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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
Summary
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.
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