1 / 12

CSII Therapy in children and young people- where are we going?

CSII Therapy in children and young people- where are we going?. Dr Gillian Lyder New Cross Hospital, Wolverhampton. Service at Wolverhampton. Started in 2000 Initially led by Dr Janet Anderson → Dr Gregory Minnaar Currently 19 patients Team: Doctor, Diabetes Nurse and Dietician

mili
Download Presentation

CSII Therapy in children and young people- where are we going?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CSII Therapy in children and young people- where are we going? Dr Gillian Lyder New Cross Hospital, Wolverhampton

  2. Service at Wolverhampton • Started in 2000 • Initially led by Dr Janet Anderson → Dr Gregory Minnaar • Currently 19 patients • Team: Doctor, Diabetes Nurse and Dietician • 2 clinics every 3 months

  3. Pump clinic at Wolverhampton

  4. Benefits of CSII • Reduces A1C and incidence of hypoglycaemia in children • Does not increase the incidence of DKA • Offers flexibility, choice and a better quality of life for children and their families

  5. Insulin Pump Therapy Offers Flexibility, Choice and a Better Quality of Life for Children and Their Families Challenges Specific to Children CSII Benefits Of 291 patients (mean duration of CSII 3.7 ± 1.9 years), 92.8% remained on Insulin Pump Therapy Scrimgeour L, et al.. Diabetes Technol Ther. 2007;9:421-428 Wilson V, Paediatric Nursing 2008; 20, 2; 14-18

  6. NICE and insulin pumps • Initial NICE guidelines published in 2003 • Guidelines revised in 2008

  7. CSII for ≥12 years • Attempts to achieve target HbA1c levels with multiple daily injections (MDIs) result in the person experiencing disabling hypoglycaemia • (disabling hypoglycaemia is defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life) or • HbA1c levels have remained high (that is, at 8.5% or above) on MDI therapy despite a high level of care.

  8. CSII < 12 years • MDI therapy is considered to be impractical or inappropriate, and • children on insulin pumps would be expected to undergo a trial of MDI therapy between the ages of 12 and 18 years.

  9. NICE guidelines • Estimated that pumps may be clinically indicated for: • 10-50% children < 12 years • 8-15% > 12 years

  10. Implications for diabetes services • How will the services develop to provide best service for patients • Who will be offering an insulin pump service • Training issues

  11. Where do we see the paediatric insulin pump service in the region in 10 years time?

More Related