Insulin pump treatment and continuous glucose monitoring

Intensive insulin treatment has continuously increased in the last 15 years for the treatment of type-1 diabetes in children and adolescents. Especially continuous subcutaneous insulin infusion (CSII) is now an established treatment option in all pediatric age groups. In very young children (< 6 years), more than two-thirds of patients are using CSII. With CSII better glycemic control and quality of life, but less severe hypoglycemia appeared compared with multiple daily injection (MDI) therapy. The use of continuous glucose monitoring (CGM) is also increasing in pediatric patients. CGM is mostly applied for several days for diagnostic reasons and to optimize therapy. Sensor augmented pump therapy is recommended when used on a nearly daily basis. CGM can be an additional tool to optimize glycemic control and maintaining target HbA1c levels, while limiting the risk of hypoglycemic events.