Insulin regimens and insulin adjustments in diabetic children, adolescentsand young adults: Personal experience

Because recent multicenter studies, even those performed in developed count ries without financial restriction, show that treatment of childhood diabet es is inadequate in general and that levels of glycated hemoglobin (HbA1c) are very different, diabetes treatment teams should individually explore th e reasons for failure, without any prejudice or bias. The "good" treatment is signed by good HbA1c associated with good quality o f life, and is not necessarily exportable without adjustment to the local w ay of life. HbA1c must be under 7%, if the upper normal limit is about 6%, which is possible, in our experience, even in diabetic children and adolesc ents. Our "recipes" are summarized. The number of daily insulin injections, 2 or 4, by itself does not necessar ily give better results, but the 4-injection regimen allows greater freedom , taking into account that the proper insulin adjustment is difficult befor e adolescence. Successful glycemic control in young patients depends mainly on the quality and intensity of diabetes education. Any dogmatism must be avoided; only t he objective result is important.