Aggiornamento
La gestione del bambino con diabete di tipo 1
Type 1 diabetes management
Tosca Suprani1, Vanna Graziani2, Arianna Cirillo3, Augusto Biasini4, Federico Marchetti3
1UO di Diabetologia Pediatrica di Cesena e Ravenna; 2Scuola di Specializzazione in Pediatria, Università di Ferrara;
3UOC di Pediatria e Neonatologia, Ospedale di Ravenna; 4UOC di Pediatria e Neonatologia, Cesena;
AUSL della Romagna
Febbraio 2014 - pagg. 87 -95
Abstract
The primary objective in type 1 diabetes management is the maintenance of good metabolic
control in order to reduce the incidence of acute adverse events and long term complications.
Recently, thanks to technological advances, use of new insulin and application
of carbohydrate counting method, the treatment has rapidly evolved. Carbohydrate counting
is a meal planning approach that focuses on carbohydrate as the primary nutrient affecting
postprandial glycemic response and leads to an improved metabolic control with
a greater flexibility in daily life style. This paper describes the importance of intensive insulin
therapy and aims to provide information about the overall management of children
with type 1 diabetes.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Contenuto riservato
Per leggere l'articolo completo è necessario effettuare il login.
Non sei ancora registrato? Registrati
Bibliografia
1. International Diabetes Federation/International
Society for Pediatric and Adolescent Diabetes.
IDF/ISPAD 2011 Global Guideline for
Diabetes in Childhood and Adolescence.
2. Tornese G, Rubert L, Tonini G, Faleschini
E. Uno, cento, mille diabeti. Diabete mellito di
tipo 1 e 2 - parte prima. Medico e Bambino
2011;30:360-6.
3. Kawamura T. The importance of carbohydrate
counting in the treatment of children
with diabetes. Pediatr Diabetes 2007;8(Suppl
6):57-62.
4. The DCCT Research Group. Nutrition interventions
for intensive therapy in the Diabetes
Control and Complications Trial. Jam
Diet Assoc 1993;93:768-72.
5. Pocecco M. Schemi e dosi di terapia insulinica
nel bambino diabetico. Medico e Bambino
1999;18:113-5.
6. DAFNE Study Group. Training in flexible,
intensive insulin management to enable dietary
freedom in people with type 1 diabetes:
dose adjustment for normal eating (DAFNE)
randomized controlled trial. BMJ 2002;325:
746.
7. Alemzadeh R, Berhe T, Wyatt DT. Flexible
insulin therapy with glargine insulin improved
glycemic control and reduced severe hypoglycaemia
among preschool-aged children
with type 1 diabetes mellitus. Pediatrics 2005;
115:1320-4.
8. Chiesa G, Piscopo MA, Rigamonti A, et al.
Insulin therapy and carbohydrate counting.
Acta Biomed 2005;76:44-8.
9. Misso ML, Egberts KJ, Page M, O’Connor
D, Shaw J. Continuous subcutaneous insulin
infusion (CSII) versus multiple insulin injections
for type 1 diabetes mellitus. Cochrane Database
Syst Rev 2010:CD005103.
10. Bergenstal RM, Tamborlane WV, Ahmann
A, et al.; STAR 3 Study Group. Sensor-augmented
pump therapy for A1C reduction
(STAR 3) study: results from the 6-month continuation
phase. Diabetes Care 2011;34(11):
2403-5.
11. Smart C, Aslander-van Vliet E, Waldron S.
Nutritional management in children and adolescents
with diabetes. Pediatr Diabetes 2009;
10(Suppl 12):100-17.
12. Società Italiana Obesità - Associazione Italiana
di Dietetica e Nutrizione Clinica: Standard
Italiani per la Cura dell’Obesità SIO/
ADI. 2012-2013.
13. Società Italiana di Nutrizione Umana:
LARN-Livelli di Assunzione di Riferimento di
Nutrienti ed energia per la popolazione italiana.
Revisione 2012. Documento di sintesi per il
XXXV Congresso Nazionale SINU. Bologna,
22-23 ottobre 2012.
14. Maffeis C, Morandi A, Ventura E, et al. Diet,
physical, and biochemical characteristics
of children and adolescents with type 1 diabetes;
relationship between dietary fat and
glucose control. Pediatr Diabetes 2012;13(2):
137-46.
15. Wolpert HA, Atakov-Castillo A, Smith SA,
Steil GM. Dietary fat acutely increases glucose
concentrations and insulin requirements
in patients with type 1 diabetes: implications
for carbohydrate-based bolus dose calculation
and intensive diabetes management. Diabetes
Care 2013;36:810-6.
16. Scavone G, Manto A, Pitocco D, et al. Effect
of carbohydrate counting and medical nutritional
therapy on glycaemic control in type 1
diabetic subjects: a pilot study. Diabet Med
2012:27;477-9.
17. Marigliano M, Morandi A, Maschio M, et
al. Nutritional education and carbohydrate
counting in children with type 1 diabetes treated
with continous subcutaneous insulin infusion:
the effects on dietary habits, body composition
and glycometabolic control. Acta Diabetol
2013;50:959-64.
18. Buethe M. C-O-U-N-T C-A-R-B-S: a 10-step
guide to teaching carbohydrate counting. Diabetes
Educ 2008;34:67-74.
19. Enander R, Gundevall C, Stromgren A,
Chaplin J, Hanas R. Carbohydrate counting
with a bolus calculator improves post-prandial
blood glucose levels in children and adolescents
with type 1 diabetes using insulin
pumps. Pediatr Diabetes 2012:13:545-51.
20. Blazik M, Pankowska E. The effect of bolus
and food calculator Diabetics on glucose
variability in children with type 1 diabetes
treated with insulin pump: the results of RCT.
Pediatr Diabetes 2012;13:534-9.
21. Spiegel G, Bortsov A, Bishop FK, et al.
Randomized nutrition education intervention
to improve carbohydrate counting in adolescents
with type 1 diabetes study: is more intensive
education needed? J Acad Nutr Diet
2012;112:1736-46.
22. Freeborn D, Dyches T, Roper SO, Mandleco
B. Identifying challenges of living with
type 1 diabetes: child and youth perspectives.
J Clin Nurs 2013;22:1890-8.
Corrispondenza: tsuprani@ausl-cesena.emr.it
