Benefits of Continuous Subcutaneous Insulin Infusion (CSII) Therapy in Preschool Children

Abstract

Our study demonstrated better metabolic control in pre-school children treated with CSII compared to those treated with MDI. This benefit sustained for 5 years after CSII initiation and was not accompanied by increased risk of severe hypoglycemia or DKA events.

Type 1 Diabetes in Children and Adolescents

“…CSII is safe and effective and can be initiated at any age (20)(21)(22). A Cochrane review found that CSII resulted in slightly improved metabolic control over basal-bolus therapy (23).…”

The Successful Management of a Breast-Feeding Type 1 Diabetic Infant

“…In the past decade, the use of CSII pump therapy in children has increased remarkably worldwide, though there is still significant variability among countries in the use of pump technology, contributed by both reimbursement issues and expertise in pump management. There are growing evidences on the safety and better metabolic control with CSII pump therapy when compared to MDI [4][5][6][7]. Results from a multi-centered childhood diabetes registry involving more than 16 000 type 1 diabetic children showed that, both HbA1c and daily insulin dose (U/kg/d) are lower among children treated with CSII, when compared to basal/bolus regimen, after adjustment for age, gender, and diabetes duration [5].…”

Physiological factors influencing diabetes control in type 1 diabetes children with insulin pumps from diagnosis

“…19 However, results regarding when an insulin pump should be implemented are inconclusive. A few studies show that early pump commencement in children and adolescents with T1D provides lower and more durable HbA1c values than a late commencement, 17,20,21 but other studies find that the timing of CSII initiation is not important and recommend a decision made on a case-by-case basis. 22 We did not find that the presence of diabetic ketoacidosis at onset influenced HbA1c levels at the end of the follow-up.…”