[Could oral antidiabetic agents be useful in the management of different types of diabetes and syndromes of insulin resistance in children and adolescents?]. / Czy doustne leki przeciwcukrzycowe znajduja zastosowanie w leczeniu mlodocianych chorych z róznymi postaciami cukrzycy i stanami insulinoopornosci?

Various pharmacological approaches can be used to improve glucose homeostasis. These pharmacological treatments may be used individually for certain types of patients, or may be combined to provide a more ideal glycaemic control. Metformin is widely used in pediatric patients and is considered to be the most effective oral agent. Addition of metformin to insulin in pediatric patients with type 1 diabetes mellitus improves metabolic control. Metformin acts by promoting glucose utilization and reducing hepatic glucose production. In many patients with type 2 diabetes, hyperglycemia can be reduced with appropriate changes in diet and exercise, however, some patients with type 2 diabetes and insulin resistance syndromes need pharmacological therapy to improve their metabolic control. The first oral agent used should be metformin. More severe pancreatic beta-cell dysfunction in the group of children requires insulin therapy. Some forms of monogenic diabetes can be successfully managed by sulphonylurea agents.

[Used of oral antidiabetic agents in pediatric patients - own observations]. / Zastosowanie doustnych leków przeciwcukrzycowych w praktyce pediatrycznej -- obserwacje wlasne.

Our present investigation demonstrates that in adolescents with various impaired glucose homeostasis oral antidiabetic agents can be used to improve glucose metabolism. Metformin is widely used in pediatric patients and is considered to be the most effective oral agent. Metformin is beneficial in improving glucose tolerance and insulin sensitivity, in lowering insulinemia, and in reducing elevated androgen levels. Addition of metformin to insulin in pediatric patients with type 1 diabetes mellitus improves metabolic control. Metformin acts by promoting glucose utilization and reducing hepatic glucose production. In many patients with type 2 diabetes, hyperglycemia can be reduced with appropriate changes in diet and exercise, however, some patients with type 2 diabetes and insulin resistance syndromes need pharmacological therapy to improve their metabolic control. The first oral agent concerned to use should be metformin. More severe pancreatic b-cell dysfunction in the group of children requires insulin therapy. Some forms of monogenic diabetes can be successfully managed by sulphonylurea agents. Metformin should be considered a first-line agent in girls with PCOS.

Transient reference values for impulse oscillometry for children aged 3-18 years.

Impulse oscillometry (IOS) is a technique of assessing mechanical properties of respiratory system by means of measuring resistances and reactances in a number of frequencies during tidal breathing. It is especially useful in preschool children, however has also been validated in older children and adults. The aim of the present study was to construct equations describing normal values of oscillatory parameters in pediatric population of healthy polish children. Six hundred twenty-six healthy children aged 3.1-18.9 years (278 boys and 348 girls) completed the study. Analysis revealed that body height was the best predictor and resistances are best described with exponential model while reactances with linear one, with correlation coefficient r reaching the value of 0.9. Oscillometric resistances decrease with height, while reactances increase. Reference values for children and adolescents will allow not only the interpretation of the measurement, but also will make possible to study changes of oscillometric indices during growth.