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TERAPIA Paziente cosciente Somministrare 2-3 zollette o cucchiaini di zucchero oppure 1 frutto e 1 panino di circa 50 gr. La chetoacidosi diabetica (DKA) Si verifica soprattutto: nel diabete tipo 1, nel diabete allesordio, in seguito a insufficienti dosi di insulina, forte stress metabolico, eccessivo consumo di alcol, disidratazione, eventi intercorrenti come traumi, infezioni, eventi cardiovascolari acuti, etc. Patogenesi della microangiopatia Iperglicemia Glicosilazione non enzimatica delle proteine strutturali(AGEs) 2 perdita di periciti, formazione di microaneurismi Attivazione proteinchinasi C (PKC) 4 Alterata trascrizine dei geni di collagene, fibronectina e matrice extracellulare Ispessimento MB, aumentata permeabilita vascolare retinica, alterazioni di flusso retinico Accumulo di polioli (sorbitolo) 1 ispessimento MB, perdita di periciti, formazione di microaneurismi Danno ossidativo 3 danno endoteliale Fattori di crescita 5 Vascular edotelial growth factors (VEGFs), Transforming growth factor (TGF- ), GH, IGF-1 (ischemia retinica VEGFs vitreali) 1.
This paper discusses the results of a survey on the usability of a new half-unit insulin pen, JuniorSTAR® (CE mark pending, under the responsibility of Haselmeier), in children with type 1 diabetes.
David Klonoff, Medical Director, Diabetes Research Institute, Mills-Peninsula Health Services, 100 South San Mateo Drive, Room 5147, San Mateo, California 94401, US. 5 The medical benefits of insulin regimes in type 1 diabetes are well established.6–8 However, there is a danger that metabolic targets may be attained at the expense of the psychological wellbeing of children and their families.
Touch Endocrinology is for informational purposes and should not be considered medical advice, diagnosis or treatment recommendations.

Insulin pen devices have advantages over the traditional vial-and-syringe method of insulin delivery, including improved patient satisfaction and adherence, greater ease of use and superior accuracy, especially when delivering small doses of insulin.
The views and opinions expressed are those of the authors and not necessarily those of Sanofi. Worldwide, there are approximately 490,000 children with type 1 diabetes, and 78,000 new cases are diagnosed each year.1 As of today, the incidence of type 1 diabetes in children younger than 15 years old is increasing.
American Diabetes Association, Standards of medical care in diabetes–2013, Diabetes Care, 2013;36(Suppl.
Genova Livelli di HbA1c e rischio realtivo di complicanze microvascolari: i risultati dello studio DCCT Rischio relativo HbA1c (%) 15 13 11 9 7 5 3 1 6789101112 20 retinopatia nefropatia neuropatia microalbuminuria DCCT, Diabetes Control and Complications Trial. The accuracy and design of insulin pens is particularly important in the paediatric population.
If this trend continues, new cases in European children less than 5 years are predicted to double between 2005 and 2020.2 Type 1 diabetes is a lifelong condition with short- and long-term implications.

As the incidence of type 1 diabetes is expected to increase in the coming years in children less than 5 years old, a higher use of half-unit dosing pens may be anticipated. Thomas Danne has received honoraria for speaking engagements from several companies involved in the diabetes field and has received grant support for the conduct of studies or scientific meetings from Abbott, Sanofi, Bayer, Roche, Boehringer, Bristol-Myers Squib, Lilly, Medtronic, DexCom and NovoNordisk. A survey with JuniorSTAR half-unit insulin pen has shown that it is easy to use, read, carry and dial back.
In conclusion, the JuniorSTAR half-unit pen is well suited to the lifestyle of young people with type 1 diabetes and could help them to gain autonomy to self-inject.

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