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Clinical Pediatrics
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Disease Management in the Young Diabetic Patient: Glucose Monitoring, Coping Skills, and Treatment Strategies

Stuart A. Weinzimer, MD

Department of Pediatrics, Yale University School of Medicine, New Haven, CT

Elizabeth A. Doyle, MSN, APRN, CDE

Department of Pediatrics, Yale University School of Medicine, New Haven, CT

William V. Tamborlane, Jr, MD

Department of Pediatrics, Yale University School of Medicine, New Haven, CT, The General Clinical Research Center, Yale University, New Haven, CT

Type 1 diabetes mellitus was thought to be the prevalent type of diabetes in children and adolescents; however, increasing numbers of juvenile patients appear to have type 2 diabetes. Management of all diabetes in young patients should include regular assessment, careful monitoring for glycemic control and the presence of hypoglycemia, and educational training on disease management. Hypoglycemic episodes, especially nocturnal events, are frequent in the young diabetic patient. Improvements in glycemic control and nocturnal hypoglycemia have been observed with continuous subcutaneous insulin infusion and insulin glargine. A continuous glucose-monitoring system can provide important insight into 24-hour glycemic control. Overall, careful management, monitoring, and education can improve glycemic control and yield positive treatment outcomes in the child or adolescent with diabetes.

Clinical Pediatrics, Vol. 44, No. 5, 393-403 (2005)
DOI: 10.1177/000992280504400503
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