insulin dose. Insulin injection technique, adherence to insulin and management regimens in general, psychosocial issues, the role of intercurrent infections and the development of other medical problems need to be considered. Children and adolescents may only be seen by specialist physicians at three monthly intervals. Exploring these issues with patients during routine general practitioner consultations is likely to allow early identification of treatable problems and improve long term glucose control.