title: Specific use of CSII during enteral nocturnal nutrition in a child with type 1 diabetes, Hashimoto's thyroiditis, and Down syndrome.
abstract: The management of insulin therapy in diabetic patients who have comorbidities that involve nutritional aspects, is a major challenge for diabetes care teams. In diabetic patients with compromised nutritional status, artificial nutrition, both enteral or parenteral, may help in the treatment of chronic and acute diseases, leading to better and faster recover of the health status but, if not adequately associated with insulin therapy, it may negatively affect blood glucose levels and lead to poorer metabolic control. In particular, evidence-based recommendations for the treatment of diabetic patients during enteral nutrition therapy are not currently available and, therefore, medical practices are often based on case reports, rather than outcomes of research. We report our experience with a diabetic patient receiving nocturnal enteral feeding due to comorbidities and malnutrition, who was followed up at our centre and precociously treated with continuous subcutaneous insulin infusion after the onset of type 1 diabetes. There is great need for adequately powered randomized controlled trials to provide scientific evidence for the insulin treatment of diabetic patients undergoing enteral feeding.
authors.affiliation: Pediatric Diabetology Unit, Meyer Children's Hospital, University of Florence, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Piccini
authors.forename: Sonia
authors.initials: S
authors.lastname: Toni
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lenzi
authors.forename: Federica
authors.initials: F
authors.lastname: Barni
authors.forename: Monica
authors.initials: M
authors.lastname: Guasti
authors.forename: Fina
authors.initials: F
authors.lastname: Belli
authors.forename: Maurizio de
authors.initials: Md
authors.lastname: Martino
mesh_terms: D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D004314:Down Syndrome / Q000150:complications*; D004750:Enteral Nutrition; D005260:Female; D050031:Hashimoto Disease / Q000150:complications*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data; D044342:Malnutrition / Q000150:complications / Q000628:therapy*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin