Long‐term benefits of continuous subcutaneous insulin infusion in children with Type 1 diabetes: a 4‐year follow‐up

Sulli, N.; Shashaj, Blegina

doi:10.1111/j.1464-5491.2006.01935.x

Cited by 72 publications

(55 citation statements)

References 31 publications

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“…However, it remained 0.3% (3.3 mmol/mol) lower than in the matched non-pump cohort. Sulli and Shashaj also noted a trend for the mean HbA 1c to increase at 2 years before improving for the next 2 years of their study [4]. This may be partly due to waning enthusiasm for the new technology.…”

Section: Discussionmentioning

confidence: 95%

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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: Discussionmentioning

confidence: 95%

“…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%

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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“…The use of insulin pumps in the pediatric diabetes population is rapidly increasing [1][2][3][4] and is approaching 35% in Sweden. 5 When starting with an insulin pump, the basal rate and bolus doses are calculated from the current dose on injection therapy.…”

Section: Introductionmentioning

confidence: 99%

Insulin Doses before and One Year after Pump Start: Children Have a Reversed Dawn Phenomenon

Nicolajsen

Samuelsson

Hanås

2012

J Diabetes Sci Technol

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Abbreviations: (HbA1c) hemoglobin A1c, (MDI) multiple daily injections, (PG) plasma glucose, (REM) rapid eye movement, (TDD) total daily dose Keywords: basal rate, bolus doses, children, dawn phenomenon, diabetes, insulin pump Abstract Objective:We aimed to investigate the basal rate and bolus doses in children and adolescents at the start of insulin pump therapy and after 1 year of use. Patients and Methods:Case records from 29 children and adolescents were examined. All pumps were started with rapid-acting insulin (Humalog). Patients were aged 13.1 ± 3.9 years, with a diabetes duration of 5.4 ± 4.1 years at pump start. Sixteen pumps were started for high hemoglobin A1c (HbA1c; >8.8%, 73 mmol/mol) and 13 for other reasons. Results:Basal rates declined in both groups by 20% at 3 days after pump start. The bolus doses were reduced by 25-30% when the indication was high HbA1c and by 15% in the others. After 1 year, there was a significant difference in the basal rate between age groups. The 3-9-year-old age group had higher basal rates during the late evening (10:00 PM-12:00 AM), while the 15-21-year-old age group had higher basal rates in the early morning (3:00 AM-7:00 AM). Conclusions:Insulin doses are reduced considerably when starting with a pump in pediatric practice. Younger children needed higher basal rates late in the evening (reversed dawn phenomenon), while older teenagers seem to need an increase in the morning, which may correspond to a true dawn phenomenon.

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“…A eficácia e a segurança do uso da bomba de insulina na população pediátrica, mesmo abaixo de 6 anos, é confirmada por outras publicações recentes que mostram ainda outras vantagens dessa modalidade terapêutica, como redução da A1c, promoção de controle metabóli-co adequado sem aumento nas taxas de ocorrência de hipoglicemia e cetoacidose, além da tendência de redução no índice de massa corpórea (24)(25)(26).…”

Section: Uso De Bomba De Insulina Em Criançasunclassified

Uso de bomba de infusão subcutânea de insulina e suas indicações

Minicucci

2008

Arq Bras Endocrinol Metab

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RESuMO tanto a bomba de infusão de insulina quanto a terapêutica de múltiplas doses de insulina (Mdi) são meios efetivos de implementar o manejo intensivo do diabetes melito tipo 1 (dM1), com o objetivo de chegar a níveis glicêmicos quase normais e obter-se um estilo de vida mais flexível. A terapia com bomba de infusão de insulina é tão segura quanto a Mdi e tem vantagens sobre ela, sobretudo em pacientes com hipoglicemias freqüentes, com um fenôme-no do alvorecer importante, com gastroparesia, na gravidez, em crianças e em pacientes com dM1 e com um estilo de vida errático. A terapia com bomba de infusão de insulina possibilita maior probabilidade de se alcançar melhor controle glicêmico com menos hipoglicemia, hipoglicemias assintomáticas e melhor qualidade de vida. Além disso, os riscos e os efeitos adversos da terapêutica insulínica em pacientes com dM1 em insulinização intensiva são menores nos pacientes usando esta terapia, quando comparados a pacientes em Mdi. Para tal, o ajuste cuidadoso das doses basais e de bólus e o seguimento adequado do paciente são vitais. Both continuous subcutaneous insulin infusion (csii) and Multiple daily injections (Mdi) are effective ways of implementing intensive management of dM1 to attain near normal glycemic levels and a more flexible lifestyle. csii is as safe as Mdi and has some advantages over it mostly in diabetic patients with frequent hypoglycemias with important dawn phenomenum, gastroparesia, during pregnancy, in children and in patients with an erratic way of living. csii allows a better chance to reach better glycemic control with less hypoglycemia, asymptomatic hypoglycemias and a better quality of life. Besides, risks are lower and adverse events are less frequent in dM1 patients under csii as compared to Mdi. to obtain results like this, a careful adjustment of basal and boluses insulin doses and an adequate patient follow-up are essential. (Arq Bras Endocrinol Metab 2008;52/2:340-348)

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Long‐term benefits of continuous subcutaneous insulin infusion in children with Type 1 diabetes: a 4‐year follow‐up

Cited by 72 publications

References 31 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

Insulin Doses before and One Year after Pump Start: Children Have a Reversed Dawn Phenomenon

Uso de bomba de infusão subcutânea de insulina e suas indicações

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