Insulin pump therapy in paediatrics

In Germany, continuous subcutaneous insulin infusion (CSII) has been firmly established as an intensive insulin regimen for paediatric and adolescent patients with diabetes mellitus. The individually programmable basal rate and the option of triggering a meal bolus without a painful injection permit an almost physiologic insulin substitution. This allows for near-normal metabolic control with no increased risk of adverse effects. Compared with other age groups, young children aged newborn to less than 5 years constitute the highest percentage of pump users. Because of their low insulin dose requirements and their high insulin sensitivity, the CSII options are particularly advantageous for them; for example, their rate of severe hypoglycaemia is significantly reduced. To initiate CSII treatment, a clear indication must be defined, the patient must accept the pump treatment, and the patient and his or her family need specific pump education. © 2007 Springer Medizin Verlag.