Use of continuous insulin infusion pumps in young children with type 1 diabetes: a systematic review.
BACKGROUND
Although insulin pump therapy has been successful in adults and adolescents, its use has been limited in young children because of perceived risk of severe or frequent hypoglycemia. The purpose of this review is to evaluate the safety and efficacy of continuous subcutaneous insulin infusion (CSII) in young children with type 1 diabetes.


METHODS
We searched Medline, PubMed, and CINAHL for clinical trials comparing multiple-dose injection therapy to CSII therapy in children 6 years of age or younger who were diagnosed with type 1 diabetes at least 6 months prior to study. Primary outcome measures were glycosylated hemoglobin (HbA1c) and hypoglycemic episodes. Other outcomes of interest were quality of life and parental satisfaction.


RESULTS
Most studies showed significant improvements in HbA1c and trends of decreased hypoglycemia. Quality of life improved in most CSII groups. Parental satisfaction with therapy was evidenced by continuation of CSII after study completion.


CONCLUSIONS
Current evidence indicates CSII is a safe and effective method of insulin delivery in young children. When parents are highly motivated, CSII should be offered as a mode of insulin delivery for this age group.
Churchill
Jeanne N
JN
Ruppe
Rebekah L
RL
Smaldone
Arlene
A
D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D055104:Infusions, Subcutaneous / Q000009:adverse effects / Q000523:psychology / Q000706:statistics & numerical data; D007332:Insulin Infusion Systems / Q000009:adverse effects / Q000523:psychology / Q000706:statistics & numerical data; D010290:Parents / Q000193:education / Q000523:psychology; D011788:Quality of Life; D012107:Research Design; D012449:Safety / Q000706:statistics & numerical data; D016896:Treatment Outcome
D006442:Glycated Hemoglobin