title: Recommendations for the use of sensor-augmented pumps with predictive low-glucose suspend features in children: The importance of education.
abstract: Sensor-augmented pumps, which consist of a pump and a continuous glucose monitoring system, offer considerable therapeutic opportunities, despite requiring close attention in the early phase of their use. The aim of this paper is to provide recommendations on the use of a predictive low glucose management (PLGM) system (Minimed 640G™, Medtronic, Northridge, CA, USA) in adolescents with type 1 diabetes either at the start of therapy or during follow-up. Sound clinical recommendations on PLGM are of increasing importance since several recent papers have reported significant clinical improvements in patients with PLGM, especially in adults. These recommendations are based on the experience of a group of pediatric endocrinologists who collaborated to closely and intensively study the on-boarding of adolescent patients with type 1 diabetes on automated systems to gain first-hand experience and peer-to-peer insights in a unique free-living environment. The suggestions provided here are indicative, so can be adapted to the individual realities and experiences of different diabetes centers. However, we believe that close adherence to the proposed scheme is likely to increase the chances of improving the clinical and metabolic outcomes of patients treated with this therapy.
authors.affiliation: Division of Pediatrics, ASST Cremona, "Ospedale Maggiore di Cremona,", Cremona, Italy.
authors.forename: Andrea E
authors.identifier: http://orcid.org/0000-0002-1518-8515
authors.initials: AE
authors.lastname: Scaramuzza
authors.affiliation: UOS Diabetologia Pediatrica ASL Viterbo, Viterbo, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Arnaldi
authors.affiliation: Division of Pediatric and Adolescent Diabetes, Department of Women's and Children's Health, AOU Salesi Hospital, Ancona, Italy.
authors.forename: Valentino
authors.initials: V
authors.lastname: Cherubini
authors.affiliation: Division of Pediatric and Adolescent Endocrinology and Diabetes, Hospital Giovanni XXIII, Bari, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Piccinno
authors.affiliation: Department of Pediatrics, University of Turin, Turin, Italy.
authors.forename: Ivana
authors.initials: I
authors.lastname: Rabbone
authors.affiliation: Juvenile Diabetes Center, Anna Meyer Children's Hospital, Florence, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Toni
authors.affiliation: Center of Pediatric Diabetology, University of Chieti, Chieti, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tumini
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Candela
authors.affiliation: Center of Pediatric Diabetology, University of Chieti, Chieti, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Cipriano
authors.affiliation: Division of Pediatric and Adolescent Diabetes, Department of Women's and Children's Health, AOU Salesi Hospital, Ancona, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Ferrito
authors.affiliation: Juvenile Diabetes Center, Anna Meyer Children's Hospital, Florence, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lenzi
authors.affiliation: Department of Pediatrics, University of Turin, Turin, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Tinti
authors.affiliation: Institute of Endocrinology, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Ohad
authors.initials: O
authors.lastname: Cohen
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Fortunato
authors.initials: F
authors.lastname: Lombardo
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D006801:Humans; D007332:Insulin Infusion Systems; D010353:Patient Education as Topic
chemical_list: D001786:Blood Glucose
keywords: 
  predictive low-glucose management
  ; 
  sensor augmented pump
  ; continuous glucose monitoring; continuous subcutaneous insulin infusion; insulin pump therapy; predictive low-glucose suspend; recommendations