Compliance and administration methods in management of type 1 diabetes.

One of the toughest aspects which health-care workers have to face in the management of diabetes is informing the family. Thanks to specialized teams of pediatric diabetologists, specialized diabetes nursing staff, dieticians and psychologists, many of these problems have by now been solved. Over the past ten years, scientific research has made it possible to identify some "critical points" which arise as the child passes through the various developmental phases. Based on this research there has been an increasing tendency to highlight contact points between diabetic patient and family management of the illness, aimed at preventing incorrect behaviour during the different growth phases. The diabetological team should not only intervene when necessary, but also work with an eye to prevention so as to improve the quality of life of the child and its family, making it possible that a diabetic child quality of life is the same of a non-diabetic child. Team work is necessary so as to get to know and, where possible, improve, compliance in every family. This is obtained also through the acquisition and subsequent carrying out of questionnaires, which help in making the family understand that there is no difference between diabetic children and non-diabetic children. Data in literature, fortunately, seems to confirm this. Clear progress has also been made in the methods of administration thanks to the introduction of devices such as pens and microinfusors (CSII). Pen devices have greatly improved compliance of young diabetic patients, making them better able to manage administration on their own. Microinfusors, on the other hand, have not only improved metabolic control, bringing it closer to the physiological model, but have also had a positive effect on the quality of life of young people, and, as a consequence, of their families.