TY - JOUR
T1 - Insulin therapy in neonatal diabetes mellitus
T2 - a review of the literature
AU - Rabbone, Ivana
AU - Barbetti, Fabrizio
AU - Gentilella, Raffaella
AU - Mossetto, Gilberto
AU - Bonfanti, Riccardo
AU - Maffeis, Claudio
AU - Iafusco, Dario
AU - Piccinno, Elvira
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Aims Neonatal diabetes mellitus (NDM) is a rare disorder, and guidance is limited regarding its optimal management. We reviewed insulin usage in NDM, with a focus on continuous subcutaneous insulin infusion (CSII). Methods A PubMed search identified 40 reports of patients with NDM treated with insulin published between 1994 and 2016. Results Data concerning treatment of NDM are limited. CSII resolves some of the issues associated with insulin therapy in neonates. No clinical trials of CSII in NDM have been reported. Case reports suggest that CSII is a safe and effective means of treating NDM. CSII was initiated to improve glycaemic control, for practicality and convenience, and to overcome difficulties associated with the maintenance of long-term intravenous catheters. CSII can provide better glycaemic control than multiple daily injections, with few hypoglycaemic events. Continuous glucose monitoring integrated with the pump helps provide more precise control of blood glucose levels. CSII generally uses short-acting insulin or rapid-acting insulin analogues, and those that are approved for use in neonates appear to be appropriate for the treatment of NDM using an insulin pump. Conclusions Information from case reports indicates that CSII is safe and effective for the management of NDM.
AB - Aims Neonatal diabetes mellitus (NDM) is a rare disorder, and guidance is limited regarding its optimal management. We reviewed insulin usage in NDM, with a focus on continuous subcutaneous insulin infusion (CSII). Methods A PubMed search identified 40 reports of patients with NDM treated with insulin published between 1994 and 2016. Results Data concerning treatment of NDM are limited. CSII resolves some of the issues associated with insulin therapy in neonates. No clinical trials of CSII in NDM have been reported. Case reports suggest that CSII is a safe and effective means of treating NDM. CSII was initiated to improve glycaemic control, for practicality and convenience, and to overcome difficulties associated with the maintenance of long-term intravenous catheters. CSII can provide better glycaemic control than multiple daily injections, with few hypoglycaemic events. Continuous glucose monitoring integrated with the pump helps provide more precise control of blood glucose levels. CSII generally uses short-acting insulin or rapid-acting insulin analogues, and those that are approved for use in neonates appear to be appropriate for the treatment of NDM using an insulin pump. Conclusions Information from case reports indicates that CSII is safe and effective for the management of NDM.
KW - Diabetes mellitus
KW - Permanent neonatal – diabetes mellitus
KW - Rapid-acting – insulin infusion systems – insulin lispro – insulin aspart
KW - Transient neonatal – insulin
UR - http://www.scopus.com/inward/record.url?scp=85019234725&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2017.04.007
DO - 10.1016/j.diabres.2017.04.007
M3 - Review article
SN - 0168-8227
VL - 129
SP - 126
EP - 135
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
ER -