scholarly journals Analysis of selected factors influencing the course of insulin pump therapy in children and adolescents

2017 ◽  
Vol 16 (3) ◽  
pp. 187-196
Author(s):  
Małgorzata Starczewska ◽  
◽  
Katarzyna Scheffler ◽  
Małgorzata Szkup ◽  
Katarzyna Augustyniuk ◽  
...  
2012 ◽  
Vol 58 (3) ◽  
pp. 46-50
Author(s):  
E A Andrianova

The data on the efficacy of using ultra-short acting insulin preparations in insulin pumps for children and adolescents presenting with diabetes mellitus. Insulin pump therapy in the patients of these age groups is finding an increasingly wider application as being more convenient for the users and leading to the improvement of glycemic control. One of the main advantages of modern insulin pump therapy is the possibility to maximally imitate the physiological profile of insulin secretion. The flexibility of both basal and bolus dosing regimens of insulin administration can be further increased by using ultra-short acting insulin preparations in insulin pumps. The choice of any of the three currently available analogs of ultra-short acting insulin guarantees their identical efficacy and safety in the children and adolescents with type 1 diabetes mellitus. They can be recommended as insulins of choice for the use in pump therapy


2019 ◽  
Vol 32 (8) ◽  
pp. 843-849 ◽  
Author(s):  
Kholoud Mohamed ◽  
Dalia Al-Abdulrazzaq ◽  
Amel Fayed ◽  
Eman El Busairi ◽  
Faisal Al Shawaf ◽  
...  

Abstract Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial.


2016 ◽  
Vol 11 (4) ◽  
pp. 753-758 ◽  
Author(s):  
Asma Deeb ◽  
Ahlam Al Hajeri ◽  
Iman Alhmoudi ◽  
Nico Nagelkerke

Background: Carbohydrate (CHO) counting is a key nutritional intervention utilized in the management of diabetes to optimize postprandial glycemia. The aim of the study was to examine the impact of accuracy of CHO counting on the postprandial glucose in children and adolescents with type 1 diabetes on insulin pump therapy. Methods: Children/adolescents with type 1 diabetes who were on insulin pump therapy for a minimum of 6 months are enrolled in the study. Patients were instructed to record details of meals consumed, estimated CHO count per meal, and 2-hour postprandial glucose readings over 3-5 days. Meals’ CHO contents were recounted by an experienced clinical dietician, and those within 20% of the dietician’s counting were considered accurate. Results: A total of 30 patients (21 females) were enrolled. Age range (median) was 8-18 (SD 13) years. Data of 247 meals were analyzed. A total of 165 (67%) meals’ CHO contents were accurately counted. Of those, 90 meals (55%) had in-target postprandial glucose ( P < .000). There was an inverse relationship between inaccurate CHO estimates and postprandial glucose. Of the 63 underestimated meals, 55 had above-target glucose, while 12 of the 19 overestimated meals were followed by low glucose. There was no association between accuracy and meal size (Spearman’s rho = .019). Conclusion: Accuracy of CHO counting is an important determining factor of postprandial glycemia. However, other factors should be considered when advising on prandial insulin calculation. Underestimation and overestimation of CHO result in postprandial hyperglycemia and hypoglycemia, respectively. Accuracy does not correlate with meal size.


2007 ◽  
Vol 24 (8) ◽  
pp. 836-842 ◽  
Author(s):  
T. M. Kapellen ◽  
B. Heidtmann ◽  
J. Bachmann ◽  
R. Ziegler ◽  
M. Grabert ◽  
...  

2020 ◽  
Vol 36 (6) ◽  
pp. 57-63
Author(s):  
O. M. Khudorozhkova ◽  
E. N. Smirnova

Aim. To assess the dependence of carbohydrate metabolism state in children and adolescents with type I diabetes mellitus (DM) in Perm Krai on patients age, disease duration, way of insulin administration (regimen of multiple insulin injections or insulin pump therapy), complications available. Materials and methods. The study enclosed 451 children and adolescents, living in Perm Krai, who were hospitalized for type 1 DM to Endocrine Unit of Regional Childrens Clinical Hospital during 2016-2017. Glycated hemoglobin level (HbA1c), daily insulin requirement, availability and character of complications were assessed in these patients. Conclusions. The state of decompensation more often is connected with the disease duration for more than 5 years and adolescent age. There was detected a feedback between the physical development level and the duration of disease and number of chronic complications. The period of development of type 1 DM chronic complications depends on patients age, sex and compensation of disease. The degree of compensation of the disease is higher when using insulin pump therapy or regimen of multiple injections of ultrashort analogs of insulin in combination with basal analogs.


2014 ◽  
Vol 16 (11) ◽  
pp. 735-741 ◽  
Author(s):  
Davide Brancato ◽  
Mattia Fleres ◽  
Vito Aiello ◽  
Gabriella Saura ◽  
Alessandro Scorsone ◽  
...  

Diabetes Care ◽  
2003 ◽  
Vol 26 (4) ◽  
pp. 1142-1146 ◽  
Author(s):  
L. P. Plotnick ◽  
L. M. Clark ◽  
F. L. Brancati ◽  
T. Erlinger

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