Reasons for the discontinuation of therapy of personal insulin pump in children with type 1 diabetes

Binek, Alicja; Rembierz-Knoll, Agnieszka; Polańska, Joanna; Jarosz-Chobot, Przemysława

doi:10.18544/pedm-21.02.0026

Cited by 20 publications

(18 citation statements)

References 13 publications

(12 reference statements)

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“…CSII offers better flexibility in basal insulin adjustments and the management of exercise-associated hyperglycaemia (100). CSII is associated with reduced post-exercise hyperglycaemia compared to MDI (94), but can create frustrating challenges for sports requiring pump disconnection (101). CSII can also contribute to a greater sense of being "diseased" for some individuals and may promote stigma (101).…”

Section: Glucose Monitoring Cgm and Other Emerging Tools For Exercismentioning

confidence: 99%

“…CSII is associated with reduced post-exercise hyperglycaemia compared to MDI (94), but can create frustrating challenges for sports requiring pump disconnection (101). CSII can also contribute to a greater sense of being "diseased" for some individuals and may promote stigma (101). Prolonged pump disconnect (> 60 minutes) should be managed with reconnecting, testing and re-infusion if necessary, or a change to basal insulin provision by needle.…”

Section: Glucose Monitoring Cgm and Other Emerging Tools For Exercismentioning

confidence: 99%

See 1 more Smart Citation

Exercise management in type 1 diabetes: a consensus statement

Riddell

Gallen

Smart

et al. 2017

The Lancet Diabetes & Endocrinology

668

797

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Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.

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Section: Glucose Monitoring Cgm and Other Emerging Tools For Exercismentioning

confidence: 99%

Section: Glucose Monitoring Cgm and Other Emerging Tools For Exercismentioning

confidence: 99%

Exercise management in type 1 diabetes: a consensus statement

Riddell

Gallen

Smart

et al. 2017

The Lancet Diabetes & Endocrinology

668

797

View full text Add to dashboard Cite

show abstract

“…For example, aerobic exercise may accelerate basal insulin absorption from the subcutaneous depot (74), whereas basal insulin glargine absorption is largely unaffected (99). Skin irritation, pump tubing, and wearing a pump that is visible to others can be concerns (100). In certain sports, such as basketball or contact sports, wearing pumps and other devices may be prohibited during competition.…”

Section: Use Of Csii and MDI For Activitymentioning

confidence: 99%

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

et al. 2016

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The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes and prediabetes. Recommendations and precautions vary depending on individual characteristics and health status. In this Position Statement, we provide a clinically oriented review and evidencebased recommendations regarding physical activity and exercise in people with type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, and prediabetes.Physical activity includes all movement that increases energy use, whereas exercise is planned, structured physical activity. Exercise improves blood glucose control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss, and improves well-being (1,2). Regular exercise may prevent or delay type 2 diabetes development (3). Regular exercise also has considerable health benefits for people with type 1 diabetes (e.g., improved cardiovascular fitness, muscle strength, insulin sensitivity, etc.) (4). The challenges related to blood glucose management vary with diabetes type, activity type, and presence of diabetes-related complications (5,6). Physical activity and exercise recommendations, therefore, should be tailored to meet the specific needs of each individual. TYPES AND CLASSIFICATIONS OF DIABETES AND PREDIABETESPhysical activity recommendations and precautions may vary by diabetes type. The primary types of diabetes are type 1 and type 2. Type 1 diabetes (5%-10% of cases) results from cellular-mediated autoimmune destruction of the pancreatic b-cells, producing insulin deficiency (7). Although it can occur at any age, b-cell destruction rates vary, typically occurring more rapidly in youth than in adults. Type 2 diabetes (90%-95% of cases) results from a progressive loss of insulin secretion, usually also with insulin resistance. Gestational diabetes mellitus occurs during pregnancy, with screening typically occurring at 24-28 weeks of gestation in pregnant women not previously known to have diabetes. Prediabetes is diagnosed when blood glucose levels are above the normal range but not high enough to be classified as diabetes; affected individuals have a heightened risk of developing type 2 diabetes (7) but may prevent/delay its onset with physical activity and other lifestyle changes (8). TYPES OF EXERCISE AND PHYSICAL ACTIVITYAerobic exercise involves repeated and continuous movement of large muscle groups (9). Activities such as walking, cycling, jogging, and swimming rely primarily on aerobic energy-producing systems. Resistance (strength) training includes exercises with free weights, weight machines, body weight, or elastic resistance bands. Flexibility exercises improve range of motion around joints (10). Balance exercises benefit gait and prevent falls (11). Activities like tai chi and yoga combine flexibility, balance, and resistance activities.

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“…Reasons for discontinuing CSII therapy include greater sense of disease, difficulties in doing sports, poorer sense of well-being during CSII therapy, wearing an insulin pump, embarrassment, pain at the site of needle insertion, poor glycaemic control, fear and dislike of frequent blood glucose monitoring. [53][54][55] Qualitative work undertaken in a study of 19 parents with children aged < 12 years who had changed from MDI to CSII reported the benefits of CSII therapy to include no longer having to administer painful injections, fewer dietary restrictions, improved quality of family life and improved glycaemic control. 56 When patients and parents were interviewed in another study, they also reported improved glycaemic control, in addition to increased lifestyle flexibility and participation in social activities, during CSII therapy.…”

Section: Acceptability Of Continuous Subcutaneous Insulin Infusion Anmentioning

confidence: 99%

Continuous subcutaneous insulin infusion versus multiple daily injections in children and young people at diagnosis of type 1 diabetes: the SCIPI RCT

Blair

McKay

Ridyard

et al. 2018

Health Technol Assess

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This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 22, No. 42. See the NIHR Journals Library website for further project information. The cost of insulin pumps and consumables supplied by F. Hoffman-La Roche AG (Basel, Switzerland) for the purpose of the study were subject to a 25% discount on standard NHS costs.

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Reasons for the discontinuation of therapy of personal insulin pump in children with type 1 diabetes

Abstract: The individual psycho-emotional state of the child and appropriate education are important at the start and continuation of CSII.

Cited by 20 publications

References 13 publications

Exercise management in type 1 diabetes: a consensus statement

Exercise management in type 1 diabetes: a consensus statement

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

Continuous subcutaneous insulin infusion versus multiple daily injections in children and young people at diagnosis of type 1 diabetes: the SCIPI RCT

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