Use of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes mellitus: a systematic mapping review

Insulin Pump Therapy and Adverse Skin Reactions With Focus on Allergic Contact Dermatitis in Individuals Living With Diabetes Mellitus: A Systematic Review and Clinical-Based Update

BACKGROUND

The use of insulin pumps (continuous subcutaneous insulin infusion [CSII]) in individuals living with type 1 diabetes (T1D) improves disease control. However, adverse skin reactions may hamper compliance. We aimed to assess the relationship of insulin pumps, particularly that of infusion set therapy, used in children and adults with T1D and dermatitis including allergic contact dermatitis (ACD).

METHODS

A systematic search of PubMed, and EMBASE, of full-text studies reporting dermatitis in persons with diabetes using a CSII was conducted from 2020 to 2023. The Newcastle-Ottawa Scale was used to assess study quality. The inventory performed at the Department of Occupational and Environmental Dermatology, Malmö, Sweden (YMDA) was also performed highlighting the diagnostic process.

RESULTS

Among the 391 screened abstracts, 21 studies fulfilled the inclusion criteria. Seven studies included data on children only, four studies were on adults, and nine studies reported data on both children and adults. Participants were exposed to a broad range of pumps. Dermatitis was rarely specified. Up to 60% of those referred to a university hospital due to skin reactions possibly related to insulin pumps had an ACD.

CONCLUSIONS

The review and our findings indicate that there is not sufficient focus on contact allergy in the primary toxicological evaluations of substances used also for insulin pump therapy products and that possible adverse skin reactions are not correctly followed up in the clinical setting.

Use of diabetes technologies in the primary school environment: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to map the literature on the use of diabetes technologies in the primary school environment by children with type 1 diabetes (T1D) and/or their parents.

INTRODUCTION

T1D is a complex chronic disorder that is one of the fastest growing diseases in childhood. Technological advances in recent times have seen a growth in the use of diabetes technologies. Despite these advances, having T1D still creates challenges for parents' and children's school experiences. Furthermore, the literature on the use of diabetes technologies during the primary school day is under-investigated.

INCLUSION CRITERIA

This review will consider peer-reviewed primary research studies or systematic reviews that include children with T1D aged 6 to 12 years who use diabetes technologies in the primary school environment and/or their parents.

METHODS

This review will be conducted in accordance with JBI methodology for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Following an initial limited search, a full search strategy was developed using index terms and key text words. This strategy will be used across relevant databases, including Embase, MEDLINE (Ovid), CINAHL (EBSCOhost), and Web of Science Core Collection for the full scoping review. There will be no limitations on language or year. Two reviewers will independently screen titles, abstracts, and full-text articles and extract relevant data using the JBI data extraction instrument. Data will be presented in a descriptive manner, supported by tables and charts, and accompanied by a narrative summary.

Entwicklung der Insulintherapie in der pädiatrischen Diabetologie- Auswertung des DPV-Registers von 1995-2021

Der Einsatz von Insulin zur Therapie des Diabetes mellitus Typ 1 beim Menschen hat vor 100 Jahren erstmals zum Überleben betroffener Patienten nach Manifestation der Erkrankung geführt. War zuvor die Diagnose mit der Gewissheit verknüpft, dass es sich um eine unmittelbar lebensbedrohliche Erkrankung handelt, wurde mit dem Einsatz des Hormons Insulin ab 1922 die Perspektive eröffnet, den Verlauf der Erkrankung zu beeinflussen und die Prognose für die Patienten damit zu verbessern.

Ziel der vorliegenden Arbeit ist die Analyse von 92366 Patienten eines pädiatrischen Patientenkollektivs aus Deutschland, Österreich, Luxemburg und der Schweiz im Hinblick auf den Einsatz der verschiedenen Insulinarten im Zeitraum 1995–2021.

Der Anteil der Insulinanaloga stieg insbesondere seit dem Jahr 2000 stark an, auch da die Nutzung von Insulinpumpen mit Analoginsulin im Vergleich zur intensivierten Insulintherapie mit Pen für alle Altersgruppen deutlich anstieg. Bereits im Jahr 2010 betrug der Anteil der Insulinanaloga in der Diabetestherapie bei Kindern insgesamt > 60 %.

Im Jahr 2022 können Diabetologen auf mehr als zehn Insulinarten und mindestens fünf verschiedene Therapieformen zur Behandlung des Diabetes mellitus Typ 1 zurückgreifen.