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Continuous subcutaneous insulin infusion in children.

C E de Beaufort, G J Bruining

    Diabetic Medicine : a Journal of the British Diabetic Association
    |March 1, 1987
    PubMed
    Summary
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    Continuous subcutaneous insulin infusion (CSII) shows promise for managing diabetes in children, particularly toddlers, but patient selection is key for adolescents. Further research is needed to confirm its effectiveness and guide optimal use in pediatric diabetes care.

    Area of Science:

    • Pediatric Endocrinology
    • Metabolic Disorders
    • Diabetes Management

    Background:

    • Insulin-dependent diabetes mellitus (IDDM) typically emerges in childhood, necessitating metabolic control to prevent complications.
    • Persisting metabolic derangements in children with diabetes are linked to micro- and macrovascular complications.
    • Continuous subcutaneous insulin infusion (CSII) is an established method for optimizing diabetes control in adults.

    Purpose of the Study:

    • To evaluate the efficacy and acceptability of CSII in pediatric diabetes management.
    • To explore the potential of CSII as a therapeutic option for diabetic toddlers.
    • To identify factors influencing the success of CSII in adolescents with diabetes.

    Main Methods:

    • Review of existing studies on CSII use in adolescents and toddlers with diabetes.

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  • Analysis of reported outcomes regarding metabolic control and patient acceptability.
  • Discussion of patient selection criteria and organizational requirements for CSII implementation.
  • Main Results:

    • Contradictory findings exist regarding CSII's acceptability and metabolic control in adolescents.
    • Some studies report near normalization of blood glucose, while others show only temporary improvements in adolescents.
    • Diabetic toddlers show good acceptability and improved metabolic control with CSII, though more research is needed.

    Conclusions:

    • Patient selection is critical for successful CSII outcomes in adolescents.
    • CSII may be a preferred therapy for diabetic toddlers, warranting further investigation.
    • High standards of clinic organization, home monitoring, education, and support are essential for effective CSII management in children.