ESPE Abstracts (2022) 95 WG4.1

ESPE2022 Working Group Symposia ESPE Working Group on Diabetes Technology (DT) Symposium (4 abstracts)

Use of Automated Insulin Delivery systems (AIDs) in preschool children

Carine de Beaufort

DECCP-Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg

Management of type 1 diabetes in preschool children is a huge challenge for their caregivers. Age-specific factors (e.g. unpredictable food intake and physical activity, small insulin doses, high insulin sensitivity, frequent intercurrent infections, high variability in insulin requirements) increase the complexity of daily diabetes management. Furthermore, the preschool child depends completely on his/her caregiver. To meet recommended treatment targets while avoiding hypoglycaemia is traveling between Scylla and Charybdis: accept an increase in risk for chronic complications or risk hypoglycaemia with a potential impact on brain function. Continuous subcutaneous insulin infusion pumps (CSII), followed by continuous glucose monitoring (CGM) have facilitated treatment and improved quality of care and outcome in preschoolers (1). Hypoglycaemia fear though, especially at night, persists (2). Over the last 5 years several Automated Insulin Delivery Systems (AIDs) have been approved for adults and older children. Only recently these tools have been tested in preschoolers, a population who may benefit most of this technology. In a randomized controlled crossover study (KIDSAP02), the use of CamAPS FX showed a significant better metabolic control, without increase in hypoglycemia (3). Caregivers reported less hypoglycemia fear and better perceived well being. When asked, parents report the CamAPS FX is a ‘game changer’ and helped them ‘getting back their life’. Use of AIDs in preschoolers improves metabolic control and reduces diabetes burden. These results suggest that AIDs in this population should be first line treatment to optimize short and long term outcome.

1. Sundberg F, et al. ISPAD Guidelines. Managing diabetes in preschool children. Pediatr Diabetes. 2017 Nov;18(7):499-517. doi: 10.1111/pedi.125542

2. Van Name MA, et al. Nighttime is the worst time: Parental fear of hypoglycemia in young children with type 1 diabetes. Pediatr Diabetes. 2018;19:114-120. doi:10.1111/pedi.12525

3. Ware J, et al. Randomized Trial of Closed-Loop Control in Very Young Children with Type 1 Diabetes. N Engl J Med. 2022;386(3):209-219. doi:10.1056/NEJMoa2111673

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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