Faster pharmacokinetics and increased patient acceptance of intradermal insulin delivery using a single hollow microneedle in children and adolescents with type 1 diabetes

2013 ◽  
Vol 14 (6) ◽  
pp. 459-465 ◽  
Author(s):  
James J Norman ◽  
Milton R Brown ◽  
Nicholas A Raviele ◽  
Mark R Prausnitz ◽  
Eric I Felner
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Insulin Delivery ◽  
Patient Acceptance ◽  
Hollow Microneedle

scholarly journals Daily insulin requirement of children and adolescents with type 1 diabetes: effect of age, gender, body mass index and mode of therapy.

2008 ◽  
Vol 158 (4) ◽  
pp. 543-549 ◽  
Author(s):  
Susanna Wiegand ◽  
Klemens Raile ◽  
Thomas Reinehr ◽  
Sabine Hofer ◽  
Andrea Näke ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Body Weight ◽  
Regression Analysis ◽  
Children And Adolescents ◽  
Multivariate Regression ◽  
Insulin Delivery ◽  
Insulin Injection ◽  
Multivariate Regression Analysis ◽  
Insulin Requirement

DesignThe purpose of this study was to generate insulin dose (ID) percentiles for children and adolescents with type 1 diabetes mellitus (DM1) having the opportunity to assess this important parameter in relation to age and sex.MethodsDaily IDs per weight (ID/kg) were recorded in 22 177 patients with DM1 (3–25 years of age, DM1 duration of more than 2 years, 48% female) and ID percentiles (ID-Perc) were created statistically. The ID-Perc were compared between male and female, and between multiple insulin injection therapy (MIT) and continuous s.c. insulin infusion (CSII). A multivariate regression analysis was performed for ID in the third year of DM1 with ID/kg, body weight, age, gender, and insulin delivery regimen as variables.ResultsThe 50th ID-Perc (P50) varied among 0.67 IU/kg (age 3 years), 0.93 IU/kg (13 years), and 0.70 IU/kg (23 years) increasing from early childhood to adolescence and decreasing toward adulthood. Highest P50 ID was found at 12 years in females (0.94 IU/kg) and at 14 years in males (0.92 IU/kg). Using ICT, the ID was significantly higher compared with CSII (P50: 0.94 IU/kg versus 0.79 IU/kg at 13 years). In multivariate regression analysis, ID was significantly (P>0.001) associated with age, gender, and insulin delivery regime.ConclusionThe ID-Perc were significantly different during various periods of childhood and were influenced by gender, body weight, and insulin injection regimes. Therefore, the presented data 1) provide evidence to interpret individual ID in children and adolescents with DM1 and 2) more specifically identify children with unusually high (insulin resistance and non-compliance) or low (MODY and persistent remission) insulin requirement.

scholarly journals Insulin-delivery methods for children and adolescents with type 1 diabetes

2020 ◽  
Vol 11 ◽  
pp. 204201882090601
Author(s):  
Zavuga Zuberi ◽  
Elingarami Sauli ◽  
Liu Cun ◽  
Jing Deng ◽  
Wen-Jun Li ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Artificial Pancreas ◽  
Insulin Delivery ◽  
Insulin Administration ◽  
Delivery Methods ◽  
Minimal Invasiveness ◽  
Insulin Pens ◽  
Alternative Routes

Efforts directed toward restoring normal metabolic levels by mimicking the physiological insulin secretion, thereby ensuring safety, efficacy, minimal invasiveness and conveniences, are of great significance in the management of type 1 diabetes among children and adolescents. Regardless of the various technologies being discovered in addressing invasiveness and enhancing medication adherence in the management of type 1 diabetes, yet limited success had been observed among children and adolescents. The multiple daily subcutaneous insulin injections route using vial and syringe, and occasionally insulin pens, remain the most predictable route for insulin administration among children and adolescents. However, this route has been associated with compromised patient compliance, fear of injections and unacceptability, resulting in poor glycemic control, which promote the demand for alternative routes of insulin administration. Alternative routes for delivering insulin are being investigated in children and adolescents with type 1 diabetes; these include the hybrid closed-loop ‘artificial pancreas’ system, oral, inhalation, intranasal routes, and others. This review article explores the current advances in insulin-delivery methods that address the needs of children and adolescents in the treatment of type 1 diabetes.

scholarly journals Assessing the efficacy, safety and utility of 6-month day-and-night automated closed-loop insulin delivery under free-living conditions compared with insulin pump therapy in children and adolescents with type 1 diabetes: an open-label, multicentre, multinational, single-period, randomised, parallel group study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027856 ◽  
Author(s):  
Gianluca Musolino ◽  
Janet M Allen ◽  
Sara Hartnell ◽  
Malgorzata E Wilinska ◽  
Martin Tauschmann ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Closed Loop ◽  
Insulin Pump ◽  
Insulin Delivery ◽  
Open Label ◽  
Pump Therapy ◽  
Glucose Levels ◽  
Sensor Glucose

IntroductionClosed-loop systems titrate insulin based on sensor glucose levels, providing novel means to reduce the risk of hypoglycaemia while improving glycaemic control. We will assess effectiveness of 6-month day-and-night closed-loop insulin delivery compared with usual care (conventional or sensor-augmented pump therapy) in children and adolescents with type 1 diabetes.Methods and analysisThe trial adopts an open-label, multicentre, multinational (UK and USA), randomised, single-period, parallel design. Participants (n=130) are children and adolescents (aged ≥6 and <19 years) with type 1 diabetes for at least 1 year, and insulin pump use for at least 3 months with suboptimal glycaemic control (glycated haemoglobin ≥58 mmol/mol (7.5%) and ≤86 mmol/mol (10%)). After a 2–3 week run-in period, participants will be randomised to 6-month use of hybrid closed-loop insulin delivery, or to usual care. Analyses will be conducted on an intention-to-treat basis. The primary outcome is glycated haemoglobin at 6 months. Other key endpoints include time in the target glucose range (3.9–10 mmol/L, 70–180 mg/dL), mean sensor glucose and time spent above and below target. Secondary outcomes include SD and coefficient of variation of sensor glucose levels, time with sensor glucose levels <3.5 mmol/L (63 mg/dL) and <3.0 mmol/L (54 mg/dL), area under the curve of glucose <3.5 mmol/L (63 mg/dL), time with glucose levels >16.7 mmol/L (300 mg/dL), area under the curve of glucose >10.0 mmol/L (180 mg/dL), total, basal and bolus insulin dose, body mass index z-score and blood pressure. Cognitive, emotional and behavioural characteristics of participants and caregivers and their responses to the closed-loop and clinical trial will be assessed. An incremental cost-effectiveness ratio for closed-loop will be estimated.Ethics and disseminationCambridge South Research Ethics Committee and Jaeb Center for Health Research Institutional Review Office approved the study. The findings will be disseminated by peer-review publications and conference presentations.Trial registration numberNCT02925299; Pre-results.

Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial

The Lancet ◽  
2010 ◽  
Vol 375 (9716) ◽  
pp. 743-751 ◽  
Author(s):  
Roman Hovorka ◽  
Janet M Allen ◽  
Daniela Elleri ◽  
Ludovic J Chassin ◽  
Julie Harris ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Closed Loop ◽  
Crossover Trial ◽  
Insulin Delivery ◽  
Phase 2

Bone status of Indian children and adolescents with type 1 diabetes mellitus

2013 ◽  
Author(s):  
Parthasarathy Lavanya ◽  
Khadilkar Anuradha ◽  
Ekbote Veena ◽  
Chiplonkar Shashi ◽  
Mughal Zulf ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Indian Children ◽  
Bone Status
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