Abstract
Background: Extremely young children aged ≤6 years old represent a unique population among patients with type 1 diabetes in terms of glycemic variation, diabetes management and complications.
Objective: We describe distinct features of diabetes care and outcomes in preschool age children. Methods: We searched PubMed, Google Scholar, and authors’ bibliographies in order to extract articles specific to type 1 diabetes in preschool age children. Findings: The preschool age group is beset by many challenges to diabetes care, including more frequent hypo- and hyperglycemia, hypoglycemia unawareness, decreased residual beta cell function, and greater long-term neurocognitive effects from severe hypoglycemia and chronic hyperglycemia. Randomized controlled trials show that equally good metabolic control can be obtained with multiple daily injections or an insulin pump. Several non-randomized trials, including an 8 year longitudinal study, show lower hemoglobin A1C and decreased hypoglycemia on insulin pumps. Sensor augmented pump therapy resulted in superior A1C as long as sensors were used regularly. In contrast to adults, continuous glucose monitoring has little to no impact on A1C, although parents appreciate the improved monitoring for hypoglycemia. Children with onset of diabetes prior to age 5 are at risk for younger onset of microalbuminuria, however do not develop earlier onset retinopathy than children diagnosed after 5 years. Both severe hypoglycemia and chronic hyperglycemia have negative impact on neurocognition. Conclusion: Special knowledge about this young population is helpful for practitioners and parents.Keywords: Type 1 diabetes, preschool children, pediatrics, outcomes, insulin pump, continuous glucose monitoring, neurocognition, hypoglycemia, hyperglycemia.
Current Diabetes Reviews
Title:Unique Challenges of Type 1 Diabetes in the Preschool Population
Volume: 13 Issue: 2
Author(s): Loyal K. Coshway and Robert P. Hoffman
Affiliation:
Keywords: Type 1 diabetes, preschool children, pediatrics, outcomes, insulin pump, continuous glucose monitoring, neurocognition, hypoglycemia, hyperglycemia.
Abstract: Background: Extremely young children aged ≤6 years old represent a unique population among patients with type 1 diabetes in terms of glycemic variation, diabetes management and complications.
Objective: We describe distinct features of diabetes care and outcomes in preschool age children. Methods: We searched PubMed, Google Scholar, and authors’ bibliographies in order to extract articles specific to type 1 diabetes in preschool age children. Findings: The preschool age group is beset by many challenges to diabetes care, including more frequent hypo- and hyperglycemia, hypoglycemia unawareness, decreased residual beta cell function, and greater long-term neurocognitive effects from severe hypoglycemia and chronic hyperglycemia. Randomized controlled trials show that equally good metabolic control can be obtained with multiple daily injections or an insulin pump. Several non-randomized trials, including an 8 year longitudinal study, show lower hemoglobin A1C and decreased hypoglycemia on insulin pumps. Sensor augmented pump therapy resulted in superior A1C as long as sensors were used regularly. In contrast to adults, continuous glucose monitoring has little to no impact on A1C, although parents appreciate the improved monitoring for hypoglycemia. Children with onset of diabetes prior to age 5 are at risk for younger onset of microalbuminuria, however do not develop earlier onset retinopathy than children diagnosed after 5 years. Both severe hypoglycemia and chronic hyperglycemia have negative impact on neurocognition. Conclusion: Special knowledge about this young population is helpful for practitioners and parents.Export Options
About this article
Cite this article as:
Coshway K. Loyal and Hoffman P. Robert, Unique Challenges of Type 1 Diabetes in the Preschool Population, Current Diabetes Reviews 2017; 13 (2) . https://dx.doi.org/10.2174/1573399812666151022143757
DOI https://dx.doi.org/10.2174/1573399812666151022143757 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
Call for Papers in Thematic Issues
Advancing Diabetic Wound Healing: Mechanisms and Interventions
In recent years, diabetic wounds have become a global health concern with the increase in the incidence of diabetes. Diabetic wounds are a kind of chronic and refractory ulcer. It is generally due to the microcirculatory disturbances and the reduced levels of endogenous growth factors. Delayed cutaneous wound healing is ...read more
Oxidative and inflammatory responses in the development of secondary diabetic complications
Diabetes, along with its associated secondary complications, represents a significant global health challenge, contributing significantly to morbidity and mortality. Unhealthy lifestyle habits, reduced physical activity, environmental pollutants, and stress are pivotal factors in the onset of diabetes, particularly type-2 diabetes. Poorly managed hyperglycemia can lead to various complications, including neuropathy, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Pleiotropic Effects of Nicotinic Acid: Beyond High Density Lipoprotein Cholesterol Elevation
Current Vascular Pharmacology ALA, Fatty Fish or Marine n-3 Fatty Acids for Preventing DM?: A Systematic Review and Meta-Analysis
Current Diabetes Reviews Potential Pathways for CNS Drug Delivery Across the Blood-Cerebrospinal Fluid Barrier
Current Pharmaceutical Design Editorial [Hot Topic: Inflammation in Atherosclerosis: Current Therapeutic Approaches (Executive Guest Editor: Dimitris Tousoulis)]
Current Pharmaceutical Design Tumor-Targeting Peptides: Ligands for Molecular Imaging and Therapy
Anti-Cancer Agents in Medicinal Chemistry Coffee: A Dietary Intervention on Type 2 Diabetes?
Current Medicinal Chemistry Subject Index To Volume 6
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Can We Move Forward After ADVANCE?
Vascular Disease Prevention (Discontinued) Role of Renin-Angiotensin-Aldosterone System in Metabolic Syndrome and Obesity-related Hypertension
Current Hypertension Reviews Neuroleptics and Migraine
Central Nervous System Agents in Medicinal Chemistry Antitubercular Properties of Substituted Hydroxycyclohexadienones
Letters in Drug Design & Discovery Diet and Metabolic Syndrome
Endocrine, Metabolic & Immune Disorders - Drug Targets Current Immunotherapies for Renal Cell Carcinoma
Current Molecular Pharmacology Testicular Dysfunction is a Common Feature in Men with Type 2 Diabetes Mellitus in a Nigerian Tertiary Hospital
Current Diabetes Reviews Protection Mechanisms Against Aβ42 Aggregation
Current Alzheimer Research Editorial (Hot Topic: Introduction to the Special Issue: Relevance of Endocrine and Metabolic Disorders in Heart Failure: From Pathophysiology to Therapeutic Approach)
Endocrine, Metabolic & Immune Disorders - Drug Targets Cerebrovascular Diseases in HIV-Infected Patients
Current HIV Research Regulation of Angiogenesis by Macrophages, Dendritic Cells, and Circulating Myelomonocytic Cells
Current Pharmaceutical Design Influence of ABCB1 Gene Polymorphisms and P-Glycoprotein Activity on Cyclosporine Pharmacokinetics in Peripheral Blood Mononuclear Cells in Healthy Volunteers
Drug Metabolism Letters Electronic Noses in Medical Diagnostics
Current Medicinal Chemistry