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1.
An Pediatr (Barc) ; 66(3): 267-71, 2007 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-17349253

RESUMO

OBJECTIVES: To evaluate the use of insulin glargine in intensively-treated children and adolescents. To assess the degree of patient and parent satisfaction with this treatment. PATIENTS AND METHODS: We studied 42 patients with type 1 diabetes. There were 27 girls and 15 boys. The mean age at diagnosis was 6.8 years (range 1.2-13.2), the mean age at initiation of glargine therapy was 12.8 years (range 7.0-17.7), and the mean duration of diabetes was 6.1 years (range 2.0-11.9). Glargine indications were poor metabolic control or frequent hypoglycemia with multiple daily injections of NPH insulin, which were substituted by one dose of glargine. Patient and parent satisfaction with diabetes treatment was assessed with the scale published by Boot. ANOVA, Student's t test, Mann-Whitney and Fisher tests were applied. RESULTS: Variables are reported as mean 6 standard deviation. After 18 months, glargine reduced hemoglobin A1c levels (7.65 % +/- 0.74 vs. 8.03 % +/- 0.69; p = 0.001), with no significant changes in insulin dose (1.03 +/- 0.19 U/kg/day vs. 1.08 +/- 0.21; p = 0.052) or body mass index SDS (standard deviation score) (+0.51 +/- 0.96 vs. 10.61 +/- 1.02; p = 0.11). Glargine also increased patient satisfaction (+44.5 +/- 18.8 points vs. -9.9 +/- 26.8; p < 0.001) and parent satisfaction (+42.0 +/- 17.9 points vs. -20.8 +/- 29.1; p < 0.001) with diabetes treatment. CONCLUSIONS: 1. Glargine insulin improves metabolic control in intensively-treated children and adolescents with type 1 diabetes. 2. Glargine also improves patient and parent satisfaction with diabetes treatment.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Insulina/análogos & derivados , Adolescente , Criança , Esquema de Medicação , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Insulina/uso terapêutico , Insulina Glargina , Insulina de Ação Prolongada , Masculino , Estudos Prospectivos
2.
Eur J Clin Nutr ; 67(4): 318-23, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23388671

RESUMO

BACKGROUND/OBJECTIVES: The home enteral nutrition (HEN) provides nutritional support to children with chronic diseases who are nutritionally compromised and allows them to be discharged more quickly from hospitals. In 2003, a web-based registry (Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria, Pediatric Ambulatory and Home Enteral Nutrition -NEPAD-) was created with the objective of gathering information about pediatric HEN practices in Spain. AIM: The aim of this study was to report the implementation of the NEPAD (Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria, Pediatric Ambulatory and Home Enteral Nutrition) registry of pediatric HEN in Spain and to analyze data evolution trends from 2003 to 2010. SUBJECTS/METHODS: The data from the Spanish NEPAD registry were analyzed according to the following variables: demographic data, diagnosis, indication for HEN, nutritional support regime and administration route. RESULTS: Over the study period, 952 patients (1048 episodes) from 20 Spanish hospitals were included in the NEPAD registry. The most frequent indication for HEN was decreased oral intake (64%), and neurological disease was the most prevalent illness. HEN was delivered via a nasogastric tube in 573 episodes (54.7%), by gastrostomy in 375 episodes (35.8%), oral feeding in 77 episodes (7.3%) and by jejunal access in 23 episodes (2.2%). Significant differences in the mode of administration were observed based on the pathology of the child (χ(2), P<0.0001). The cyclic feeding was the most widely used technique for the administration of HEN. Most of the patients used a pump and a polymeric formula. Transition to oral feeding was the primary reason for discontinuation of this type of support. CONCLUSIONS: Since the NEPAD registry was established in Spain, the number of documented patients has increased more than 25-fold. Many children with chronic illness benefit from HEN, mainly those suffering from neurological diseases.


Assuntos
Nutrição Enteral/estatística & dados numéricos , Sistema de Registros , População Branca , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Nutrição Enteral/tendências , Feminino , Gastrostomia , Hospitais , Humanos , Lactente , Internet , Intubação Gastrointestinal , Masculino , Doenças do Sistema Nervoso/dietoterapia , Nutrição Parenteral no Domicílio , Alta do Paciente , Estudos Prospectivos , Espanha
3.
Acta pediatr. esp ; Acta pediatr. esp;75(9/10): e159-e163, sept.-oct. 2017. graf, tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-168566

RESUMO

El síndrome de realimentación es un proceso fisiopatológico asociado a trastornos de la glucosa y desequilibrio hidroelectrolítico que involucran principalmente a los iones intracelulares (fosfato, potasio y magnesio). Este síndrome se asocia con el soporte nutricional (oral, enteral o parenteral) en pacientes con riesgo de desnutrición o con desnutrición severa. Es muy importante valorar la presencia de factores de riesgo, estudiar los iones séricos e iniciar la alimentación de manera progresiva. El apoyo nutricional correcto es fundamental, con la supervisión diaria de los electrólitos séricos, los signos vitales y el equilibrio de líquidos, así como un correcto diseño del soporte nutricional (AU)


Refeeding syndrome (RFS) is a term that describes the metabolic and clinical changes that occur on aggressive nutritional rehabilitation of a malnourished patient. A shift from carbohydrate metabolism to fat and protein catabolism occurs. Hypophosphatemia is the hallmark of RFS. Other electrolyte abnormalities are associated with RFS, however, such as hypokalemia and hypomagnesemia. RFS is associated to any nutritional support (more frequently to parenteral nutrition) in malnourished patients'. A proper nutritional support is required to avoid RFS, checking daily liquid balance, electrolytes and vital signs (AU)


Assuntos
Humanos , Criança , Síndrome da Realimentação/etiologia , Terapia Nutricional/normas , Desnutrição/dietoterapia , Síndrome da Realimentação/prevenção & controle , Eletrólitos/sangue , Fatores de Risco , Desequilíbrio Hidroeletrolítico/dietoterapia , Jejum/fisiologia
4.
Acta pediatr. esp ; Acta pediatr. esp;75(7/8): e117-e123, jul.-ago. 2017. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-165547

RESUMO

El paciente pediátrico críticamente enfermo (CE) presenta una situación de alto riesgo nutricional, secundaria a la respuesta adaptativa al estrés que desencadena una situación proinflamatoria y de catabolismo en fases iniciales de la enfermedad. La prevalencia de desnutrición en estos pacientes es elevada y se asocia a una mayor mortalidad. Además, tanto la desnutrición como la obesidad conllevan un aumento de la morbilidad. En estos pacientes el soporte nutricional (SN) debe tener como objetivo no sólo mantener un adecuado estado nutricional, sino también modular dicha respuesta metabólica, neuroendocrina e inflamatoria, optimizar los beneficios de la respuesta adaptativa al estrés y, a medio-largo plazo, reducir las consecuencias negativas que pudieran derivarse de esta respuesta. A pesar de la importancia del SN en el paciente CE, la evidencia de la que disponemos es aún escasa, por lo que muchas de las recomendaciones de las guías clínicas se basan en opiniones de expertos y en estudios realizados en pacientes adultos o en niños no CE. Sin embargo, en los últimos años se han publicado distintos estudios cuyos resultados permiten mejorar el SN de estos pacientes: ajustar el aporte energético-proteico en función de la fase de la enfermedad, evitar la sobrenutrición y la hiperglucemia, la importancia de la nutrición enteral como vía de elección del SN, la superación de distintas barreras que dificultan su instauración o el momento de inicio de la nutrición parenteral. Estos aspectos se abordarán en esta revisión (AU)


Paediatric critically ill (CI) patients are characterised by a high nutritional risk, due to the hyper-catabolism and the inflammatory state secondary to the stress response to critical illness in the acute phase. Malnutrition prevalence in these patients remains high and it is associated to a higher mortality rate. In addition, both malnutrition and obesity are associated with a worse clinical evolution. Nutritional support (NS) should focus not only in the achievement of an adequate nutritional status, moreover it can also modulate the metabolic, neuro-endocrine and inflammatory response, optimizing the benefits of this response in the short term and reducing the adverse outcomes in the medium and long term. Despite the importance of NS in the paediatric CI patient, the evidence available is scare, so international consensus-based guidelines mostly rely on expert opinion, studies in adults or non-critically ill children. Nevertheless, during recent years several studies have provided more data regarding NS in these patients; to adjust the energy provided depending of the illness phase, to avoid overfeeding and hyperglycaemia, the choice of appropriate route of feeding, the necessity of overcoming several barriers to start enteral nutrition and its importance in the CI patient or the timing to initiate parental nutrition, are topics that will be covered in this review (AU)


Assuntos
Humanos , Apoio Nutricional/métodos , Estado Terminal/terapia , Cuidados Críticos/métodos , Fatores de Risco , Nutrição Enteral/métodos , Nutrição Parenteral/métodos , Transtornos da Nutrição Infantil/prevenção & controle , Necessidades Nutricionais , Padrões de Prática Médica
5.
Nutr Hosp ; 27(5): 1429-36, 2012.
Artigo em Espanhol | MEDLINE | ID: mdl-23478688

RESUMO

BACKGROUND: Malnutrition among hospitalized patients has clinical implications, and interest has arisen to find screening tools able to identify subjects under risk. At present, there is no consensus about the most suitable nutrition screening tool for pediatric patients. AIM: To validate STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) pediatric screening tool in Spain. METHODS: Descriptive cross-sectional study of patients admitted to a 3rd level children's hospital with both medical and surgical specialities. During the first 24 hours of admission, STAMP screening tool was applied. For its validation, results were compared with those obtained from a nutritional assessment performed by specialist staff, which included clinical, anthropometric and body composition data. RESULTS: A sample of 250 children was studied. Nutritional assessment identified 64 patients (25.6%) under risk, 40 of whom were malnourished (16%). STAMP classified 48.4% of the patients as being under nutritional risk. This tool showed 75% sensitivity and 60.8% specificity when identifying patients under risk according to nutritional assessment. It showed 90% sensitivity and 59.5% specificity when identifying malnourished patients. COMMENTS: Malnutrition was less frequent than that reported in other European countries, although diagnosis technique was different. STAMP is a simple and useful tool for nutritional screening, avoiding the need to assess all patients on admission in order to identify those under nutritional risk.


Assuntos
Desnutrição/diagnóstico , Avaliação Nutricional , Adolescente , Antropometria , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hospitalização , Humanos , Lactente , Masculino , Desnutrição/epidemiologia , Estado Nutricional , Reprodutibilidade dos Testes , Risco , Espanha/epidemiologia
6.
Nutr. hosp ; Nutr. hosp. (Internet);27(5): 1429-1436, sept.-oct. 2012. ilus, tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-110170

RESUMO

Introducción: La malnutrición en los pacientes hospitalizados tiene implicaciones clínicas y evolutivas, por lo que existe interés en desarrollar métodos de cribado que identifiquen los individuos de riesgo. En la actualidad no existe consenso acerca de la herramienta de cribado nutricional más apropiada para aplicar en población pediátrica. Objetivo: Validar en España la herramienta de cribado nutricional pediátrico STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics). Métodos: Estudio descriptivo transversal en pacientes ingresados en un hospital pediátrico de tercer nivel con diferentes especialidades médicas y quirúrgicas. En las primeras 24 horas de ingreso se aplicó el método de cribado nutricional STAMP. Para la validación de sus resultados se llevó a cabo una valoración del estado nutricional que incluyó datos clínicos, antropométricos y de composición corporal realizada por personal especializado en nutrición. Resultados: Fueron estudiados 250 niños. La valoración nutricional detectó 64 pacientes (25,6%) considerados de riesgo, de los cuales 40 (16%) estaban ya malnutridos. STAMP clasificó un 48,4% de la muestra como de riesgo nutricional elevado. Dicho método mostró una sensibilidad del 75% y una especificidad del 60,8% para identificar los pacientes considerados de riesgo en la valoración nutricional, y una sensibilidad del 90% y especificidad del 59,5% para detectar los malnutridos. Comentarios: La frecuencia de malnutrición fue algo inferior a la de otros países de nuestro entorno, aunque el método diagnóstico fue diferente. El método STAMP es una herramienta sencilla y útil para el cribado nutricional, que evitaría la necesidad de valorar a todos los pacientes al ingreso para detectar los sujetos de riesgo (AU)


Background: Malnutrition among hospitalized patients has clinical implications, and interest has arisen to find screening tools able to identify subjects under risk. At present, there is no consensus about the most suitable nutrition screening tool for pediatric patients. Aim: To validate STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) pediatric screening tool in Spain. Methods: Descriptive cross-sectional study of patients admitted to a 3rd level children's hospital with both medical and surgical specialities. During the first 24 hours of admission, STAMP screening tool was applied. For its validation, results were compared with those obtained from a nutritional assessment performed by specialist staff, which included clinical, anthropometric and body composition data. Results: A sample of 250 children was studied. Nutritional assessment identified 64 patients (25.6%) under risk, 40 of whom were malnourished (16%). STAMP classified 48.4% of the patients as being under nutritional risk. This tool showed 75% sensitivity and 60.8% specificity when identifying patients under risk according to nutritional assessment. It showed 90% sensitivity and 59.5% specificity when identifying malnourished patients. Comments: Malnutrition was less frequent than that reported in other European countries, although diagnosis technique was different. STAMP is a simple and useful tool for nutritional screening, avoiding the need to assess all patients on admission in order to identify those under nutritional risk (AU)


Assuntos
Humanos , Transtornos da Nutrição Infantil/epidemiologia , Desnutrição/epidemiologia , Avaliação Nutricional , Criança Hospitalizada/estatística & dados numéricos , Programas de Rastreamento/métodos
7.
Acta pediatr. esp ; Acta pediatr. esp;69(4): 165-172, abr. 2011. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-90074

RESUMO

La valoración del estado nutricional consiste en la cuantificación de los depósitos energéticos y su contenido proteico, con el objetivo de determinar la presencia o el riesgo de malnutrición por defecto (desnutrición) o por exceso (obesidad) y aportar herramientas preventivas y terapéuticas en los casos en que sea necesario. Para su evaluación existen diversos niveles de complejidad, con aspectos básicos que deben ser incluidos en la historia clínica y en la exploración física, haciendo hincapié en los estigmas de malnutrición. La determinación de la composición corporal puede realizarse mediante pruebas antropométricas muy sencillas, como el peso, la talla, el perímetro braquial o los pliegues grasos, o con herramientas más complejas, entre las que destaca la bioimpedancia eléctrica. Cuando existe posibilidad de malnutrición en un paciente, es fundamental la valoración de su ingesta dietética, sobre todo mediante el registro dietético de 24 horas, así como del gasto energético y de las pérdidas de macro/micronutrientes. Las pruebas bioquímicas pueden aportar información útil tanto de la situación nutricional global como de los déficit concretos. La detección del riesgo nutricional mediante métodos subjetivos de cribado sencillos no ha sido aún suficientemente validada en pediatría. Pese a ello, existen ya métodos propuestos para su realización que podrían permitir el cribado sistemático nutricional en la práctica clínica (AU)


Nutritional assessment involves the measurement of the energy store and protein content of the organism, which goal is to determine the risk or presence of malnutrition by defect or obesity by excess, and to provide the necessary tools to prevent and treat it. For the evaluation there exist different levels of complexity, with basic aspects that shall be included in the medical history and in the physical examination, with special emphasis on malnutrition signs. The study of the body composition can be carried out using simple anthropometric measurements such as weight, height, brachial perimeter or the thick skin fold; more complex devices are also available, like the bioelectrical impedance analysis. When there exists a malnutrition risk, an evaluation of energy intake is very important, e.g. with the 24-hourdiet recall, and of energy expenditure and macro and micronutrients losses should be performed. The biochemical tests can provide useful information concerning both global nutritional status and the essential elements status. Nutritional screening, performed through subjective butstraight forward methods, have not been applied in pediatrics yet. Anyway, several tools have been currently proposed, which could allow the desirable goal of the systematic nutritional screening in the future for clinical practice (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Estado Nutricional , Avaliação Nutricional , Composição Corporal , Desnutrição/diagnóstico , Necessidade Energética , Ingestão de Energia , Exame Físico , Micronutrientes/sangue , Micronutrientes , Antropometria/instrumentação , Antropometria/métodos , Água Corporal , Proteínas Sanguíneas , Peso-Estatura
8.
Acta pediatr. esp ; Acta pediatr. esp;69(9): 393-402, oct. 2011. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-99248

RESUMO

La elección de la fórmula es la fase más importante al instaurarla nutrición enteral. Puesto que los requerimientos nutricionales y energéticos del niño no son los mismos que en el adulto, existen diferentes preparados adaptados a la etapa pediátrica y, dentro de ésta, a los distintos grupos de edad. Además, en los últimos años se han comercializado nuevos tipos de fórmulas, como dietas específicas para las enfermedades en la edad pediátrica o dietas poliméricas para lactantes. Esta variedad de preparados nos permite ahora, más que nunca, individualizar la nutrición de nuestros pacientes. El objetivo de este artículo es revisar, clasificar y establecer las indicaciones para las distintas fórmulas existentes actualmente en el mercado español(AU)


The choice of the correct nutritional formula is the most important phase when establishing enteral nutrition. Given that children´s energy and protein requirements are not the same as those in adults, there are different formulations adapted to the pediatric stage and within this, to different age groups. Furthermore, in recent years new types of formulas have been commercialized, as special foods or polymeric formulas for infants. This variety of formulas has allowed us to individualize nutritional support in pediatric patients. The aim of this article is to review, classify and establish the indications for the different formulas available at this time in the Spanish market(AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Nutrição Enteral/métodos , Alimentos Formulados/análise , Fórmulas Infantis/administração & dosagem , Nutrição da Criança , Nutrição do Lactente
9.
Acta pediatr. esp ; Acta pediatr. esp;69(10): 455-462, nov. 2011. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-99258

RESUMO

La evolución de la nutrición enteral (NE) dentro de la nutrición artificial en pediatría es manifiesta, tanto para el soporte del paciente desnutrido como para tratar patologías específicas, lo que da lugar al concepto de «alimento-medicamento». La indicación básica de la NE se da en el paciente que no consigue la cobertura energético-proteica adecuada con la ingesta oral espontánea. En el presente artículo se revisan las principales enfermedades subsidiarias de beneficiarse de una NE efectiva, así como las vías de acceso a través de las que se administrará la NE en el paciente pediátrico: sondas oro/naso enterales y sondas a través de ostomías. Las modalidades de administración de NE son: continua, intermitente y cíclica. Finalmente, se incide en las complicaciones de la NE, relacionándolas con el tipo de sonda utilizada, el tipo de fórmula y su administración, la edad de instauración de la sonda, y la enfermedad de base y clínica del paciente(AU)


The evolution of the enteral nutrition (EN) in the artificial nutrition in pediatrics is manifested, both for the nutritional support of malnourished patients and in the treatment of specific pathologies, what gives place to the concept of “food medication”. The basic indication of the EN is given to that patient that does not reach the adequate protein energy with the spontaneous oral ingestion. In this article, the main subsidiary diseases which may improve on an effective EN, as well as the routes of access through which the EN will be administered in the pediatric patient: gold probe/naso enteral feeding tubes and feeding through an ostomy are mentioned. The modalities of administration extend across the continuous, intermittent and periodical EN. Finally, we will have on effect on the complications of EN relating them with the type of feeding tube used the type of formula and its administration, the age of implantation of the probe and the base disease and clinical condition of the patient(AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Nutrição Enteral/métodos , Desnutrição Proteico-Calórica/dietoterapia , Apoio Nutricional/métodos , Dietoterapia/métodos , Intubação Gastrointestinal , Gastrostomia
10.
An. pediatr. (2003. Ed. impr.) ; 66(3): 267-271, mar. 2007. tab
Artigo em Es | IBECS (Espanha) | ID: ibc-054381

RESUMO

Objetivos Evaluar el tratamiento con una pauta insulínica con análogo glargina en niños y adolescentes y valorar el grado de satisfacción de los pacientes y sus padres con esta nueva pauta. Pacientes y métodos Estudio prospectivo de 18 meses de duración con 42 pacientes con diabetes mellitus tipo 1, 27 mujeres y 15 varones, con edad media al inicio de 6,8 años (rango: 1,2-13,2), edad media al inicio del tratamiento con glargina 12,8 años (rango: 7,0-17,7), tiempo de evolución medio 6,1 años (rango: 2,0-11,9). Las indicaciones de la nueva pauta fueron mal control metabólico o hipoglucemias frecuentes con la pauta intensiva con 3 dosis de insulina de acción intermedia (NPH), que fueron sustituidas por una dosis de glargina. El nivel de hemoglobina A1c (HbA1c), la dosis diaria de insulina, el índice de masa corporal (IMC) y la satisfacción de pacientes y padres con el tratamiento de la diabetes se valoraron. Pruebas ANOVA (análisis de la varianza), t de Student, Mann-Whitney y Fisher. Resultados Tras 18 meses de tratamiento con la nueva pauta, se observó una disminución del nivel de HbA1c (7,65 6 0,74 % frente a 8,03 6 0,69 %; p 5 0,001), sin cambios significativos en la dosis de insulina (1,03 6 0,19 U/kg/día frente a 1,08 6 0,21 U/kg/día; p 5 0,052) ni en la EDE (escala de desviación estándar) del IMC (10,51 6 0,96 frente a 10,61 6 1,02; p 5 0,11), mientras que aumentó el grado de satisfacción con el tratamiento de los niños (144,5 6 18,8 puntos en la escala frente a ­9,9 6 26,8; p < 0,001) y de sus padres (142,0 6 17,9 puntos en la escala frente a ­20,8 6 29,1; p < 0,001). Conclusiones 1. La pauta insulínica con glargina mejora el control metabólico en niños y adolescentes con diabetes mellitus tipo 1 en tratamiento intensivo. 2. También mejora el grado de satisfacción de pacientes y padres con el tratamiento de la diabetes


Objectives To evaluate the use of insulin glargine in intensively-treated children and adolescents. To assess the degree of patient and parent satisfaction with this treatment. Patients and methods We studied 42 patients with type 1 diabetes. There were 27 girls and 15 boys. The mean age at diagnosis was 6.8 years (range 1.2-13.2), the mean age at initiation of glargine therapy was 12.8 years (range 7.0-17.7), and the mean duration of diabetes was 6.1 years (range 2.0-11.9). Glargine indications were poor metabolic control or frequent hypoglycemia with multiple daily injections of NPH insulin, which were substituted by one dose of glargine. Patient and parent satisfaction with diabetes treatment was assessed with the scale published by Boot. ANOVA, Student's t test, Mann-Whitney and Fisher tests were applied. Results Variables are reported as mean 6 standard deviation. After 18 months, glargine reduced hemoglobin A1c levels (7.65 % 6 0.74 vs. 8.03 % 6 0.69; p 5 0.001), with no significant changes in insulin dose (1.03 6 0.19 U/kg/day vs. 1.08 6 0.21; p 5 0.052) or body mass index SDS (standard deviation score) (10.51 6 0.96 vs. 10.61 6 1.02; p 5 0.11). Glargine also increased patient satisfaction (144.5 6 18.8 points vs. ­9.9 6 26.8; p < 0.001) and parent satisfaction (142.0 6 17.9 points vs. ­20.8 6 29.1; p < 0.001) with diabetes treatment. Conclusions 1. Glargine insulin improves metabolic control in intensively-treated children and adolescents with type 1 diabetes. 2. Glargine also improves patient and parent satisfaction with diabetes treatment


Assuntos
Masculino , Feminino , Criança , Humanos , Insulina/uso terapêutico , Satisfação do Paciente , Análise de Variância , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Estudos Prospectivos , Hipoglicemia/diagnóstico , Hipoglicemia/terapia
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