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Continuous Subcutaneous Insulin Infusion in Children: A Pilot Study Validating a Protocol to Avoid Hypoglycemia at

Despoina Manousaki1,2, Johnny Deladoëy1,2, Louis Geoffroy1,2

  • 1Endocrinology Service and Diabetes Unit, CHU Sainte-Justine, Montreal, QC, Canada.

Frontiers in Endocrinology
|May 10, 2017
PubMed

Insights

This study shows that a new protocol for starting continuous subcutaneous insulin infusion (CSII) is safe for children with type 1 diabetes. The CSII initiation protocol effectively prevents hypoglycemia in pediatric patients.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Systematic studies on hypoglycemia and hyperglycemia during continuous subcutaneous insulin infusion (CSII) initiation in children with type 1 diabetes are lacking.
  • Assessing the safety of CSII initiation protocols is crucial for pediatric diabetes care.

Purpose of the Study:

  • To evaluate the safety of a specific CSII initiation protocol in pediatric patients with type 1 diabetes.
  • To determine the impact of CSII initiation on glycemic control, specifically hypoglycemia and hyperglycemia, in children.

Main Methods:

  • Prospective study involving 22 pediatric patients with type 1 diabetes.
  • Continuous glucose monitoring (CGM) was used to assess glycemic values before and within 3 days after CSII initiation.

Main Results:

  • No significant difference was observed in the rates of hypoglycemic events (RR = 0.85, p = 0.52) or prolonged hypoglycemic events (>1 h) per day (RR = 1.12, p = 0.56) after CSII initiation.
  • A trend towards prolonged hyperglycemia episodes was noted post-pump initiation (RR = 1.52, p = 0.06).

Conclusions:

  • This prospective study is the first to utilize CGM to assess the impact of a CSII initiation protocol on glycemic control in children.
  • The established CSII initiation protocol demonstrates a safe model for avoiding hypoglycemia in pediatric patients starting insulin pump therapy.
Abstract

Keywords:
continuous glucose monitoringcontinuous subcutaneous insulin infusionhypoglycemiapediatricstype 1 diabetes

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