Continuous subcutaneous insulin infusion benefits quality of life in preschool-age children with type 1 diabetes mellitus

Opipari-Arrigan, Lisa; Fredericks, Emily M.; Burkhart, N.; Dale, Linda; Hodge, Mary Beth; Foster, Carol M.

doi:10.1111/j.1399-5448.2007.00283.x

Cited by 58 publications

(63 citation statements)

References 16 publications

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“…Some of the available trials found an improvement of health-related quality of life associated with CSII [9,10,17], but this result was not confirmed by other studies [11,12,18]. No trial reported a better quality of life with MDI in comparison with CSII.…”

Section: Discussionmentioning

confidence: 40%

“…Several randomized clinical trials, usually on small samples of patients, comparing CSII using short-acting analogs and multiple daily injections (MDI) have been performed, reporting either a similar efficacy of the two approaches [6][7][8][9][10][11][12][13][14][15][16] or a superiority of CSII [17,18]. A meta-analysis on patient-level data from three clinical trials suggests an improvement of HbA1c with CSII (with lispro) as compared with MDI [19].…”

Section: Introductionmentioning

confidence: 99%

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Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis

et al. 2009

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Continuous subcutaneous insulin infusion (CSII) is considered an option for type 1 diabetic patients unsatisfactorily controlled with multiple daily injections (MDI). Short-acting analogs are superior to regular human insulin in CSII. This meta-analysis is aimed at assessing the advantages of short-acting analog-based CSII over MDI in type 1 diabetes. Randomized clinical trials (RCTs) comparing CSII (with analogs) and MDI for at least 12 weeks in type 1 diabetic patients were retrieved, assessing between-group differences in HbA1c and incidence of hypoglycemia. A total of 11 RCTs was included in the analysis. CSII was associated with a significant improvement of HbA1c in comparison with MDI (standardized difference in mean: -0.3 [-0.4;-0.1]%; P \ 0.001). No significant difference was observed in the rate of severe hypoglycemic episodes. The reduction of HbA1c with CSII was evident in trials enrolling patients with mean age greater than 10 years, but not in younger children. Available data justify the use of CSII for basal-bolus insulin therapy in type 1 diabetic patients unsatisfactorily controlled with MDI.

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Section: Discussionmentioning

confidence: 40%

Section: Introductionmentioning

confidence: 99%

Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis

et al. 2009

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“…Treatment with CSII has also been shown to reduce the frequency of severe hypoglycemia episodes [ 17 , 18 ] . In addition, in some studies CSII has been shown to improve quality of life [ 19 ] . While CSII treatment seems a good option for preschool children with diabetes, only a few studies focused specifi cally on this age group.…”

Section: Discussionmentioning

confidence: 99%

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

Levy‐Shraga

Lerner‐Geva

Modan‐Moses

et al. 2013

Exp Clin Endocrinol Diabetes

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“…Similar results were seen in A1c among adolescents over 12 years of age, while less difference was seen among children 12 years of age and younger ( Figure 1). Also, no significant difference was observed between CSII and MDI in measures for daytime 29,31,36 and nocturnal hypoglycemia 35,36 (low strength of evidence), severe hypoglycemia 29 (low strength of evidence), frequency of hyperglycemia 37 (insufficient strength of evidence), and ratio of basal to bolus The mean between-group difference in fasting glucose over 6 months was -12.3 mg/dL (95% CI, -32.9 to 8.2; P = NS) favoring CSII in 1 study, 38 while 2 other studies reported no difference in fasting glucose between the intervention groups (low strength of evidence). 43,44 Additionally, the mean betweengroup difference in pre-prandial glucose over 6 months was -17.1 mg/dL (95% CI, -42.1 to 8.0; P = NS) favoring CSII in 1 study, 38 and in another study, pre-dinner glucose was lower with CSII (128 mg/dL) compared with MDI (148 mg/dL) at the end of 5 weeks (P = NS).…”

Section: Children and Adolescents With T1dmmentioning

confidence: 99%

“…[28][29][30][31][32][33][34][35][36][37] Participants generally had diabetes for 5 to 6 years prior to study entry, had poor glycemic control at study entry (mean A1c, 8% to 9%), and were treated in the intervention groups for an average of 52 weeks. The mean age of participants in the RCTs was 16.5 years (range, 4.4 to 18.9 years) and 11.4 years (range, 4.4 to 17.9 years) in the MDI and CSII groups, respectively, and 1 study did not report age of participants.…”

Section: Children and Adolescents With T1dmmentioning

confidence: 99%

Methods for Insulin Delivery and Glucose Monitoring in Diabetes: Summary of a Comparative Effectiveness Review

Golden¹,

Sapir²

2012

JMCP

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, before training in internal medicine and endocrinology and metabolism at the Johns Hopkins Hospital. During her fellowship in endocrinology, she received a master of health science degree in clinical epidemiology from the Johns Hopkins University Bloomberg School of Public Health. Her primary research interest centers around identifying endocrine risk factors associated with the development of diabetes and cardiovascular disease through the incorporation of measures of hormonal function into the design of clinical trials of cardiovascular risk modification, observational studies of incident cardiovascular disease and diabetes, and studies evaluating diabetic complications. Her current research focuses on studying the neuroendocrine response to chronic psychological stress as a risk factor for diabetes and cardiovascular disease. Dr Supplement Policy Statement Standards for Supplements to the Journal of Managed Care PharmacySupplements to the Journal of Managed Care Pharmacy are intended to support medical education and research in areas of clinical practice, health care quality improvement, or efficient administration and delivery of health benefits. The following standards are applied to all JMCP supplements to ensure quality and assist readers in evaluating potential bias and determining alternate explanations for findings and results. 1. Disclose the principal sources of funding in a manner that permits easy recognition by the reader. 2. Disclose the existence of all potential conflicts of interest among supplement contributors, including financial or personal bias. 3. Describe all drugs by generic name unless the use of the brand name is necessary to reduce the opportunity for confusion among readers. 4. Identify any off-label (unapproved) use by drug name and specific off-label indication. 5. Strive to report subjects of current interest to managed care pharmacists and other managed care professionals. S15 References Target AudiencesThis CME activity is designed to meet the educational needs of physicians, pharmacists, nurses, and case managers involved in the management and care of patients with diabetes. Learning ObjectivesBased on the findings from the Agency for Healthcare Research and Quality' s (AHRQ) comparative effectiveness review of insulin delivery and glucose-monitoring modalities for diabetes, participants should be able to: 1. Compare the benefits of insulin delivery systems in improving clinical outcomes, glycemic control, hypoglycemia, and quality of life in diabetic patients receiving intensive insulin therapy 2. Evaluate the differential effect of glucose-monitoring approaches on the process measures and intermediate and clinical outcomes in diabetic patients receiving intensive insulin therapy 3. Apply the AHRQ findings to guide effective, patient-centered clinical decisions Funding There is no fee for this CME/CE activity. This learning activity was prepared and funded under contract HHSA290201000006G from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Hea...

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Continuous subcutaneous insulin infusion benefits quality of life in preschool-age children with type 1 diabetes mellitus

Abstract: For young children with T1DM, CSII therapy is comparable to MDI therapy with regard to glucose control but is associated with higher treatment satisfaction and improved quality of life.

Cited by 58 publications

References 16 publications

Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis

Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis

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

Methods for Insulin Delivery and Glucose Monitoring in Diabetes: Summary of a Comparative Effectiveness Review

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