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Insulin therapy in pediatric patients with type I diabetes: continuous subcutaneous insulin infusion versus multiple

Leena Nahata1

  • 1College of Medicine, The Ohio State University, Columbus, OH, USA.

Clinical Pediatrics
|August 9, 2006
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) may offer benefits over multiple daily insulin injections (MDIs) for type 1 diabetes in children. However, more research is needed to establish CSII as a first-line therapy.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes management in children and adolescents requires effective insulin delivery.
  • Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDIs) are primary treatment modalities.

Purpose of the Study:

  • To systematically review and compare CSII versus MDIs in pediatric patients with type 1 diabetes.
  • To evaluate five key parameters: glycemic control, adverse events, insulin dosage, weight gain, and psychosocial impact.

Main Methods:

  • A review of existing studies comparing CSII and MDIs in children and adolescents with type 1 diabetes.
  • Analysis of outcomes across five predefined parameters.

Main Results:

  • Two studies indicated CSII offered superior glycemic control, fewer adverse events, and better psychosocial outcomes compared to MDIs.
  • Three studies reported lower insulin dosage requirements with CSII; one study found less weight gain.
  • No significant differences were observed in preschoolers across any parameter in two specific studies.

Conclusions:

  • CSII shows potential advantages over MDIs for type 1 diabetes in pediatric populations, though not definitively established as first-line therapy.
  • Further large-scale, randomized controlled trials are necessary to confirm efficacy, safety, and cost-effectiveness.
  • MDIs remain a viable first-line option, with CSII recommended for patients with poor control or adherence issues with injections.

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