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Optimizing Glycemic Management in Pediatric Populations with Type 1 Diabetes:...
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Optimizing Glycemic Management in Pediatric Populations with Type 1 Diabetes: Challenges and Advances

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Endocrinology & Diabetes".

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 6186

Special Issue Editors

Prof. Dr. Assimina Galli-Tsinopoulou

E-Mail Website
Guest Editor
Unit of Pediatric and Adolescent Diabetes Mellitus, Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, 54636 Thessaloniki, Greece
Interests: pediatric endocrinology; diabetes; adolescent medicine
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Christina Kanaka-Gantenbein

E-Mail Website
Guest Editor
First Department of Pediatrics, National and Kapodistrian, University of Athens Medical School, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
Interests: diabetes; childhood obesity; insulin resistance; glucose metabolism; clinical endocrinology; human nutrition; obesity; diabetes mellitus; metabolic syndrome
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diabetes Mellitus type 1 (T1DM) represents one of the most prevalent chronic conditions affecting children and adolescents worldwide. Despite significant advancements in therapeutics and technology in diabetes management, achieving and maintaining optimal glycemic control in pediatric and adolescent population remains a clinical challenge and an emerging public health issue. The interplay of developmental, psychosocial, and physiological factors uniquely complicates diabetes management during early life stages.

We are pleased to invite you to contribute to the Special Issue “Optimizing Glycemic Management in Pediatric Populations with Type 1 Diabetes: Challenges and Advances”. This newly launched issue seeks to provide a comprehensive overview of the latest research, innovations, and clinical insights into glycemic control among youth with T1DM. It also aims to offer a range of pluralistic contributions examining novel therapeutic strategies, advances in technology integration in the disease management, and individualized approaches to effective glycemic control.

Original research articles and reviews are welcomed. Research areas may include (but are not limited to) all aspects related to glycemic control in children and adolescents with T1DM. Emphasis will be given to studies addressing precision medicine approaches, barriers to effective care, and strategies to improve long-term outcomes of the disease. Through this Special Issue, we aspire to foster academic excellence and advance standards of care for children and adolescents diagnosed and living with T1DM.

We look forward to your contributions.

Prof. Dr. Assimina Galli-Tsinopoulou
Prof. Dr. Christina Kanaka-Gantenbein
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • type 1 diabetes mellitus
  • glycemic control
  • children
  • adolescents
  • continuous glucose monitoring
  • insulin therapy
  • insulin pump
  • advanced hybrid closed loop therapy
  • diabetes management

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Published Papers (4 papers)

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Research

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9 pages, 999 KB  
Article
Assessment of Long-Term Knowledge Retention in Children with Type 1 Diabetes and Their Families: A Pilot Study
by Lior Carmon, Eli Hershkovitz, David Shaki, Tzila Gratzya Chechik, Inna Uritzki, Itamar Gothelf, Dganit Walker, Neta Loewenthal, Majd Nassar and Alon Haim
Children 2025, 12(8), 1016; https://doi.org/10.3390/children12081016 - 1 Aug 2025
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Abstract
Background: The education process for newly diagnosed Type 1 diabetes mellitus (T1D) patients and their families, primarily led by diabetes specialist nurses, is essential for gaining knowledge about the disease and its management. However, few assessment tools have been employed to evaluate long-term [...] Read more.
Background: The education process for newly diagnosed Type 1 diabetes mellitus (T1D) patients and their families, primarily led by diabetes specialist nurses, is essential for gaining knowledge about the disease and its management. However, few assessment tools have been employed to evaluate long-term knowledge retention among T1D patients years after diagnosis. Methods: We developed a 20-question test to assess the knowledge of patients and their families at the conclusion of the initial education process and again 6–12 months later. Demographic and clinical data were also collected. Statistical analyses included comparisons between the first and second test results, as well as evaluation of potential contributing factors. The internal consistency and construct validity of the questionnaire were evaluated. Results: Forty-four patients completed both assessments, with a median interval of 11.5 months between them. The average score on the first test was 88.6, which declined to 82.7 on the second assessment (p < 0.001). In univariate analysis, factors positively associated with higher scores included Jewish ethnicity, lower HbA1c levels, and shorter hospitalization duration. Multivariate analysis revealed that parents had lower odds of experiencing a significant score decline compared to patients. Cronbach’s alpha was 0.69, and Principal Component Analysis (PCA) identified eight components accounting for 67.1% of the total variance. Conclusions: Healthcare providers should consider offering re-education to patients and their families approximately one year after diagnosis, with particular attention to high-risk populations during the initial education phase. Further studies are needed to examine this tool’s performance in larger cohorts. Full article
(This article belongs to the Special Issue Optimizing Glycemic Management in Pediatric Populations with Type 1 Diabetes: Challenges and Advances)
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Review

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14 pages, 360 KB  
Review
Disordered Eating Behaviors in Children and Adolescents with Type 1 Diabetes: Age-Specific Challenges and Management Insights
by Aristeidis Giannakopoulos, Ioanna Kosteria, Alexandra Efthymiadou, Eirini Kostopoulou, Natasa Chrysanthakopoulou and Dionisios Chrysis
Children 2026, 13(4), 474; https://doi.org/10.3390/children13040474 - 29 Mar 2026
Viewed by 500
Abstract
Type 1 diabetes is the most common autoimmune endocrine disorder in children and adolescents, with incidence rising worldwide. Its management demands comprehensive care encompassing glucose monitoring, insulin therapy, and individualized nutritional education to support glycemic control and overall health. Establishing normal eating patterns [...] Read more.
Type 1 diabetes is the most common autoimmune endocrine disorder in children and adolescents, with incidence rising worldwide. Its management demands comprehensive care encompassing glucose monitoring, insulin therapy, and individualized nutritional education to support glycemic control and overall health. Establishing normal eating patterns is pivotal not only for prandial euglycemia but also for reducing the risk of disordered eating behaviors and eating disorders that are more frequently observed in youth with diabetes. Because eating patterns and self-management capabilities vary by developmental stage, interventions must be tailored to the physical, psychological, and social context of each age group. Screening tools such as the Diabetes Eating Problem Survey—Revised (DEPS-R) enable timely identification of at-risk individuals. In this scoping review we present the data from the literature regarding the eating patterns and deviations from infancy to adolescence, report the complications and discuss the challenges and insights for their management. Full article
(This article belongs to the Special Issue Optimizing Glycemic Management in Pediatric Populations with Type 1 Diabetes: Challenges and Advances)
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21 pages, 880 KB  
Review
Early Detection of Pediatric Type 1 Diabetes: The Expanding Role of Screening
by Marco Calderone, Sara Aramnejad, Elèna Giliberto, Bruno Bombaci, Mariarosaria La Rocca, Arianna Torre, Fortunato Lombardo, Giuseppina Salzano and Stefano Passanisi
Children 2026, 13(2), 235; https://doi.org/10.3390/children13020235 - 7 Feb 2026
Viewed by 1110
Abstract
Type 1 diabetes (T1D) is a common chronic autoimmune disease in childhood, often presenting abruptly and frequently complicated by diabetic ketoacidosis at diagnosis. T1D develops through well-defined presymptomatic stages characterized by islet autoimmunity and progressive dysglycemia, offering a window for early identification. This [...] Read more.
Type 1 diabetes (T1D) is a common chronic autoimmune disease in childhood, often presenting abruptly and frequently complicated by diabetic ketoacidosis at diagnosis. T1D develops through well-defined presymptomatic stages characterized by islet autoimmunity and progressive dysglycemia, offering a window for early identification. This narrative review summarizes current evidence on screening for T1D in children and adolescents, focusing on target populations, screening strategies, and methodological approaches for autoantibody detection. Data from major international programs involving familial, high-risk, and general population screening are discussed, highlighting their impact on reducing diabetic ketoacidosis at onset, improving metabolic outcomes, and facilitating structured follow-up and family education. Advances in assay technologies, including electrochemiluminescence, multiplex platforms, and novel ultrasensitive methods, have enhanced the feasibility and accuracy of large-scale screening. The review also examines the public health implications, cost-effectiveness, and ethical considerations of implementing population-based screening, particularly in light of emerging disease-modifying therapies such as teplizumab. Overall, available evidence supports screening as a meaningful strategy to shift T1D diagnosis from an acute emergency to a predictable clinical trajectory, with potential benefits extending from individual patient outcomes to healthcare system sustainability. Full article
(This article belongs to the Special Issue Optimizing Glycemic Management in Pediatric Populations with Type 1 Diabetes: Challenges and Advances)
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10 pages, 208 KB  
Review
Dietary Fat and Protein Intake and Their Impact on Glycemic Control in Pediatric Type 1 Diabetes: A Narrative Review
by Kosmas Margaritis, Vasiliki Rengina Tsinopoulou, Eleni P. Kotanidou and Assimina Galli-Tsinopoulou
Children 2025, 12(12), 1664; https://doi.org/10.3390/children12121664 - 8 Dec 2025
Viewed by 2985
Abstract
Carbohydrates have been the center of type 1 diabetes dietary management. Emerging evidence highlights the important effects of fat and protein in postprandial hyperglycemia, suggesting that an increase in daily fat and protein intake, combined with appropriate insulin dose adjustments, might lead to [...] Read more.
Carbohydrates have been the center of type 1 diabetes dietary management. Emerging evidence highlights the important effects of fat and protein in postprandial hyperglycemia, suggesting that an increase in daily fat and protein intake, combined with appropriate insulin dose adjustments, might lead to better glycemic control. It is well studied that meals containing fat or protein lead to late postprandial hyperglycemia. Studies that researched the use of these macronutrients observed the need for extended or dual wave boluses to achieve euglycemia and that no consistent improvement in HbA1c or time in range was related to higher protein or fat intake. Optimizing glycemic control in pediatric T1D requires strategies beyond carbohydrate counting. While balanced macronutrient distribution remains the main solid factor in stable glycemic profiles, more studies regarding the variety of macronutrients’ formulation in optimizing glycemic control are needed. Full article
(This article belongs to the Special Issue Optimizing Glycemic Management in Pediatric Populations with Type 1 Diabetes: Challenges and Advances)
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