The Diabetes Control and Complications Trial demonstrated that improved blood glucose control produced a marked reduction in microvascular complications. Although the majority of participants were adults, there was a cohort of adolescents included in the study population. The follow-up of those adolescents, in the Epidemiology of Diabetes Interventions and Complications (EDIC) study, indicated that intensive diabetes management had long-lasting beneficial effects. With the revelations of the DCCT and EDIC, there has been a tremendous effort to attain strict glucose control in children with diabetes while avoiding hypoglycemia. The therapeutic goals for children with diabetes have been summarized recently in a position statement from the American Diabetes Association. Fortunately, biotechnology has provided an array of tools to assist patients in achieving intensive control while reducing the risks and discomfort of diabetes treatment.
ABOUT THE AUTHORS
Ann S. Christiano, MS, ARNP, CDE, is Clinical Instructor, Dartmouth Medical School, Pediatric Diabetes Coordinator, Children’s Hospital at Dartmouth. Samuel J. Casella, MD, is Associate Professor of Pediatrics, Dartmouth Medical School, and Section Chief, Pediatric Endocrinology, Children’s Hospital at Dartmouth. Address correspondence to: Samuel J. Casella, MD, Department of Pediatrics, Dartmouth Hitchcock, Medical Center, One Medical Center Drive, Lebanon, NH 03756, e-mail: Samuel.J.Casella@hitchcock.org.