Abstract
Treatment of childhood diabetes requires specific approaches adjusted to needs of growing organism. Type 1 diabetes (T1D) is the most prevalent form of diabetes in children and adolescents comprising more than 95% cases.
Etiological basis of childhood diabetes is, however, significantly more heterogeneous then has been predicted several years ago. Monogenic forms of diabetes are responsible for about 3-4% of all cases.
Prevalence of Type 2 diabetes (T2D) varies significantly among different ethnics and populations. In Caucasian in Europe is the proportion of T2D among diabetic children still very low, about 1%.
Nevertheless, in Asian or Afro-American children the frequency of T2D increases very rapidly reaching 90% in some populations. These proportions are strongly dependent on age at diabetes onset.
In newborns, all cases are monogenic, caused by a single mutation of genes influencing the physiology of beta cells or insulin action. Strong dominance of T1D is observed in older age categories.
For treatment of T1D and monogenic forms of diabetes we use all drugs routinely used for diabetes treatment in adults, but in different dosage and efficacy. High-dosed metformin is the first choice medicament for treatment of T2D in children, with early introduction of insulin in case of insufficient or incomplete reaction.