The use of insulin pump therapy in the pediatric age group.
Diabetic children and their caregivers face the never-ceasing challenge of maintaining blood glucose levels as close as possible to the normal range so as to prevent or delay long-term micro- and macrovascular complications, to minimize the risk of severe hypoglycemic episodes, and to improve quality of life. Continuous subcutaneous insulin infusion (CSII) therapy represents a treatment option that can aid in achieving these goals. Granted that insulin secretor responses to physiological stimuli are complex and difficult to duplicate, CSII is the most physiological method of insulin delivery currently available, simulating the pattern of insulin secretion with a continuous adjustable 'basal' delivery and superimposed mealtime 'boluses'. CSII offers greater flexibility and more precise insulin delivery than do multiple daily injections, and thus can reduce the frequency of severe hypoglycemia. However, when CSII was compared to multiple daily injections in randomized crossover or controlled trials in children or adolescents, generally there was no significant difference in HbA1c. This review briefly summarizes the current state of knowledge regarding the use of CSII in pediatric and adolescent patients with type 1 diabetes mellitus.
Shalitin
S
S
Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center of Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Phillip
M
M
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems / Q000009:adverse effects; D008297:Male; D014652:Vascular Diseases / Q000097:blood / Q000517:prevention & control
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human