Use of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes mellitus: a systematic mapping review

Abstract

Background Among the treatments for type 1 diabetes mellitus (T1DM), Continuous Subcutaneous Insulin Infusion (CSII) is a device that infuses insulin through the subcutaneous tissue in an uninterrupted manner and that comes closest to the physiological secretion of insulin. The use of CSII can provide the family with greater security and children and adolescents have more autonomy in relation to the treatment of T1DM. There is a lack of reviews that systematically gather the mounting evidence about the use of CSII in children and adolescents with T1DM. Therefore, the aim of this review was to group and describe primary and secondary studies on the use of CSII in children and adolescents with T1DM. Methods A systematic mapping review was performed based on searches in the following databases: PubMed, Embase, CINAHL, Lilacs and PsycINFO, using a combination of descriptors and keywords. The screening of the studies was carried out with the aid of the Rayyan software and reading in full was conducted independently by two reviewers. The data extraction of the studies was performed using an extraction tool adapted and validated by researchers specialized in diabetes. The data were analyzed according to the content analysis technique. The map from geocoding of the studies was produced using the ArcGis 10.5 software. Results A total of 113 studies were included in the review, including primary studies, literature reviews and gray literature publications. The content analysis of the results of the studies allowed for the identification of four categories: 1) metabolic control; 2) support networks; 3) benefits of using CSII; and 4) challenges of using CSII, each category having its respective subcategories. The review also made it possible to conduct a rigorous mapping of the literature on the use of CSII considering the location of development and the design of the studies. Conclusions The use of CSII should be indicated by health professionals able to prepare children, adolescents, and their families for the treatment of T1DM, and, despite being a technological device, it may not be suitable for the entire pediatric population.

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

“…Some psychological disadvantages of diabetes technology adoption have been reported, including issues with body image, 186 disruptive alarms and painful insertions. 176 The large amount of data and real‐time remote glucose monitoring can be a source of conflict between children with T1D and their parents, as deviations from recommended diabetes management are more readily and immediately noticeable to caregivers.…”

Tratamento com Perfusão Subcutânea Contínua de Insulina na adolescência – a perceção materna

“…Estes tipos de sentimentos foram também descritos pelos participantes no processo de transição para a No global, as mães revelaram-se satisfeitas com o sistema PSCI e consideraram que este era promotor do bem-estar do adolescente e da família, resultados também identificados na literatura (Alvarenga et al, 2022;Alsaleh et al ,2014;Rankin et al,2015;Shee et al, 2019). O impacto positivo da bomba de insulina na qualidade de vida da família tem sido já demonstrado em outros estudos, em que os pais descrevem mudanças que aproximam a vida familiar do que consideram uma rotina mais "normal", por trazer uma maior flexibilidade a nível dos estilos de vida (Rankin et al, 2015) e da realização de atividades sociais (Alsaleh et al ,2014) (Rankin et al, 2021).…”

“…Injeções Diárias (MID) ou com recurso a sistemas de Perfusão Subcutânea Contínua de Insulina (PSCI), denominada também de bomba de insulina (Katsarou et al, 2017). O tratamento com PSCI tem obtido melhor ajuste da insulina basal às necessidades diárias e circadianas, proporcionado melhor controle glicémico e, consequentemente, melhor qualidade de vida (Alvarenga et al, 2022;Rosner et al, 2019). A análise de dados foi sequencial e orientada pelas fases do método de análise de conteúdo de Bardin (2009).…”

Entwicklung der Insulintherapie in der pädiatrischen Diabetologie- Auswertung des DPV-Registers von 1995-2021

“…Zu Beginn unserer Auswertung im Jahr 1995, lag der Anteil des Normalinsulins in der Insulinpumpe bei unseren Patienten teszentrums für den jeweiligen Patienten. Nicht zuletzt ist die Akzeptanz des Hilfsmittels Voraussetzung eines erfolgreichen Einsatzes [16].…”

“…der jugendliche Patient nicht mehr zwingend an bestimmte Mahlzeiten zu festgelegten Uhrzeiten gebunden war. Die schnellwirksamen Insulinanaloga machten dies ab 1995 noch besser möglich [15,16,17] Allerdings ist eine derart individualisierte Therapie für Menschen mit Diabetes mellitus Typ 1 nicht in allen Ländern der Welt möglich. Nicht nur der Zugang zu den verschiedenen Therapieformen, sondern bereits der Zugang zu Insulin ist nicht allen Ärzten und Patienten gleichermaßen möglich.…”