Continuous Subcutaneous Insulin Infusion Characteristics in Type 1 Diabetes Children and Adolescents in Qatar

Petrovski, Goran; Khalaf, Fawziya Al; Hussain, Khalid; Campbell, Judith; Awwa, Ahmed El

doi:10.1007/s13300-018-0510-5

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…This open-label, non-randomized, single-arm, single-center, clinical investigation study was conducted at Sidra Medicine in Doha, Qatar, and enrolled individuals aged 7-18 years with type 1 diabetes > 1 year, on MDI with SMBG, with or without RT-CGM or isCGM, with no prior pump experience, and with an HbA1c level < 12.5%. Individuals were recruited at regular clinic visits, following the clinical pathway for therapy [21]. This clinical assessment emphasizes the following individual aspects: frequency of SMBG controls per day, knowledge of carbohydrate counting, insulin dose adjustments based on carbohydrate intake and blood glucose level, the ability to identify changes in insulin requirements due to physical activity and sick days, ability to recognize, troubleshoot and manage hyperglycemia and hypoglycemia.…”

Section: Methodsmentioning

confidence: 99%

10-Day structured initiation protocol from multiple daily injection to hybrid closed-loop system in children and adolescents with type 1 diabetes

et al. 2020

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Aim The aim of this study was to evaluate the 10-day initiation protocol for MiniMed 670G hybrid closed-loop (HCL) system in individuals with type 1 diabetes on multiple daily injection (MDI) in achieving desirable glycemic control. Methods An open-label single-arm, single-center, clinical investigation in children aged 7-18 years on MDI following a structured protocol: 2 days, HCL system assessment; 5 days, HCL system training (2-h sessions on 5 consecutive days with groups of 3-5 participants and families); 3 days, Manual Mode use of HCL system; 84 days, Auto Mode use of the HCL system, cumulating in 10 days from MDI to Auto Mode activation. Results A total of 30 children (age 10.24 ± 2.6 years) were enrolled in the study, and all completed the planned 84 days on Auto Mode. The participants used the sensor for a median of 92% of the time and spent a median of 89% in Auto Mode. The mean HbA1c decreased from 8.2 ± 1.4% (66 ± 15.3 mmol/mol) at baseline to 6.7 ± 0.5% (50 ± 5.5 mmol/mol) at the end of the study (p = 0.017). Time in range (70-180 mg/dL) increased from 46.9 ± 18.5% at baseline to 75.6 ± 6.9% in Auto Mode (p < 0.001). This was achieved while spending 2.8% of the time below 70 mg/dL and without any severe hypoglycemia or DKA. Conclusion Children and adolescents with type 1 diabetes on MDI therapy can successfully initiate the HCL system, using a concise structured 10-day protocol.

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Section: Methodsmentioning

confidence: 99%

10-Day structured initiation protocol from multiple daily injection to hybrid closed-loop system in children and adolescents with type 1 diabetes

et al. 2020

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“…In a study from Qatar, CSII significantly improved glucose control in T1DM children and adolescents who use a standardized protocol. A reduction of HbA1c by 1.6% was achieved after 1 year of CSII initiation (95). A report from Qatar was the first to demonstrate the use of the hybrid closed-loop system in managing a patient with T1DM that resulted in a 1.3% decrease in HBA1c value.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Childhood Diabetes Research in the Middle East Region

et al. 2019

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Background: Diabetes mellitus (DM) is a common chronic disorder in children and is caused by absolute or relative insulin deficiency, with or without insulin resistance. There are several different forms of childhood DM. Children can suffer from neonatal diabetes mellitus (NDM), type 1 diabetes (T1DM), type 2 diabetes (T2DM), Maturity Onset Diabetes of the Young (MODY), autoimmune monogenic, mitochondrial, syndromic and as yet unclassified forms of DM. The Middle East has one of the highest incidences of several types of DM in children; however, it is unclear whether pediatric diabetes is an active area of research in the Middle East and if ongoing, which research areas are of priority for DM in children.Objectives: To review the literature on childhood DM related to research in the Middle East, summarize results, identify opportunities for research and make observations and recommendations for collaborative studies in pediatric DM.Methods: We conducted a thorough and systematic literature review by adhering to a list recommended by PRISMA. We retrieved original papers written in English that focus on childhood DM research, using electronic bibliographic databases containing publications from the year 2000 until October 2018. For our final assessment, we retrieved 429 full-text articles and selected 95 articles, based on our inclusion and exclusion criteria.Results: Our literature review suggests that childhood DM research undertaken in the Middle East has focused mainly on reporting retrospective review of case notes, a few prospective case studies, systemic reviews, questionnaire-based studies, and case reports. These reported studies have focused mostly on the incidence/prevalence of different types of DM in childhood. No studies report on the establishment of National Childhood Diabetes Registries. There is a lack of consolidated studies focusing on national epidemiology data of different types of childhood DM (such as NDM, T1DM, T2DM, MODY, and syndromic forms) and no studies reporting on clinical trials in children with DM.Conclusions: Investing in and funding basic and translational childhood diabetes research and encouraging collaborative studies, will bring enormous benefits financially, economically, and socially for the whole of the Middle East region.

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“…4,20 The results from previous studies comparing MDI versus CSII are conflicting. 4,[21][22][23][24][25] In some literature, it has been shown that CSII is superior to MDI in lowering hemoglobin A1c levels as well improving glycemic profile. 21,23 However, others showed no difference between the 2 groups especially in the first year of treatment.…”

Section: Introductionmentioning

confidence: 99%

“…4,[21][22][23][24][25] In some literature, it has been shown that CSII is superior to MDI in lowering hemoglobin A1c levels as well improving glycemic profile. 21,23 However, others showed no difference between the 2 groups especially in the first year of treatment. 4,25 Also, there was no significant difference between CSII and MDI regarding non-severe hypoglycemia as an adverse effect in previous studies.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Insulin Pump Therapy Versus Multiple Daily Injections in Children With Type 1 Diabetes Mellitus in a Specialized Center in Riyadh

Babiker

Alammari

Aljuraisi

et al. 2022

Clin Med Insights Endocrinol Diabetes

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Objectives: Comparison of continuous subcutaneous insulin infusion (CSII) with multiple daily injections (MDI) in achieving glycemic control in youths with type 1 diabetes mellitus (T1DM). Methods: Retrospective cohort study including 2 matched groups of youths with T1DM treated by CSII or MDI in a tertiary specialized children’s hospital in Saudi Arabia. Children and adolescents aged up to 18 years, diagnosed with T1DM and using CSII or MDI, from the period 2016 to 2018. Patients on MDI were newly-diagnosed patients with T1DM who had the disease for only 1 year duration; all CSII patients had at least 1 to 2 years of T1DM but who had just started on pumps in the past 3 months. We excluded patients with other autoimmune diseases, non-ambulatory patients and those admitted to hospital for non-diabetes reasons. Primary outcome was HbA1c at 1, 2, and 3 years, with weight gain as a secondary outcome. Ambulatory glycemic profile was analyzed from a subset of patients using intermittently scanned continuous glucose monitoring (isCGM). Results: A total of 168 youths with T1DM (n = 129 in the MDI group, n = 39 in the CSII group) were included. The CSII group consistently had lower HbA1c levels compared to the MDI group throughout a 3-year follow up period: 8.1% versus 10.1, P-value < .001 at 1 year, 7.5% versus 10.1% at 2 years, P-value < .001, 8.9% versus 10.3% at 3 years, P-value = .033. Body mass index significantly increased in both groups at 1 year, although greater in CSII group. In a subgroup using isCGM (n = 37 on MDI and n = 29 on CSII), the CSII group had a lower average blood glucose (194 mg/dL vs 228 mg/dL, P-value = .028) and a lower estimated HbA1c level (8.4% vs 9.6%, P-value = .022). Conclusion: Treatment with CSII resulted in lower HbA1c compared to MDI in our cohort, which was sustained over a 3-year period.

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Continuous Subcutaneous Insulin Infusion Characteristics in Type 1 Diabetes Children and Adolescents in Qatar

Cited by 7 publications

References 30 publications

10-Day structured initiation protocol from multiple daily injection to hybrid closed-loop system in children and adolescents with type 1 diabetes

10-Day structured initiation protocol from multiple daily injection to hybrid closed-loop system in children and adolescents with type 1 diabetes

A Systematic Review of Childhood Diabetes Research in the Middle East Region

The Effectiveness of Insulin Pump Therapy Versus Multiple Daily Injections in Children With Type 1 Diabetes Mellitus in a Specialized Center in Riyadh

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