The renaissance of insulin pump treatment in childhood type 1 diabetes.

General Clinical Research Center, Yale University School of Medicine, New Haven, CT 06520-8064, USA.
Reviews in Endocrine and Metabolic Disorders (Impact Factor: 3.81). 10/2006; 7(3):205-13. DOI: 10.1007/s11154-006-9018-9
Source: PubMed

ABSTRACT 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.

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    ABSTRACT: The aim of this study is to assess long-term metabolic outcomes in children with diabetes mellitus and to compare the efficacy, feasibility and metabolic control expenses for treatment with continuous subcutaneous insulin infusion (CSII), compared to human insulin treatment. The study sample included 34 children aged 3 to 18 years with type 1 diabetes, 17 with continuous subcutaneous insulin infusion (CSII) therapy and 17 with standard treatment with human insulin. The study observed for the following variables: duration of the disease, diabetic control, HbA1c deviation scores; height and weight deviation and price of the treatment. Methods applied include meta-analyses in the published medical lit-erature, pharmacoeconomic analysis and statistical analysis. From the 34 children with diabetes type 1 observed retro-spectively during the period 1999-2012, 17 were on CSII (mean age 10 years, mean duration of the disease—7 years, average usage of CSII—3 years). The test stripes cost 533 Euro/year (1100 stripes per year) and their average cost ac-cording to the duration of the disease is 3779.45 Euro since diagnosis. The blood glucose monitoring system costs 20 Euro and for the duration of the disease—4.96 Euro per patient per year. The average improvement of HbA(1c) after the CSII introduction is 1.85, while after the application of human insulin—0.28. The treatment with CSII leads to signifi-cant improvement in glycemic control compared to the treatment with human insulin. The reduced HbA(1c) shows good diabetes management, from one point of view, and good quality of life—from another.
    Modern Economy 01/2013; 4(10):9-13. DOI:10.4236/me.2013.410A002
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