Update on Treatment of Type 1 Diabetes in Childhood

After 90 years of using insulin to treat type 1 diabetes, there has been no radical change in the treatment. Although several discoveries have improved both quality of life and metabolic control, they have not eradicated, morbidity, and mortality. Insulin analogues are sometimes helpful, and pens, pumps, smart glucometers, and educational tools have facilitated and improved treatment. Soon, better insulin pumps and glucose sensors together with sophisticated algorithms and connections leading to closed-loop systems will probably further improve and facilitate treatment of many patients with type 1 diabetes. However, the burden for patients will not disappear completely, and modern therapy will still require both competence and motivation of patients. Therefore, the goal should be either to cure the disease via replacement therapy (transplantations) or to stop the destructive process, preserve residual insulin secretion, or even improve insulin secretion via beta-cell regeneration. This will result in a milder disease, a stabler metabolism, simpler treatment, and perhaps even cure. Several studies are ongoing, but nothing has proved useful so far in clinical practice. © 2013, Springer Science + Business Media New York.