Evidence synthesis: are continuous subcutaneous insulin pumps with continuous-glucose monitoring effective in outpatient adolescents with type 1 diabetes?

2013 ◽  
Vol 11 (3) ◽  
pp. 239
Author(s):  
E Matsuda ◽  
P Brennan ◽  
M Sullivan
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Evidence Synthesis ◽  
Glucose Monitoring ◽  
Subcutaneous Insulin ◽  
Insulin Pumps

scholarly journals Practical Approach to Using Trend Arrows on Real-Time Continuous Glucose Monitoring System in Type 1 Diabetes Adolescents Living Camp Setting Treated With Multiple Daily Injection or Continuous Subcutaneous Insulin Infusion Insulin Therapy

2020 ◽  
pp. 193229682093480
Author(s):  
Marta Bassi ◽  
Nicola Minuto ◽  
Graziella Fichera ◽  
Clara Rebora ◽  
Alice Parodi ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Real Time ◽  
Continuous Glucose Monitoring ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Training Session ◽  
Glucose Monitoring ◽  
Daily Injection ◽  
Subcutaneous Insulin

Background: The aim of the study was to determine the effect of an educational intervention on the use of trend arrows of a real-time continuous glucose monitoring (rt-CGM) to manage daily therapy decisions in a group of adolescents with type 1 diabetes attending a camp. The secondary aim was to evaluate the variations in total daily dose (TDD) of insulin requirement. Methods: Twenty patients (15-17 years) on multiple insulin injections ( n = 8) or continuous subcutaneous insulin infusion ( n = 12) attended a training session at the beginning of the camp to learn our algorithm for the management of therapy depending on trend arrows. TDD, time in range (TIR), time above range (TAR), and time below range (TBR) (in the 24 hours and in the three hours after breakfast) before the training session (run-in) and at the end of the camp (T1) were analyzed. Results: Data showed a reduction of TAR (run-in 42.6%, T1 32.05%, P = .036) and an increase in TIR (run-in 52.9%, T1 62.4%, P = .013). Reduction of TBR (run-in 42.5%, T1 37.5%, P = .05) and improvement in TIR (run-in 49.0%, T1 57.0%, P = .02) were also observed in the post-breakfast period. Data showed a significant reduction in the TDD (run-in 52.02 ± 17.44 U/die, T1 46.49 ± 12.39 U/die, P = .024). Conclusions: Statistically significant improvement of glycemic control and reduction of TTD were observed in all patients regardless of therapy type. The improvement between run-in and T1 demonstrates the importance of patients’ education on the correct use of rt-CGM with simple algorithms for the management of therapy.

scholarly journals Cutaneous Reactions to Continuous Glucose Monitoring and Continuous Subcutaneous Insulin Infusion Devices in Type 1 Diabetes Mellitus

2020 ◽  
pp. 193229682091889 ◽  
Author(s):  
Rachel S. Rigo ◽  
Laura E. Levin ◽  
Donald V. Belsito ◽  
Maria C. Garzon ◽  
Rachelle Gandica ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Diabetes Management ◽  
Demographic Data ◽  
Glucose Monitoring ◽  
Subcutaneous Insulin ◽  
Cutaneous Reactions

Background: Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are the standard of care for type 1 diabetes in children. There is little reported on device-related skin complications and treatment options. This study documents cutaneous reactions to CGM and CSII devices in children and young adults with type 1 diabetes. Methods: One hundred and twenty-one subjects (3-25 years) with type 1 diabetes and CGM and/or CSII use were recruited over a three-month period from the Naomi Berrie Diabetes Center at Columbia University Irving Medical Center. A five-question survey was completed for each subject detailing demographic data, diabetes management, and device-related skin complications. Results: Sixty percent of subjects reported skin complications related to CGM and/or CSII use. Terms most frequently used to describe cutaneous reactions were “red,” “itchy,” “painful,” and “rash.” Subjects who used both CGM and CSII were more likely to report skin problems than those who used only CSII (odds ratio 2.9, [95% confidence interval: 1.2-6.7]; P = .015). There were no associations between skin complications and sex or race/ethnicity. Twenty-two percent of subjects with adverse skin event(s) discontinued use of a device due to their skin problem. Seven percent were evaluated by a dermatologist. Eighty-one percent used a range of products to treat their symptoms, with variable perceived clinical outcomes. Conclusions: Skin complications related to CSII or CGM devices are commonly reported in pediatric patients with type 1 diabetes and may lead to interruption or discontinuation of device use. Future studies are needed to elucidate the causes of these reactions and determine the best methods for prevention.

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