Dr.Daniel Zamanfar PEDIATRIC ENDOCRINOLOGIST

Transcript:Dr.Daniel Zamanfar PEDIATRIC ENDOCRINOLOGIST:
Dr.Daniel Zamanfar PEDIATRIC ENDOCRINOLOGIST Children and Adolescents: Standards of Care in Diabetes— 2024 1 The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. 2 The management of diabetes in children and adolescents (individuals <18 years of age) cannot simply be derived from care routinely provided to adults with diabetes. The epidemiology, pathophysiology, developmental considerations, and response to therapy in pediatric diabetes are often different from those of adult diabetes. There are also differences in recommended care for children and adolescents with type 1 diabetes, type 2 diabetes, and other forms of pediatric diabetes. 3 In addition to comprehensive diabetes care, youth with diabetes should receive age-appropriate and developmentally appropriate pediatric care, including immunizations as recommended by the Centers for Disease Control and Prevention (CDC). 4 5 TYPE 1 DIABETES 6 Type 1 diabetes is the most common form of diabetes in youth , although data suggest that it accounts for a large proportion of cases diagnosed in adult life. 7 The health care professional must consider the unique aspects of care and management of children and adolescents with type 1 diabetes, such as changes in insulin sensitivity related to physical growth and sexual maturation, ability to provide self-care, supervision in the childcare and school environment, neurological vulnerability to hypoglycemia and hyperglycemia in young children, and possible adverse neurocognitive effects of diabetic ketoacidosis (DKA). 8 An interprofessional team trained in pediatric diabetes management and sensitive to the challenges of children and adolescents with type 1 diabetes and their families should provide diabetes-specific care for this population. It is essential that diabetes self-management education and support, medical nutrition therapy, and psychosocial/behavioral support be provided at diagnosis and regularly thereafter in a developmentally appropriate format. 9 School and Child Care 10 As a large portion of a youth’s day is spent in school and/or day care, training of school or day care personnel to provide care in accordance with the child’s individualized diabetes medical management plan is essential for optimal diabetes management and safe access to all school or day care–sponsored opportunities. 11 Psychosocial Care 12 Rapid and dynamic cognitive, developmental, and emotional changes occur during childhood, adolescence, and emerging adulthood. Diabetes management during childhood and adolescence places substantial burdens on the youth