Managing diabetes in preschool children

ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes technologies

“…Consensus guidelines have been developed for use of pump therapy in youth with T1D, which, based on the indications, likely apply to every youngster living with T1D (Table ) . Recently, an ISPAD Clinical Practice Consensus Guideline has been released entitled “Managing Diabetes in Preschool Children,” which states pump therapy is the recommended mode of insulin delivery for those under the age of 7 years . In order to overcome the mechanical barrier dictated by the lowest basal and bolus delivery doses feasible with pump therapy, application of diluted insulin to the youngest population has offered the opportunity to more finely tune insulin delivery .…”

ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes

“…Information about dietary quality and carbohydrate counting should be provided together . International consensus is that carbohydrate counting is best introduced at the onset of diabetes for those using intensive insulin therapy, however, no randomized studies exist on the optimal timing of carbohydrate counting interventions.…”

“…Below is a summary of the specific characteristics to consider when working with different age groups. See chapter on Managing Diabetes in Preschool Children for more detailed information on the nutritional management of toddlers and preschool‐aged children with type 1 diabetes.…”

Young children with type 1 diabetes can achieve glycemic targets without hypoglycemia: Results of a novel intensive diabetes management program

“…Young children with type 1 diabetes (T1D) are totally dependent on their parents for their physical needs. It is normal for them to experience variable appetite and to seek independence by resisting treatment, typically manifesting as refusal of food presented at meal times . Age appropriate behavioral modification guidance to address disruptive food behaviors is important as they impact glycemic control and are challenging for parents .…”