Intensive diabetes management and goal setting are key aspects of improving metabolic control in children and young people with type 1 diabetes mellitus

Diabetes control in children remains poor in spite of advances in treatment for last 10 years. The aim of this review was to look at various aspects of intensive therapy in the management of type 1 diabetes such as insulin regimes, role of target setting, psycho-educational approaches and self-management. To achieve good metabolic control, clear goal setting with adequate support for self-management are essential. Psycho-educational and behavioural interventions aimed at specific areas of management have shown significant improvement in quality of life and diabetes control.

The aim of diabetes treatment is to maintain normoglycaemia in order to prevent long term complications. Insulin is the mainstay of diabetes treatment and is delivered by various regimens. Superiority of one regimen over the other is not established. Newer techniques with sensor augmented pumps have shown improvement in the diabetes control. Other aspects of intensive treatment are goal setting and adequate multidisciplinary support for self-management. Self-management is necessary to achieve the goals of diabetes treatment. Interventions based on clear psycho-educational principles are shown to be effective in improving outcomes.