Continuous Subcutaneous Insulin Infusion Pump Treatment in Children with Type 1 Diabetes Mellitus

Liberatore, Raphael Del Roio; Perlman, Kusiel; Buccino, Jennifer; Artiles-Sisk, Ana; Daneman, Denis

doi:10.1515/jpem.2004.17.2.223

Cited by 29 publications

(23 citation statements)

References 9 publications

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“…45,46 Among older children (>13 years old), the risk of DKA increased with higher HbA 1c (relative risk [RR] 1.43 per 1% increase; 95% CI, 1.3-1.6), higher reported insulin dose, underinsurance, and the presence of psychiatric disorders, including major depression, bipolar or anxiety disorder, and/ or use of psychotropic medications. These factors were also found to confer an increased risk of recurrent DKA.…”

Section: Risk Factors In Children With Established Type 1 Diabetes Mementioning

confidence: 99%

Preventing Diabetic Ketoacidosis

Jefferies

Nakhla

Derraik

et al. 2015

Pediatric Clinics of North America

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Section: Risk Factors In Children With Established Type 1 Diabetes Mementioning

confidence: 99%

Preventing Diabetic Ketoacidosis

Jefferies

Nakhla

Derraik

et al. 2015

Pediatric Clinics of North America

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“…Numerous studies involving several cohorts with a total of more than 900 pediatric patients on CSII [6, 7,10,11,12, 15,21,22,23,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41] reported a significant improvement in metabolic control, with a decrease of 0.5–1% in HbA 1c . However, when CSII was compared to MDI in randomized crossover trials in children [42] or adolescents [43] and in randomized controlled trials of short duration in diabetic toddlers and young children [5, 13], there was no significant difference in HbA 1c values.…”

Section: Advantages Of Csiimentioning

confidence: 99%

The Use of Insulin Pump Therapy in the Pediatric Age Group

Shalitin

Phillip²

2008

Horm Res Paediatr

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Diabetic children and their caregivers face the never-ceasing challenge of maintaining blood glucose levels as close as possible to the normal range so as to prevent or delay long-term micro- and macrovascular complications, to minimize the risk of severe hypoglycemic episodes, and to improve quality of life. Continuous subcutaneous insulin infusion (CSII) therapy represents a treatment option that can aid in achieving these goals. Granted that insulin secretor responses to physiological stimuli are complex and difficult to duplicate, CSII is the most physiological method of insulin delivery currently available, simulating the pattern of insulin secretion with a continuous adjustable ‘basal’ delivery and superimposed mealtime ‘boluses’. CSII offers greater flexibility and more precise insulin delivery than do multiple daily injections, and thus can reduce the frequency of severe hypoglycemia. However, when CSII was compared to multiple daily injections in randomized crossover or controlled trials in children or adolescents, generally there was no significant difference in HbA_1c. This review briefly summarizes the current state of knowledge regarding the use of CSII in pediatric and adolescent patients with type 1 diabetes mellitus.

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“…A comparação entre regular e lispro em crianças pequenas mostrou ausência de variação na HbA1c, porém menor excursão glicêmica pós-prandial e maiores valores à meia-noite e 3 horas da manhã com lispro (26). Em crianças com mais idade, não houve diferença entre a lispro e a aspart, e a bomba também foi associada a maior ganho ponderal e redução da dose diária de insulina (27). Para se obter bons resultados com a bomba de insulina há a necessidade de treinamento adequado por meio de time multidisciplinar, composto de enfermeira, nutricionista e médico com experiência nesse tipo de terapêutica (28), além de ser um tratamento oneroso e que exige comprometimento familiar intenso.…”

Section: Diabetes Na Primeira Infânciaunclassified

Abordagem do diabetes melito na primeira infância

Calliari¹,

Monte²

2008

Arq Bras Endocrinol Metab

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RESuMOA ocorrência de diabetes melito tipo 1 em crianças abaixo de 5 anos é rara, mas vem apresentando um aumento em sua incidência em vários países do mundo. o diagnóstico é comumente postergado e a criança em geral encontra-se em estado avançado de descompensação. um dos desafios do acompanhamento desses casos é estimular o total envolvimento da família, já que a criança é dependente de seus cuidados. A atenção com os pequenos pacientes deve ser intensa, já que dificilmente há queixas que possam sugerir a hipoglicemia. A aceitação alimentar e as atividades físicas são irregulares e imprevisíveis e a sensibilidade insulínica é maior. A terapêutica com insulina necessita ser individualizada, e a monitorização glicêmica domiciliar é fundamental para que o melhor controle seja obtido. ABStRActManagement of Diabetes Mellitus in young children. the occurrence of type 1 diabetes mellitus in children under 5-years-old is rare, but its incidence has been growing all over the world. the diagnosis is usually delayed and the patient presents advanced states of ketoacidosis. After the diagnosis, it is extremely crucial the involvement of the family in the treatment from the beginning, due to the dependency of the young children. the attention focused on the patient must be intense, since there are no evident hypoglycemic symptoms, the food intake and physical activities are irregular and there is higher insulin sensitivity. insulin administration has to be individualized, and glucose monitoring is essential to obtain a good control. (Arq Bras Endocrinol Metab 2008;52/2:243-249)Keywords: diabetes mellitus; Young children; Manegement iNtRODuÇÃO N os últimos anos temos visto um aumento na incidência de diabetes melito em crianças menores que 5 anos. Constitui-se em um grande desafio a obtenção de um bom controle, já que as dificuldades em relação ao tratamento medicamentoso e ao acompanhamento não são poucas. Nessa faixa etária as crianças têm atividades muito irregulares, não referem sintomas, mudam padrões alimentares com rapidez, e o tratamento depende totalmente da família. Este artigo procura abordar as características mais significativas do diabetes na primeira infância.

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Continuous Subcutaneous Insulin Infusion Pump Treatment in Children with Type 1 Diabetes Mellitus

Cited by 29 publications

References 9 publications

Preventing Diabetic Ketoacidosis

Preventing Diabetic Ketoacidosis

The Use of Insulin Pump Therapy in the Pediatric Age Group

Abordagem do diabetes melito na primeira infância

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