Present and future perspectives on children with type 1 diabetes

This review presents current achievements in paediatric diabetology and dis cusses potential new approaches. Recent multinational investigations have d emonstrated that in spite of multidisciplinary diabetes care only one-third of young patients with diabetes have an HbA1c below 8%, which is associate d with a lower risk for development of secondary complications. Since there is no standard protocol for the optimal treatment of diabetes in children and adolescents, the therapy has to be tailored to the individual child's n eeds, involving not only paediatricians, but also dieticians, diabetes educ ators, psychologists and social workers. To improve the current situation a major goal for the next few years appears to be the establishment of stand ards for structure, process and outcome quality in paediatric diabetology. Future perspectives include possibilities for a cure via islet- or pancreas transplantation or improved pharmacological therapy following the introduc tion of new types of insulin or other beta cell-related peptides as adjunct ive therapy not currently used.