14. Children and Adolescents: Standards of Care in Diabetes—2024

Abstract

The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Comprehensive management of children and adolescents with type 1 diabetes mellitus through personalized physical exercise and education using an mHealth system: The Diactive-1 study protocol

“…The Diactive-1 Study is a 24 weeks smartphone intervention with the aim of improving daily insulin dose requirements, glucose control management, adherence to resistance training, and compliance with PA guidelines recommendations ( 10 , 27 , 28 ) for children and adolescents with T1DM. The Diactive-1 App has been developed to be compatible with both IOS and Android smartphones.…”

“…The Diactive-1 App was developed by a team of researchers with expertise in PA and T1DM. Intervention includes evidence-based recommendations at management of glucose control and physical exercise for children and adolescent with T1DM ( 10 , 27 , 28 ).…”

“…The Diactive-1 App consists of an automated program designed to offer evidence-based guidance for creating exercise training sessions ( 10 , 27 , 28 ). The sessions are tailored based on the individual’s physical fitness level (assessed beforehand), glucose levels, and glucose trend arrow at the moment.…”

“…Additionally, the glucose coefficient of variation (CV) will be calculated ( 30 ) and the number of hypoglycemic events per day, mean glucose level during this period, and percentage of time the CGM sensor was active will be recorded. In accordance with ADA guidelines ( 10 ), we will consider the following metrics as meeting glycemic targets: HbA1c <7%; CV ≤36%; TR very high <5%; TR high <25%; TR target >70%; TR low <4%; and TR very low <1%.…”

“…The American Diabetes Association (ADA) recommends that individuals under 20 years old with diabetes engage in 60 minutes of moderate to vigorous aerobic physical activity daily. This should be paired with vigorous muscle-strengthening and bone-strengthening activities at least three days per week ( 10 ). However, children and adolescents with T1DM are less active, more sedentary, and less fit than their healthy counterparts ( 11 ).…”