Glycemic Control Strategies and Management of Acute Complications in Children with Type 1 Diabetes: A Systematic Review

Abstract

Aims: This review aims to identify and analyze the main strategies for glycemic control and the management of acute complications in children with type 1 diabetes (T1D), focusing on the effectiveness of technologies, nutritional interventions, and structured education. Study Design: Systematic literature review. Place and Duration of Study: Database searches (PubMed, SciELO, LILACS, BVS, and MEDLINE) were conducted between March and April 2025. Methodology: Studies published in the last 10 years were selected according to inclusion criteria targeting children with T1D. Articles addressing glycemic control (e.g., insulin therapy, continuous glucose monitoring, closed-loop systems), nutritional therapy, diabetes education, and management of acute complications (hypoglycemia and diabetic ketoacidosis) were analyzed. Data extraction was performed independently by two reviewers and thematically organized. Results: The findings revealed that insulin pumps and continuous glucose monitoring significantly improve glycemic control compared to multiple daily injections. Nutritional therapy with a low glycemic index and structured educational programs enhance adherence and metabolic outcomes. Acute complications such as severe hypoglycemia and diabetic ketoacidosis remain leading causes of hospitalization, especially in settings with limited access to technology. Differences between public and private healthcare systems affect outcomes, and multidisciplinary education is crucial in both hospital and home care. Conclusion: Glycemic control in children with T1D is more effective when technology, nutrition, and education are integrated. However, disparities in access to care and technologies persist. Healthcare professionals should adopt a comprehensive, individualized approach, and policymakers must ensure equitable access to effective interventions across healthcare systems.