Insulin Delivery Technology for Treatment of Infants with Neonatal Diabetes Mellitus: A Systematic Review

Area of Science:

• Pediatrics
• Endocrinology
• Metabolic Disorders

Background:

• Neonatal diabetes mellitus (NDM) is a rare glucose metabolism disorder presenting within the first six months of life.
• Initial management typically involves insulin infusion, but technological advancements offer new therapeutic avenues.

Purpose of the Study:

• To comprehensively review the literature on the safety and efficacy of technology-assisted insulin treatment for infants with NDM.
• To provide clinicians with evidence-based support for managing NDM in infants.

Main Methods:

• A systematic literature review of 22 papers, primarily case reports and case series, was conducted.
• The review focused on studies detailing the use of insulin pumps, continuous glucose monitoring (CGM), and advanced algorithms in NDM management.

Main Results:

• Technology-assisted insulin treatment, including insulin pumps and CGM, has been used for nearly two decades in NDM.
• These technologies allow for customized insulin administration, dose minimization (e.g., insulin dilution), and optimized blood glucose control.
• New devices and algorithms are safe and effective, potentially shortening hospital stays and facilitating insulin weaning or switching to sulfonylurea based on molecular diagnosis.

Conclusions:

• Modern diabetes technologies, including closed-loop algorithms, can be safely and effectively implemented in infants with NDM.
• These advancements optimize glycemic control and support clinical decision-making in managing transient and permanent forms of NDM.