Hypoglycemia and ketoacidosis with insulin pump therapy in children and adolescents

Ragnar Hanas; Johnny Ludvigsson; Diabetes Research in Children Network (DirecNet) Study Group

doi:10.1111/j.1399-543X.2006.00142.x

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Hypoglycemia and ketoacidosis with insulin pump therapy in children and adolescents

Journal article

Peer reviewed

Hypoglycemia and ketoacidosis with insulin pump therapy in children and adolescents

Ragnar Hanas, Johnny Ludvigsson and Diabetes Research in Children Network (DirecNet) Study Group

Pediatric diabetes, Vol.7 Suppl 4(4), pp.32-38

08/2006

DOI: 10.1111/j.1399-543X.2006.00142.x

PMID: 16774616

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http://doi.org/10.1111/j.1399-543X.2006.00142.xView

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Abstract

This review deals with the two most serious side effects encountered with insulin pump therapy, severe hypoglycemia and diabetic ketoacidosis (DKA). Although clinical follow-up studies reported decreased rates of severe hypoglycemia, randomized studies have not confirmed this, showing no difference between the pump and injection groups. Less-severe hypoglycemia (mild/moderate/symptomatic hypoglycemia) was found to be more common with pump use. Some patients have inadvertently dosed or overdosed while awake or during sleep, causing fatal outcome in rare cases. Population-based or retrospective clinical studies reported a low rate of DKA in pump users that was still a higher rate than those using injection therapy, at least in some countries. In research settings and for patients with good compliance and adequate family support, the risk of DKA seems lower; many short-term studies report no DKA at all, possibly due to the increased attention given to participants. The use of continuous subcutaneous insulin infusion (CSII) seems to decrease the risk in patients who had recurrent DKA before pump start. Most episodes of DKA occur early after pump start, suggesting a learning curve occurs in all new forms of treatment. Increased teaching and awareness programs are vital to prevent severe hypoglycemia and DKA in children and adolescents using insulin pumps.

3-Hydroxybutyric Acid - blood

Glycated Hemoglobin A - metabolism

Humans

Insulin Infusion Systems - adverse effects

Insulin - administration & dosage

Clinical Trials as Topic

Diabetes Mellitus, Type 1 - drug therapy

Adolescent

Blood Glucose - metabolism

Hypoglycemia - chemically induced

Child

Insulin - adverse effects

Diabetic Ketoacidosis - chemically induced

Details

Title: Subtitle: Hypoglycemia and ketoacidosis with insulin pump therapy in children and adolescents
Creators: Ragnar Hanas - Department of Pediatrics, Uddevalla Hospital, Uddevalla, Sweden. ragnar.hanas@vgregion.se
Johnny Ludvigsson
Diabetes Research in Children Network (DirecNet) Study Group
Contributors: Eva Tsalikian (Contributor) - University of Iowa, Stead Family Department of Pediatrics
Resource Type: Journal article
Publication Details: Pediatric diabetes, Vol.7 Suppl 4(4), pp.32-38
DOI: 10.1111/j.1399-543X.2006.00142.x
PMID: 16774616
NLM abbreviation: Pediatr Diabetes
ISSN: 1399-543X
eISSN: 1399-5448
Language: English
Date published: 08/2006
Academic Unit: Stead Family Department of Pediatrics
Record Identifier: 9984093494802771

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