The use of intensive insulin strategies in children with type-1 diabetes mellitus (T1D) to improve glycaemic control has increased considerably in recent years, particularly in the US and Europe. In an attempt to give a more physiological insulin replacement, the use of continuous subcutaneous insulin infusion (CSII), delivered by insulin pump, is now well established in children. Technological advances mean that modern pumps are compact, 'user-friendly', and possess an excellent safety record. Recent guidance from the National Institute of Health and Clinical Excellence (NICE) indicates that CSII should be considered for many children with T1D. In this paper we review the pros and cons of this mode of treatment, and highlight the importance of CSII being delivered as part of a comprehensive package of care by a specialist paediatric diabetes team. We present some of our early experiences of insulin pump use and consider how CSII may develop in the future.
- Continuous subcutaneous insulin infusion
- Diabetic ketoacidosis
- Insulin pump
- Type-1 diabetes mellitus