Ewa Pańkowska

Continuous subcutaneous insulin infusion vs. multiple daily injections in children with type 1 diabetes: a systematic review and meta‐analysis of randomized control trials

Objective:  To investigate potential effects of continuous subcutaneous insulin infusion (CSII) compared with multiple daily injections (MDI) on glycemic control in children with type 1 diabetes mellitus (T1DM).

Application of novel dual wave meal bolus and its impact on glycated hemoglobin A1c level in children with type 1 diabetes

Background: An insulin pump is an advanced technology offering new options of bolus – normal (N), dual wave (D‐W) or square wave (S‐W) bolus to deliver mealtime insulin.

Bolus Calculator with Nutrition Database Software, a New Concept of Prandial Insulin Programming for Pump Users

Bolus calculators are effective tools in controlling blood glucose levels in patients treated with insulin. Diabetics is a new software devised for patients to facilitate and improve self-managing for prandial insulin dosing and for better controlling food intake. This device contains two integral parts: A nutrition database and a bolus calculator. The algorithm is based on a formula in which carbohydrate (CHO) and either fat and/or protein (FP) products are engulfed in insulin. The insulin dose setting is programmed individually for CHO in a normal bolus (N-W) and for FP in a square-wave bolus (S-W). The device calculates the dose of insulin for N-W or S-W, suggests the optimal kind of bolus, and indicates the timing in hours for an S-W bolus. In addition, this calculator, which contains a nutrition database and insulin dosing software, helps determine the correct type of necessary boluses for selected foods.

Basal insulin and total daily insulin dose in children with type 1 diabetes using insulin pumps

Objective:  To assess the contribution of basal insulin to the total daily dose (CBITDD) and to identify the determinant factors in children with type 1 diabetes mellitus.

The effect of bolus and food calculator Diabetics on glucose variability in children with type 1 diabetes treated with insulin pump: the results of RCT.

The calculation of prandial insulin dose is a complex process in which many factors should be considered. High glucose variability during the day, arising from difficulties which include errors made in food counting and inappropriate insulin adjustments, influence hemoglobin A1c levels. During this study, in children using insulin pumps to manage type 1 diabetes, we compared 2‐h postprandial blood glucose levels (BGL) and glucose variability when calorie tables and mental calculation were used, to when Diabetics software was used.

Sensor augmented pump therapy from onset of type 1 diabetes: late follow-up results of the Pediatric Onset Study

To evaluate the metabolic control and β‐cell function 1 yr after the end of the European multicentre randomized Pediatric Onset Study.

Sustained metabolic control and low rates of severe hypoglycaemic episodes in preschool diabetic children treated with continuous subcutaneous insulin infusion

Aim: To evaluate the safety and efficacy of continuous subcutaneous insulin infusion (CSII) in children under 7 years of age.

Age‐dependent basal insulin patterns in children with type 1 diabetes treated with continuous subcutaneous insulin infusion

Aims: Identifying age‐dependent basal rates in type 1 diabetic children treated with continuous subcutaneous insulin infusion (CSII).

Insulin requirement in preschoolers treated with insulin pumps at the onset of type 1 diabetes mellitus

The aim: The aim of this study is to analyze changes in the basal insulin requirement in preschoolers treated with insulin pump at the onset of T1DM, using system to calculate meal time insulin.

Equal Metabolic Control but Superior Caregiver Treatment Satisfaction with Insulin Aspart in Preschool Children

BACKGROUND The aim of this study was to compare the metabolic outcomes, safety, and caregiver treatment satisfaction of basal-bolus multiple daily injection (MDI) therapy with mealtime insulin aspart (IAsp) or human insulin (HI) (both with basal NPH insulin), or of continuous subcutaneous infusion (CSII) with IAsp in preschool-age children with type 1 diabetes mellitus. METHODS After a 3-week HI MDI run-in, 61 children <7 years old were randomized to IAsp MDI or HI MDI or allocated to IAsp CSII for 26 weeks. Efficacy measures were glycated hemoglobin (A1C) and overall metabolic control at study end point. Safety evaluation included hypoglycemia and adverse events. Caregiver treatment satisfaction was evaluated using a World Health Organization questionnaire with 7-point scale answers. RESULTS A1C level and overall metabolic control remained unchanged in all groups. Minor hypoglycemic episodes were equivalent between groups; few major hypoglycemic events occurred. Caregivers of children receiving IAsp CSII documented a greater increase in treatment satisfaction total scores (P = 0.04 vs. HI MDI and IAsp MDI group) and expressed satisfaction with the frequency of hypoglycemic events. CONCLUSIONS After 26 weeks of treatment with IAsp CSII, IAsp MDI, or HI MDI, all metabolic control parameters remained unchanged and equivalent. Caregiver treatment satisfaction was higher in parents who chose IAsp CSII pump therapy for their children.