Therapy strategies in children and adolescents with type-1-diabetes [Moderne behandlungskonzepte für kinder und jugendliche mit diabetes mellitus typ 1]

Diabetes mellitus type 1 is one of the most common chronic diseases in childhood. Acute treatment of diabetic ketoacidosis (DKA) includes treatment of shock, slow and moderate rehydration, correction of electrolyte deficits and substitution of insulin.The most severe complication is brain edema. Associated risk factors are rehydration with large volumes and hypotonic solutions, rapid decrease in serum osmolarity as well as duration and severity of clinical signs of DKA. Insulin therapy in children and adolescents includes the conventional two or multi-injection therapy and also insulin pump treatment. Continuous care of diabetic children and adolescents requires multidisciplinary teams including pediatric diabetologists, diabetes educators and psychologists. Furthermore, collaboration with ophthalmologists, gynecologists and pediatricians is mandatory.