Insulin therapy in neonatal diabetes mellitus: a review of the literature

I Rabbone, F Barbetti, R Gentilella, G Mossetto, R Bonfanti, C Maffeis, D Iafusco, E Piccinno

Research output: Contribution to journalArticle

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Abstract

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. © 2017 Elsevier B.V.
Original languageEnglish
Pages (from-to)126-135
Number of pages10
JournalDiabetes Research and Clinical Practice
Volume129
Issue number5
DOIs
Publication statusPublished - 2017

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Subcutaneous Infusions
Diabetes Mellitus
Insulin
Therapeutics
Short-Acting Insulin
Newborn Infant
Hypoglycemic Agents
PubMed
Blood Glucose
Catheters
Clinical Trials
Glucose
Injections

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Insulin therapy in neonatal diabetes mellitus: a review of the literature. / Rabbone, I; Barbetti, F; Gentilella, R; Mossetto, G; Bonfanti, R; Maffeis, C; Iafusco, D; Piccinno, E.

In: Diabetes Research and Clinical Practice, Vol. 129, No. 5, 2017, p. 126-135.

Research output: Contribution to journalArticle

Rabbone, I ; Barbetti, F ; Gentilella, R ; Mossetto, G ; Bonfanti, R ; Maffeis, C ; Iafusco, D ; Piccinno, E. / Insulin therapy in neonatal diabetes mellitus: a review of the literature. In: Diabetes Research and Clinical Practice. 2017 ; Vol. 129, No. 5. pp. 126-135.
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AU - Maffeis, C

AU - Iafusco, D

AU - Piccinno, E

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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. © 2017 Elsevier B.V.

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. © 2017 Elsevier B.V.

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