Treating Diabetes In Children, Adolescents, And The Dcct

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In past it was thought that blood glucose was a secondary option in treating children and adolescents with diabetes

. The focus was more on their various hormonal and psychosocial changes and illness than glucose control.

But the convincing results of the Diabetes Control and Complications Trial (DCCT) have changed the scenario now. It is now realized that the major factor in controlling the complications of diabetes in adults as well as in adolescents is the blood glucose control. In the start of the study of the trial, where about 14 percent (195) of the patients were insulin dependent and age around thirteen to seventeen, it was assumed that a different response would be received by these children as they were experiencing a growth of different hormonal factors along with certain other factors, which are chemically similar to insulin.

But in fact the results showed that the adolescents response to intensive and conventional diabetes therapy was similar to that of adults. The common response was prominent in terms of risk of micro vascular changes that effect kidneys and eyes.

As far as the effects of intensive therapy are concerned, adolescents have the same adverse effects as that of adults, i.e. severe hypoglycemia and risk of weight gain. The study of the trial showed that the rate of hypoglycemia is higher in the adolescents than adults. But yet investigators didnt find any long term negative results of hypoglycemia. The investigators are of the view that this higher rate of hypoglycemia may be due to the lack of physical activities, changing eating habits, or the larger consumption of insulin might be the reason.

The vital statistics of the DCCT highlight the importance of insulin doses within a day to have a good control the blood glucose. Now this can be a critical point. Every patient of diabetes require different dose of insulin. For instance, two injections per day are enough for some teenagers to have their blood glucose under control and others may require three or more injections per day to keep things under control. However, it is said that three or more injection will produce far better results. Teenagers are old enough to get manage to this dosage, but the real problem arises with kids. Here insulin pump will serve the purpose well, but here more teenagers dont like using these pumps.

For children younger than thirteen years old, the physicians merely infer from the data available and the general view regarding their physiology and biochemistry that intensive therapy is less beneficial than conventional therapy (especially for infants and toddlers). Physicians believe that they are relatively more protected against eye and kidney changes with conventional therapy. They also believe that hypoglycemia is extremely dangerous for brain development in young children, just because of their irregularities in physical activities and food intake.

To keep blood glucose level well under control, it is necessary to monitor blood glucose frequently and adjust your insulin dosage accordingly to reduce the risk of hypoglycemia

by: Tauqeer Hassan

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