Continuous subcutaneous insulin infusion (CSII) pump therapy was introduced to treat patients with type 1 diabetes (T1DM) more than 20 years ago1,2. At that time, most children and adolescents were being treated with one or two daily injections of mixtures of NPH and regular insulin of animal origin and treatment was adjusted based on urinary glucose excretion. With these inadequate methods, it’s not surprising that glucose levels often averaged over 300 mg/dl and that the children were at high risk for the later development of the devastating complications of diabetes. CSII offered the opportunity to more closely simulate the patterns of plasma insulin levels seen in normal children. The more predictable pharmacokinetics of fast-acting versus intermediate-acting insulin3 and the administration of bolus doses immediately prior to each meal were two obvious advantages of this approach to insulin replacement. The development of newer, smaller pumps with variable basal rate profiles allowed for a closer match in insulin needs, particularly overnight, leading to a reduction in nocturnal hypoglycemia.
KeywordsSevere Hypoglycemia Lispro Insulin Continuous Subcutaneous Insulin Infusion Pump Therapy Continuous Glucose Monitoring System
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- 11.Ahem JH, Boland EA, Doane R, Vincent M, Tamborlane WV. Insulin pump therapy in pediatrics: a therapeutic alternative to safely lower therapy HbA1c levels across all age groups. Pediatric Diabetes, in pressGoogle Scholar
- 14.Buckingham BA, Paguntalan H, Fassl B, Wilson DM. Continuous subcutaneous infusio (CSII) in children under five years of age. Diabetes 2001; 50 (Suppl. 2): A107.Google Scholar
- 16.White NH, Hollander AS, Sadler M, Daniels L. Risks and benefits of continuous subcutaneous insulin infusion (CSII) therapy in children. Diabetes 2001; 50 (Suppl. 2):A66Google Scholar
- 17.Celona-Jacobs N, Weinzimer SA, Rearson M, Hartz D, Katz L, Murphy K. Insulin pump therapy in children: a cautionary tale. Diabetes 2001; 50 (Suppl. 2): A67.Google Scholar
- 18.Laffel L, Loughlin C, Ramchandani N, Butler D, Laffel N, Levine B-S, Anderson B. Glycemic challenges of pump therapy (CSII) in youth with type 1 diabetes (T1DM). Diabetes 2001; 50 (Suppl.2):A66.Google Scholar
- 20.Boland EA. Teens Pumping it Up, 2nd Edition. Sylmar, CA:MiniMed, 1998.Google Scholar
- 26.Boland EA, Monsod T, DeLucia M, Brandt C, Fernando S, Tamborlane WV. Limitations of conventional methods of self monitoring of blood glucose: lessons learned from three days of continuous glucose sensing in pediatric patients with type I diabetes. Diabetes Care 2001; 24Google Scholar