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Continuous subcutaneous insulin infusion therapy for Type 1 diabetes mellitus in children

  • Review Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Purpose

Continuous subcutaneous insulin pump therapy (CSII or pump therapy) is a well-recognised treatment option for Type 1 diabetes mellitus (T1DM) in paediatrics. It is especially suited to children because it optimises control by improving flexibility across age-specific lifestyles. The NICE guidelines (2008) recognise that pump therapy is advantageous and that it should be utilised to deliver best practice. In Ireland, the National Clinical Program for Diabetes will increase the availability and uptake of CSII in children and thus more clinicians are likely to encounter children using CSII therapy.

Methods

This is a narrative review which discusses the basic principles of pump therapy and focuses on aspects of practical management.

Results

Insulin pump management involves some basic yet important principles which optimise the care of diabetes in children.

Conclusions

This review addresses the principles of insulin pump management in children which all health care professionals involved in caring for the child with diabetes, shoud be familiar with.

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References

  1. Hughes CR, McDowell N, Cody D, Costigan C (2012) Sustained benefits of continuous subcutaneous insulin infusion. Arch Dis Child [Internet] 97(3):245–7. http://www.ncbi.nlm.nih.gov/pubmed/21109506. Accessed 13 May 2014

  2. Johnson SR, Cooper MN, Jones TW, Davis EA (2013) Long-term outcome of insulin pump therapy in children with Type 1 diabetes assessed in a large population-based case-control study. Diabetologia [Internet] 56(11):2392–400. http://www.ncbi.nlm.nih.gov/pubmed/23963323. Accessed 15 May 2014

  3. McMahon SK, Airey FL, Marangou DA, McElwee KJ, Carne CL, Clarey AJ et al (2005) Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life. Diabet Med [Internet] 22(1):92–6. http://www.ncbi.nlm.nih.gov/pubmed/15606698. Accessed 16 Feb 2016

  4. Pickup JC, Sutton AJ (2008) Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabet Med [Internet] 25(7):765–74. http://www.ncbi.nlm.nih.gov/pubmed/18644063. Accessed 7 May 2014

  5. Müller-Godeffroy E, Treichel S, Wagner VM (2009) Investigation of quality of life and family burden issues during insulin pump therapy in children with Type 1 diabetes mellitus—a large-scale multicentre pilot study. Diabet Med [Internet] 26(5):493–501. http://www.ncbi.nlm.nih.gov/pubmed/19646189. Accessed 16 Feb 2016

  6. Weintrob N, Benzaquen H, Galatzer A, Shalitin S, Lazar L, Fayman G et al (2003) Comparison of continuous subcutaneous insulin infusion and multiple daily injection regimens in children with Type 1 diabetes: a randomized open crossover trial. Pediatrics [Internet] 112(3 Pt 1):559–64. http://www.ncbi.nlm.nih.gov/pubmed/12949284. Accessed 16 Feb 2016

  7. O’Riordan S, Turner G (2012) Model of care for the provision of continuous subcutaneous insulin infusion for the treatment of Type 1 diabetes in the under five age group. http://www.hse.ie/eng/about/Who/clinical/natclinprog/diabetesprogramme/paed.pdf. Accessed July 2012

  8. O’Riordan S; Turner G; Browne C (2015) National clinical programmes for diabetes and paediatrics model of care for all children and young people with Type 1 diabetes. https://www.diabetes.ie/wp-content/uploads/2015/12/National-Clinical-Programme-for-Diabetes-and-Paediatrics.pdf. Accessed Nov 2015

  9. Roche EF, Mckenna A, Ryder K, Brennan A, Hoey H (2014) The incidence of childhood Type 1 diabetes in Ireland and the National Childhood Diabetes Register. Ir Med J 107(9):278–281

    CAS  PubMed  Google Scholar 

  10. Savage T, Clarke A, Costigan C, Loftus BG, Cody D (2008) Services for children with diabetes. Ir Med J 101:15–17

    CAS  PubMed  Google Scholar 

  11. Hawkes CP, Murphy MN (2014) Paediatric Type 1 diabetes in Ireland-results of the first national audit. Ir Med J 107(4):102–105

    CAS  PubMed  Google Scholar 

  12. Beardsall K, Pesterfield CL, Acerini CL (2011) Neonatal diabetes and insulin pump therapy. Arch Dis Child Fetal Neonatal Ed 96(3):F223–F224

    Article  PubMed  Google Scholar 

  13. Hanas R, Adolfsson P (2006) Insulin pumps in pediatric routine care improve long-term metabolic control without increasing the risk of hypoglycemia. Pediatr Diabetes [Internet] 7(1):25–31. http://www.ncbi.nlm.nih.gov/pubmed/16489971. Accessed 14 May 2014

  14. Levy-Shraga Y, Lerner-Geva L, Modan-Moses D, Graph-Barel C, Mazor-Aronovitch K, Boyko V et al (2013). Benefits of continuous subcutaneous insulin infusion (CSII) therapy in preschool children. Exp Clin Endocrinol Diabetes [Internet] 121(4):225–9. http://www.ncbi.nlm.nih.gov/pubmed/23329580. Accessed 13 May 2014

  15. Blackman SM, Raghinaru D, Adi S, Simmons JH, Ebner-Lyon L, Chase HP et al (2014) Insulin pump use in young children in the T1D exchange clinic registry is associated with lower hemoglobin A1c levels than injection therapy. Pediatr Diabetes [Internet]. http://www.ncbi.nlm.nih.gov/pubmed/24494980. Accessed 14 May 2014

  16. Pańkowska E, Błazik M, Dziechciarz P, Szypowska A, Szajewska H (2009) Continuous subcutaneous insulin infusion vs. multiple daily injections in children with Type 1 diabetes: a systematic review and meta-analysis of randomized control trials. Pediatr Diabetes [Internet] 10(1):52–8. http://www.ncbi.nlm.nih.gov/pubmed/18761648. Accessed 17 July 2015

  17. Kordonouri O, Hartmann R, Lauterborn R, Barnekow C, Hoeffe J, Deiss D (2006) Age-specific advantages of continuous subcutaneous insulin infusion as compared with multiple daily injections in pediatric patients: one-year follow-up comparison by matched-pair analysis. Diabetes Care [Internet] 29(1):133–4. http://www.ncbi.nlm.nih.gov/pubmed/16373909. Accessed 17 July 2015

  18. Misso ML, Egberts KJ, Page M, O’Connor D, Shaw J (2010) Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for Type 1 diabetes mellitus. Cochrane database Syst Rev [Internet] (1):CD005103. http://www.ncbi.nlm.nih.gov/pubmed/20091571. Accessed 17 July 2015

  19. Buckingham B, Cobry E, Clinton P, Gage V, Caswell K, Kunselman E et al (2009) Preventing hypoglycemia using predictive alarm algorithms and insulin pump suspension. Diabetes Technol Ther [Internet] 11(2):93–7. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2979338&tool=pmcentrez&rendertype=abstract. Accessed 22 May 2014

  20. Elleri D, Dunger DB, Hovorka R (2011) Closed-loop insulin delivery for treatment of Type 1 diabetes. BMC Med [Internet]. BioMed Central Ltd 9(1):120. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3229449&tool=pmcentrez&rendertype=abstract. Accessed 1 May 2014

  21. Castle JR, Engle JM, El Youssef J, Massoud RG, Yuen KCJ, Kagan R et al (2010) Novel use of glucagon in a closed-loop system for prevention of hypoglycemia in Type 1 diabetes. Diabetes Care [Internet] 33(6):1282–7. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2875438&tool=pmcentrez&rendertype=abstract. Accessed 22 May 2014

  22. Weinzimer SA, Sherr JL, Cengiz E, Kim G, Ruiz JL, Carria L et al (2012) Effect of pramlintide on prandial glycemic excursions during closed-loop control in adolescents and young adults with Type 1 diabetes. Diabetes Care [Internet] 35(10):1994–9. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3447854&tool=pmcentrez&rendertype=abstract. Accessed 22 May 2014

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Authors and Affiliations

  1. Department of Paediatric Endocrinology, Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland

    M. Mavinkurve

  2. Department of Paediatric Endocrinology, University Hospital Limerick, Limerick, Ireland

    A. Quinn & C. S. O’Gorman

  3. Department of Paediatrics, Graduate Entry Medical School, University of Limerick, Limerick, Ireland

    C. S. O’Gorman

Authors
  1. M. Mavinkurve
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  2. A. Quinn
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  3. C. S. O’Gorman
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Corresponding author

Correspondence to C. S. O’Gorman.

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Mavinkurve, M., Quinn, A. & O’Gorman, C.S. Continuous subcutaneous insulin infusion therapy for Type 1 diabetes mellitus in children. Ir J Med Sci 185, 335–340 (2016). https://doi.org/10.1007/s11845-016-1441-7

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  • DOI: https://doi.org/10.1007/s11845-016-1441-7

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