Ewha Med J.  2021 Jul;44(3):55-62. 10.12771/emj.2021.44.3.55.

Clinical Utilities of Continuous Glucose Monitoring and Insulin Pumps in Pediatric Patients with Type 1 Diabetes

Affiliations
  • 1Department of Pediatrics, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
  • 2Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

Abstract

Type 1 diabetes requires lifelong insulin therapy because insulin-secretion capability is diminished. Glycemic control and glucose monitoring are important to prevent type 1 diabetes complications. Diabetes technologies have developed rapidly; continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are now common and greatly aid glycemic control, especially in children and adolescents. The National Health Insurance Service has provided partial reimbursements for both CGM and CSII devices since 2019 and 2020, respectively; the devices are thus expected to become more popular. CGM reduces the frequency of hypoglycemia and the level of glycated hemoglobin. CSII affords more precise glycemic control than multi-dose insulin therapy. CSII showed reduced frequency of hypoglycemia and improved metabolic outcome without an increase in the body mass index z-score. Technological advancement of combined CGM and CSII will eventually serve as an artificial pancreas. The National Health Insurance Service should fund not only the devices but also education of patients and caregivers. In addition, healthcare providers must be continuously updated on new diabetes technologies.

Keyword

Diabetes mellitus; type 1; Technology; Blood glucose self-monitoring; Insulin infusion systems

Figure

  • Fig. 1 Ambulatory glucose profile (AGP) of glucose monitoring data. (A) AGP report for Abbott’s Freestyle Libre flash glucose monitor. (B) AGP report for Dexcom G6 continuous glucose monitor.

  • Fig. 2 Medtronic’s Minimed 640G pump Carelink Professional (Medtronic Inc., Minneapolis, MN, USA) report summary.

  • Fig. 3 Type of insulin pumps available in Korea.


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