The State Of The Science Of Continuous Subcutaneous Insulin Infusion Use By Adolescents and Adults With Type 1 Diabetes

Background and Significance: Diabetes mellitus is a collection of metabolic diseases, characterized by high blood sugar level, but stemming from different causes (ADA, 2005). The utilization of insulin pump therapy has been increasing over the past number of years in many countries and there currently, there are 20 – 25% of insulin pump users (M. Alsaleh, F., Smith, S. Keady et al., 2009, p. 127). A remarkable decrease in diabetic complications is achievable through close control of blood glucose. Individuals must first meet the criteria for pump utilization which has been established by the American Diabetes Association. Objectives: to systemically and comprehensively review, analyze and synthesize research on the utilization of continuous subcutaneous insulin infusion (CSII) by adolescents and adults with type 1 diabetes. Methods: Clearly delineated literature search and inclusion criteria. Literature was reviewed, analyzed and synthesized. The review of current practice standards from the American Diabetes Association was also included. Adolescents and adults with type 1 diabetes on insulin pump therapy were included in this study. Research articles (n = 14) published in the English language and within the past ten years met the inclusion criteria. Results/Conclusion: Continuous subcutaneous insulin infusion (CSII) is a durable and an effective means of optimizing glycemic control. The ability of CSII to achieve lower blood glucose while simultaneously reducing the rate of severe hypoglycemia is the most significant feature of pump therapy. Study show that intensive insulin therapy with pump is safe and well acceptable by adolescents and adults. Studies indicate that 80% of the adolescents and adults with type 1 diabetes were satisfied with the pump therapy. There are many advantages and disadvantages to pump utilization. Implications to practice: Insulin pump requires adequate education and supportive measures from health care providers. Prior to pump initiation, providers must take into account the advantages and disadvantages of pump utilization, the patient’s preferences, and the cost of pump therapy. Limitations: Generalization is limited to adolescents and adults with type 1 diabetes. Majority of the research studies were conducted at a particular clinic and hospital. Recommendations: Future research should expand the research settings and include different age group using pump therapy. Research should focus the continuous motivation and perhaps long-term complications and expensive from pump therapy