Current opportunities for glycaemic control in children and adolescents with type 1 diabetes mellitus: the path to achieving a goal

Abstract

Type 1 diabetes is a highly prevalent disorder worldwide and the commonest form of diabetes in children and adolescents. The incidence rates are steadily increasing, despite numerous efforts aimed at finding the possibility to detect and interrupt autoimmune inflammation in the pancreas at preclinical stages. Modern technologies make it possible to set metabolic control goals that are increasingly closer to physiological ones. The article presents recommendations regarding new technologies for glycaemic control and criteria for compensation of T1DM in children and adolescents in accordance with the updated guidelines of the International Society of Diabetes Mellitus in Children and Adolescents (ISPAD, 2022) and the Russian standards for self-monitoring of glycemia using an individual blood glucose meter associated with the use of continuous glucose monitoring technologies to assess the accuracy and/or calibration of monitoring data and address treatment adjustment issues. The possibilities and advantages of modern blood glucose meters are highlighted both in terms of accuracy of readings and functional expandability. Clinical cases demonstrating the importance of using blood glucose meters in decision-making by patients (adolescents) with type 1 diabetes who receive insulin pump therapy are presented. Excessive haste in decision-making by patients resulting in non-target results on glycaemic levels, which could have been avoided with timely measurement of blood glucose levels with a glucose meter was stressed. The great role of continuous education of children and adolescents with T1DM together with assessment and analysis of the significance of new and existing technologies for diagnosis, treatment, and monitoring of this chronic disease is emphasized, so that the patients and their parents can fully and effectively use constantly emerging opportunities.