CONTROL OF TYPE 1 DIABETES IN CHILDREN USING AN INSULIN PUMP: THE ЕXPERIENCE OF ODESA DOCTORS
DOI:
https://doi.org/10.32782/2226-2008-2023-4-10Keywords:
children, adolescents, diabetes, diabetes control, insulin pump therapy, continuous glucose monitoringAbstract
Insulin pump therapy for type 1 diabetes in children is known to be associated with improved glycemic control. In 2010, a Cochrane systematic review of 23 randomized controlled trials comparing pump insulin therapy with multiple daily injections found a significant difference in glycemic control, namely glycated hemoglobin levels, in favor of pump insulin therapy. In the SWEET (Better Control of Diabetes in Children and Adolescents: Working to Create Centers of Reference) registry, 49% of children aged 6 to 11 years and 42% of children aged 12 to 18 years used insulin pumps in 2016; rates ranged from 0 to 90% among 46 diabetes centers worldwide. In addition to the actual insulin pump of a patient with type 1 diabetes, it is necessary to conduct continuous glucose monitoring. We have developed a certain algorithm for providing assistance, namely, the transfer of a child to pump insulin therapy. The results of our patients inspire us to further work. After all, glycemic control improves almost immediately and, what is very important, the quality of life of the child and his family. One of our patients, M., 11 years old, has been suffering from type 1 diabetes for 4 years. Before the insulin pump was installed, the patient had episodes of hyperglycemia following continuous glucose monitoring with peak values of approximately 12.3 mmol/L and episodes of hypoglycemia (3.2 mmol/L). After the insulin pump was installed, the patient's maximum glycemic values were 8.4 mmol/l, and the minimum was 4.5 mmol/l. These outcomes indicate that this patient has improved T1DM control after the insulin pump and that the boy will have a better quality of life without diabetes complications. Odesa has joined the worldwide trend of installing insulin pumps for children living with type 1 diabetes. PIT improves the quality and life expectancy of patients with diabetes. Our activities within the "Type 1 Diabetes School" will continue. We invite colleagues and patients to cooperate on the diabetes issue.
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