Insulin Pump Treatment of Childhood Type 1 Diabetes

Weinzimer, Stuart A.; Sikes, Kristin; Steffen, Amy; Tamborlane, William V.

doi:10.1016/j.pcl.2005.07.004

Cited by 23 publications

(37 citation statements)

References 44 publications

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“…This is probably ascribable to a better, more physiological and precise pharmacokinetic delivery of insulin, less insulin subcutaneous storing, and a lesser variability in insulin subcutaneous absorption assured by the use of pumps. 3,27 Differences among the various groups of pubertal development exist in basal rate profiles. In prepubertal subjects, the percentage of daily insulin requirement supplied as basal is higher than in the other groups.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Most of them report a better metabolic control, a reduction in glycemia variations and hypoglycemic episodes, and a better quality of life. [4][5][6][7][8][9] While shared guidelines are used in adult patients regarding the modifications of insulin requirement during the transition from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII), the basal=bolus distribution and the circadian profiles of basal insulin, bibliographic references, and suggestions for children are poor.…”

Section: Introductionmentioning

confidence: 99%

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Difference in Insulin Usage Patterns with Pubertal Development in Children with Type 1 Diabetes During Transition from Multiple Daily Injections to Continuous Subcutaneous Insulin Infusion (CSII) and Through the CSII Treatment

Shashaj

Sulli

2009

Diabetes Technology & Therapeutics

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Difference in Insulin Usage Patterns with Pubertal Development in Children with Type 1 Diabetes During Transition from Multiple Daily Injections to Continuous Subcutaneous Insulin Infusion (CSII) and Through the CSII Treatment

Shashaj

Sulli

2009

Diabetes Technology & Therapeutics

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“…6,7 CSII improves matching of insulin to carbohydrate intake, involves fewer injections, gives freedom to adjust basal insulin rates at different times of the day, allows a flexible lifestyle, and improves coping with diabetes and quality of life in children and adolescents. 8 There has been a worldwide increase in T1DM in the preschool age group, and management of this cohort of patients is often quite challenging because of unpredictable food intake and activity level. 9-12 CSII use has increased in this age group since it allows more precise dosing and flexibility in life-style, with resultant beneficial effects on glycemic control.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Adherence to Continuous Subcutaneous Insulin Infusion in Pediatric Diabetes

Babar

Ali

Parton

et al. 2009

Diabetes Technology & Therapeutics

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“…Subsequently, the use of continuous subcutaneous insulin infusion (CSII) to achieve strict metabolic control increased exponentially. The advantages of CSII over multiple daily injections include increased lifestyle flexibility, variable basal infusion rates with boluses given before meals, and only one injection for insulin administration every few days (2). CSII in children lowers A1C and decreases hypoglycemia (3,4).…”

mentioning

confidence: 99%

Factors Correlating With Improved A1C in Children Using Continuous Subcutaneous Insulin Infusion

McVean

Eickhoff²,

MacDonald³

2007

Diabetes Care

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The Diabetes Control and Complications Trial demonstrated that tight metabolic control in patients with type 1 diabetes reduces the risk of microvascular complications (1). Subsequently, the use of continuous subcutaneous insulin infusion (CSII) to achieve strict metabolic control increased exponentially. The advantages of CSII over multiple daily injections include increased lifestyle flexibility, variable basal infusion rates with boluses given before meals, and only one injection for insulin administration every few days (2). CSII in children lowers A1C and decreases hypoglycemia (3,4). The American Diabetes Association recommended A1C treatment goals for pediatric patients of 7.5-8.5% for those aged Ͻ6 years, Յ8% for those aged 6 -12 years, Ͻ7.5% for those aged 13-19 years, and Ͻ7% for those aged 19 -22 years (5), but few children and adolescents reach these goals. The reason for this remains unclear. We conducted this study to determine the percentage of children using CSII who reached their A1C goal and to identify differences between children who met their goal and those who did not. RESEARCH DESIGN ANDMETHODS -Medical records of all patients (aged 2-22 years, n ϭ 236) with type 1 diabetes for Ն1 year using CSII for Ն6 months who were followed at the University of Wisconsin pediatric diabetes clinic were reviewed. Data from the time of initiation of CSII were analyzed. Age, duration of diabetes, A1C before CSII initiation, duration of CSII use, number of visits to the diabetes clinic in the previous year, number of basal rates and catheter sites (arms, legs, buttocks, or abdomen), and days between catheter changes were evaluated. A1C was determined using the DCA 2000ϩ instrument (Bayer Diagnostics, Tarrytown, NY).Baseline A1C, age, days between catheter changes, number of visits to the diabetes clinic, and basal rates were summarized by standard descriptive statistics in terms of means, SDs, and ranges. Comparisons of outcome measures between children who did and did not reach their A1C goal at their last clinic visit were performed using a nonparametric Wilcoxon's rank-sum test. The comparisons of duration of diabetes and duration of CSII use between children who reached their A1C goal and those who did not were age adjusted by fitting ANCOVA models. Categorical variables were analyzed using 2 analysis. All data analyses were performed using SAS version 6.12. A two-sided significance level of 0.05 was used.RESULTS -The mean Ϯ SD age of the subjects was 14.5 Ϯ 3.9 years, the duration of diabetes was 6.8 Ϯ 3.7 years (range 1.0 -18.6), the duration of CSII use was 2.9 Ϯ 3.7 years (0.5-9.8), and the age at initiation of CSII was 11.7 Ϯ 3.5 years.We found that 38% of patients using CSII (90 of 236) met their A1C goal at their most recent clinic visit. Patients who met their goal were significantly younger, had a shorter duration of diabetes, had a lower A1C before CSII, and had more catheter sites. There were no significant differences regarding sex, number of visits to the diabetes clinic in the previous yea...

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Insulin Pump Treatment of Childhood Type 1 Diabetes

Cited by 23 publications

References 44 publications

Difference in Insulin Usage Patterns with Pubertal Development in Children with Type 1 Diabetes During Transition from Multiple Daily Injections to Continuous Subcutaneous Insulin Infusion (CSII) and Through the CSII Treatment

Difference in Insulin Usage Patterns with Pubertal Development in Children with Type 1 Diabetes During Transition from Multiple Daily Injections to Continuous Subcutaneous Insulin Infusion (CSII) and Through the CSII Treatment

Factors Associated with Adherence to Continuous Subcutaneous Insulin Infusion in Pediatric Diabetes

Factors Correlating With Improved A1C in Children Using Continuous Subcutaneous Insulin Infusion

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