Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life

McMahon, Sandra; Airey, F.L.; Marangou, D.A.; McElwee, Karen; Carne, Christine L; Clarey, A.J.; Davis, Elizabeth A.; Jones, Timothy W.

doi:10.1111/j.1464-5491.2004.01359.x

Cited by 141 publications

(139 citation statements)

References 34 publications

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“…The mean improvement in HbA 1c of 0.6% (6.6 mmol/ mol) in the pump cohort is in keeping with other studies [3,10,11]. This magnitude of change is clinically significant, as the DCCT has reported reductions in microvascular complications of 21 to 49% with every 1% reduction in HbA 1c [15].…”

Section: Discussionsupporting

confidence: 71%

“…Pump therapy was introduced at our centre in 1999. We have previously reported on the first 100 patients who commenced pump therapy at our institution [3]. Over the 2 year follow-up presented in that study, patients on pump therapy had a reduction in HbA 1c of 0.5% (5.5 mmol/mol) and a 65% reduction in episodes of severe hypoglycaemia.…”

mentioning

confidence: 99%

“…associated with pump therapy [3][4][5], although some report no improvement or an initial improvement followed by a return to pre-pump levels after a short time [6][7][8][9]. Reports have also suggested that insulin pumps may be associated with a reduction in severe hypoglycaemia [3,10,11].…”

mentioning

confidence: 99%

“…Reports have also suggested that insulin pumps may be associated with a reduction in severe hypoglycaemia [3,10,11]. Most studies, however, have been of short duration; very few with greater than 4 years of follow-up.…”

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confidence: 99%

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Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study

et al. 2013

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Aims/hypothesis We determined the impact of insulin pump therapy on long-term glycaemic control, BMI, rate of severe hypoglycaemia and diabetic ketoacidosis (DKA) in children. Methods Patients on pump therapy at a single paediatric tertiary hospital were matched to patients treated by injections on the basis of age, duration of diabetes and HbA 1c at the time of pump start. HbA 1c , anthropometric data, episodes of severe hypoglycaemia and rates of hospitalisation for DKA were collected prospectively.

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Section: Discussionsupporting

confidence: 71%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study

et al. 2013

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“…Nos últimos anos, vários estudos têm demonstrado que a bomba de infusão de insulina subcutânea (BIISC) é uma boa alternativa terapêutica em pacientes na faixa etária pediátrica e que é bem aceita por crianças e adolescentes (6)(7)(8)(9). Os avanços técnicos, tanto nas BIISC como nos cateteres, entre outros aspectos como a redução no seu tamanho e dispositivos de segurança, têm permitido ampliar o seu uso na faixa etá-ria pediátrica.…”

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Comparação entre a bomba de infusão de insulina subcutânea e o esquema de múltiplas doses de insulina em adolescentes com diabetes melito do tipo 1 da rede pública de saúde na abordagem da hipoglicemia grave

Gabbay

Dib

2007

Arq Bras Endocrinol Metab

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RESUMOObjetivo: Avaliação comparativa da freqüência de hipoglicemia severa após mudança da terapia com múltiplas doses de insulina (MDI) para bomba de insulina subcutânea (BIISC). Pacientes e Métodos: Sete pacientes DM1, idade Mi = 14 anos e tempo médio de diabetes de 8 anos, comparados de acordo com a incidência de hipoglicemia, a dose total de insulina (U/Kg/d), IMC (Kg/m 2 ) e HbA1c (vn: 3,5-6,7%) 1 ano antes e 1 ano após a transferência de terapêutica. Houve redução significativa dos episódios de hipoglicemia severa (1,3 episódio/paciente/ano para zero episódio/paciente/ano; p = 0,04), na dose total diária de insulina (1,33 ± 0,26 U/Kg/dia para 0,87 ± 0,17 U/kg/dia; p = 0,04) e na HbA1c (8,7 ± 0,7% para 7,8 ± 0,9%; p = 0,05 com BIISC). Concluímos que a BIISC é eficaz e segura na redução de hipoglicemia severa em um subgrupo de pacientes DM1 com MDI. Entretanto, os resultados obtidos precisam ser reproduzidos em centros semelhantes e estudos de custo são necessários para que a sua viabilidade seja confirmada e aplicada nos sistemas públicos de saúde, que correspondem à maioria no nosso país. ABSTRACT Comparison Between Continuous Subcutaneous Insulin Infusion and Multiple Daily Injection Regimens in Adolescent with Type 1Diabetes from a Public Health Care System Approach to Severe Hypoglycemia. Objective: We compared the incidence of severe hypoglycemia episodes with therapy with multiple doses of insulin (MDI) and after changing to pump (CSII). Patients and methods: 7 T1DM patients with 14 years median and median duration of diabetes of 8 years. We analyzed insulin requirement (U/kg/day), BMI (Kg/m 2 ), HbA1c (normal range: 3.5-6.7%) one year before and one year after changing therapy. The severe hypoglycemia episodes decreased from 1.3 to 0 episodes/patient/year; p = 0.00). The insulin requirement decreased from 1.33 ± 0.26 U/Kg/day to 0.87 ± 0.17 U/kg/day; p = 0.04 and HbA1c decreased from 8.7 ± 0.7% to 7.8 ± 0.9%; p = 0.05. Conclusion: CSII is efficient in decreasing severe hypoglycemia in a subgroup of T1DM using MDI also in Public Health Care System (PHCS) conditions. However, these finding should be reproduced by other Diabetes Care centers and cost studies are necessary to confirm the viability and possibility of this therapy, when necessary, to T1DM patients, which correspond to the majority of these individuals in our country, seeing in the PHCS.

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Health-Related Quality of Life of Children and Adolescents With Type 1 or Type 2 Diabetes Mellitus

Naughton

Ruggiero²,

Lawrence³

et al. 2008

Arch Pediatr Adolesc Med

116

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Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life

Abstract: Pump therapy is proving an effective means of insulin therapy in the young patient that shows promise to improve glycaemic control with a reduction in hypoglycaemia frequency. Quality of Life measures suggest that psychosocial outcomes may be improved.

Cited by 141 publications

References 34 publications

Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study

Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study

Comparação entre a bomba de infusão de insulina subcutânea e o esquema de múltiplas doses de insulina em adolescentes com diabetes melito do tipo 1 da rede pública de saúde na abordagem da hipoglicemia grave

Health-Related Quality of Life of Children and Adolescents With Type 1 or Type 2 Diabetes Mellitus

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