PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2021; 04(04): 175-181
DOI: 10.4103/jdep.jdep_36_21
Original Article

Effectiveness, safety, and parental satisfaction of insulin pump therapy versus multiple-dose injection therapy in preschool children with type 1 diabetes: A systematic review and meta-analysis

Autoren

  • Tawfik Muammar

    Imperial College London Diabetes Centre, Abu Dhabi

  • Julia Smyth

    1   Department of Paediatrics, Craigavon Area Hospital, Craigavon

  • Omar Aldaleel

    2   Department of Paediatrics, Dumfries and Galloway Royal Infirmary, Dumfries

  • Salah Gashout

    2   Department of Paediatrics, Dumfries and Galloway Royal Infirmary, Dumfries

  • Matthew Jamieson

    3   Department of Statistics, University of Glasgow, Glasgow, UK
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints

Background: Despite the increasing demand for continuous subcutaneous insulin infusion (CSII) or insulin pump therapy in preschool children with Type 1 diabetes (T1D), reports on its advantages over conventional methods, particularly multiple dose injection (MDI) therapy, are scant. Objectives: We aimed to investigate the effectiveness, safety, and parental satisfaction of using CSII compared to MDI in preschool children with T1D. This study also seeks to establish criteria to help clinicians choose patients most suitable for CSII. Methods: Relevant terms based on the study outcomes were used to search electronic databases and manual search for the literature. Selected articles were then thoroughly reviewed and evaluated. Results: The effect in the meta-analysis showed a small, nonsignificant positive effect on HbA1c of the CSII compared to the MDI insulin intervention method (mean Cohen's d effect size = 0.25, Standard Error = 0.18, P = 0.16 (n = 127)) and a small, nonsignificant negative effect on safety of the CSII compared to the MDI insulin intervention method (mean Cohen's d effect size = −0.26, SE = 0.36, P = 0.47 [n = 70]). For parental satisfaction, data were small and therefore inappropriate for meta-analysis. Conclusion: For preschool children, the effectiveness and safety of insulin pump therapy compared with MDI therapy was considered statistically nonsignificant. All preschool children with T1D can be considered potentially eligible candidates for insulin pump therapy. Suggested selection criteria to apply when considering preschool children for insulin pump therapy were presented.

Keywords

Child - diabetes mellitus - insulin - insulin infusion systems - preschool - type 1

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 04. August 2021

Angenommen: 21. August 2021

Artikel online veröffentlicht:
14. Juli 2022

© 2021. Gulf Association of Endocrinology and Diabetes (GAED). All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Pickup JC, Hammond P. NICE guidance on continuous subcutaneous insulin infusion 2008: Review of the technology appraisal guidance. Diabet Med 2009;26:1-4.
  • 2 Barnard K, Thomas S, Royle P, Noyes K, Waugh N. Fear of hypoglycaemia in parents of young children with type 1 diabetes: A systematic review. BMC Pediatr 2010;10:50.
  • 3 Whittemore R, Jaser S, Chao A, Jang M, Grey M. Psychological experience of parents of children with type 1 diabetes: A systematic mixed-studies review. Diabetes Educ 2012;38:562-79.
  • 4 Kobos E, Imiela J. Factors affecting the level of burden of caregivers of children with type 1 diabetes. Appl Nurs Res 2015;28:142-9.
  • 5 Hilliard ME, Monaghan M, Cogen FR, Streisand R. Parent stress and child behaviour among young children with type 1 diabetes. Child Care Health Dev 2011;37:224-32.
  • 6 Weinzimer SA, Doyle EA, Steffen AT, Sikes KA, Tamborlane WV. Rediscovery of insulin pump treatment of childhood type 1 diabetes. Minerva Med 2004;95:85-92.
  • 7 Smaldone A, Ritholz MD. Perceptions of parenting children with type 1 diabetes diagnosed in early childhood. J Pediatr Health Care 2011;25:87-95.
  • 8 Misso ML, Egberts KJ, Page M, O'Connor D, Shaw J. Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus. Cochrane Database Syst Rev 2010;20:CD005103.
  • 9 Shehadeh N, Battelino T, Galatzer A, Naveh T, Hadash A, de Vries L, et al. Insulin pump therapy for 1–6-year-old children with type 1 diabetes. Isr Med Assoc J 2004;6:284-6.
  • 10 Monami M, Lamanna C, Marchionni N, Mannucci E. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: A meta-analysis. Acta Diabetologica Dec 2010;47:77-81.
  • 11 Steineck I, Cederholm J, Eliasson B, Rawshani A, Eeg-Olofsson K, Svensson AM, et al. Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18,168 people with type 1 diabetes: Observational study. BMJ 2015;350:h3234.
  • 12 Wheeler BJ, Donaghue KC, Heels K, Ambler GR. Family perceptions of insulin pump adverse events in children and adolescents. Diabetes Technol Ther 2014;16:204-7.
  • 13 Phillip M, Battelino T, Rodriguez H, Danne T, Kaufman F; European Society for Paediatric Endocrinology, et al. Use of insulin pump therapy in the pediatric age-group: Consensus statement from the European Society for Paediatric Endocrinology, the Lawson Wilkins Pediatric Endocrine Society, and the International Society for Pediatric and Adolescent Diabetes, endorsed by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2007;30:1653-62.
  • 14 Zysberg L, Lang T. Supporting parents of children with type 1 diabetes mellitus: A literature review. Patient Intelligence 2015;7:21-31.
  • 15 Holopainen A, Hakulinen-Viitanen T, Tossavainen K. Systematic review--a method for nursing research. Nurse Res 2008;16:72-83.
  • 16 Whiting LS. Systematic review protocols: An introduction. Nurse Res 2009;17:34-43.
  • 17 Bougnères PF, Landier F, Lemmel C, Mensire A, Chaussain JL. Insulin pump therapy in young children with type 1 diabetes. J Pediatr 1984;105:212-7.
  • 18 Litton J, Rice A, Friedman N, Oden J, Lee MM, Freemark M. Insulin pump therapy in toddlers and preschool children with type 1 diabetes mellitus. J Pediatr 2002;141:490-5.
  • 19 Jeha GS, Karaviti LP, Anderson B, Smith EO, Donaldson S, McGirk TS, et al. Insulin pump therapy in preschool children with type 1 diabetes mellitus improves glycemic control and decreases glucose excursions and the risk of hypoglycemia. Diabetes Technol Ther 2005;7:876-84.
  • 20 Qin Y, Yang LH, Huang XL, Chen XH, Yao H. Efficacy and safety of continuous subcutaneous insulin infusion vs. multiple daily injections on type 1 diabetes children: A meta-analysis of randomized control trials J Clin Res Pediatr Endocrinol 2018;10:316-23.
  • 21 Li AY, So WK, Leung DY. Effectiveness of continuous subcutaneous insulin infusion on parental quality of life and glycemic control among children with T1D: Meta-analysis. Worldviews Evid Based Nurs 2018;15:394-400.
  • 22 Opipari-Arrigan L, Fredericks EM, Burkhart N, Dale L, Hodge M, Foster C. Continuous subcutaneous insulin infusion benefits quality of life in preschool-age children with type 1 diabetes mellitus. Pediatric Diabetes 2007;8:377-83.
  • 23 Nuboer R, Borsboom GJ, Zoethout JA, Koot HM, Bruining J. Effects of insulin pump vs. injection treatment on quality of life and impact of disease in children with type 1 diabetes mellitus in a randomized, prospective comparison. Pediatr Diabetes 2008;9:291-6.
  • 24 Wilson DM, Buckingham BA, Kunselman EL, Sullivan MM, Paguntalan HU, Gitelman SE. A two-center randomized controlled feasibility trial of insulin pump therapy in young children with diabetes. Diabetes Care 2005;28:15-9.
  • 25 Ferguson CJ. An effect size primer: A guide for clinicians and researchers. Prof Psychol Res Pract 2009;40:532.
  • 26 DiMeglio LA, Pottorff TM, Boyd SR, France L, Fineberg N, Eugster EA. A randomized, controlled study of insulin pump therapy in diabetic preschoolers. J Pediatr 2004;145:380-4.
  • 27 Fox LA, Buckloh LM, Smith SD, Wysocki T, Mauras N. A randomized controlled trial of insulin pump therapy in young children with type 1 diabetes. Diabetes Care 2005;28:1277-81.
  • 28 Nabhan ZM, Kreher NC, Greene DM, Eugster EA, Kronenberger W, DiMeglio LA. A randomized prospective study of insulin pump vs. insulin injection therapy in very young children with type 1 diabetes: 12-month glycemic, BMI, and neurocognitive outcomes. Pediatr Diabetes 2009;10:202-8.