The renaissance of insulin pump treatment in childhood type 1 diabetes.
Current goals for the treatment of children and adolescents with type 1 diabetes mellitus include achieving near-normal blood sugar levels, minimizing the risk of hypoglycemia, optimizing quality of life, and preventing or delaying long-term microvascular and macrovascular complications. Continuous subcutaneous insulin infusion (CSII), or insulin pump therapy, provides a treatment option that can assist in the attainment of all of these goals in all ages of children. In pediatric patients, CSII has been demonstrated to reduce both glycosylated hemoglobin levels and frequency of severe hypoglycemia, without sacrifices in safety, quality of life, or weight gain, particularly in conjunction with the use of new insulin analogs and improvements in pump technology. Clinical studies of safety and efficacy of CSII in children are reviewed, as well as criteria for patient selection and practical considerations using pump therapy in youth with T1DM.
Tamborlane
William V
WV
General Clinical Research Center, Yale University School of Medicine, New Haven, CT 06520-8064, USA. William.tamborlane@yale.edu
Swan
Karena
K
Sikes
Kristin A
KA
Steffen
Amy T
AT
Weinzimer
Stuart A
SA
D002648:Child; D002986:Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects; D007332:Insulin Infusion Systems / Q000009:adverse effects; D018579:Patient Selection; D011584:Psychology; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human