Home Forums Other Specialities Paediatrics INSULIN PUMP THEREPY

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      Anonymous
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      • Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study
      • Source: Diabetologia
      This Australian study (7-year follow-up) found that insulin pump therapy improved HbA1c, and was associated with a lower incidence of severe hypoglycaemia (7.2 vs. 10.2 events per 100 patient-years) and hospitalisation for DKA compared to those receiving insulin injections.

      NICE published an updated technology appraisal on continuous subcutaneous insulin infusion (CSII or ‘insulin pump’) therapy in 2008 (TA 151).
      This recommends CSII as an option for the treatment of adults and children ?12 years with type 1 diabetes when either attempts to achieve target haemoglobin A1c (HbA1c) levels with multiple daily injections (MDIs) result in the person experiencing disabling hypoglycaemia, or HbA1c levels have remained high (8.5% or above) on MDI therapy (including, if appropriate, the use of long-acting insulin analogues) despite a high level of care.

      CSII therapy should only be continued if it results in a sustained improvement in glycaemic control (a fall in HbA1c or a sustained decrease in the rate of hypoglycaemic episodes).

      CSII therapy is also recommended as a treatment option for younger children, provided that MDI therapy is considered to be impractical or inappropriate.
      Children on insulin pumps would be expected to undergo a trial of MDI therapy between the ages of 12 and 18 years.

      NICE- NATIONAL INSTITUTE OF CLINICAL EXCELLENCE.

      G Mohan.

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