The role of modern technologies in management of Type 1 diabetes in children

Authors: Z. Šumník ;  L. Petruželková ;  S. Koloušková ;  Š. Průhová
Authors‘ workplace: Pediatrická klinika 2. LF UK a FN Motol, Praha
Published in: Čes-slov Pediat 2019; 74 (1): 5-10.


Type 1 diabetes (T1D) treatment in children has been changed significantly by the implementation of modern technologies into clinical practice in the last decade. Novel insulins and its combinations enables tailoring the insulin program personally in accord with the patients´ needs. Major changes have been achieved in the development of continuous glucose monitoring systems (CGM). These devices help our patients to follow, archive and analyze complete glycemic profiles, and – if necessary – to send it to the physician. Modern insulin pumps sense data from CGM devices and adjust insulin dosage automatically to effectively prevent hypo- and hyperglycemia and prolong time in glycemic target. There is no doubt that the process of tighter connection between CGM and insulin pumps will continue in the near future aiming to develop full closed-loop system independent on patient’s diet and regimen. Current data show that such progress seems to be realistic in the relative short run.


type 1 diabetes – insulin analogs – continuous glucose monitoring – insulin pump

  1. Kucera ML, Graham JP. Insulin lispro, a new insulin analog. Pharmacotherapy 1998; 18 (3): 526–538.
  2. Wolf J, Kapellen T, Stachow R, et al. Morning hyperglycemia in children and adolescents with type 1 diabetes and different modes of therapy: an evaluation of the DPV data pool. Klin Padiatr 2012; 224 (7): 471–475.
  3. Mastrototaro J. The MiniMed Continuous Glucose Monitoring System (CGMS). J Pediatr Endocrinol Metab 1999; 12 (Suppl 3): 751–758.
  4. Schmelzeisen-Redeker G, Schoemaker M, Kirchsteiger H, et al. Time Delay of CGM Sensors: Relevance, causes, and countermeasures. J Diabetes Sci Technol 2015; 9: 1006–1015.
  5. Pettus J, Price DA, Edelman SV. How patients with type 1 diabetes translate continuous glucose monitoring data into diabetes management decisions. Endocr Pract 2015; 21: 613–620.
  6. Battelino T, Conget I, Olsen B, et al. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Diabetologia 2012; 55: 3155–3162.
  7. Lind M, Polonsky W, Hirsch IB, et al. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with Type 1 diabetes treated with multiple daily insulin injections: The GOLD Randomized Clinical Trial. JAMA 2017; 317: 379–387.
  8. Beck RW, Riddlesworth TD, Ruedy KJ, et al. Effect of initiating use of an insulin pump in adults with type 1 diabetes using multiple daily insulin injections and continuous glucose monitoring (DIAMOND): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol 2017; 5: 700–708.
  9. Szypowska A, Ramotowska A, Dzygalo K, et al. Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and meta-analysis of randomized trials. Eur J Endocrinol 2012; 166: 567–574.
  10. Petruzelkova L, Pickova K, Sumnik Z, et al. Effectiveness of SmartGuard Technology in the prevention of nocturnal hypoglycemia after prolonged physical activity. Diabetes Technol Ther 2017; 19: 299–304.
  11. Messer LH, Forlenza GP, Sherr JL, et al. Optimizing hybrid closed-loop therapy in adolescents and emerging adults using the MiniMed 670G System. Diabetes Care 2018; 41 (4): 789–796.
  12. Garg SK, Weinzimer SA, Tamborlane WV, et al. Glucose outcomes with the in-home use of a Hybrid Closed-Loop Insulin Delivery System in adolescents and adults with Type 1 diabetes. Diabetes Technol Ther 2017; 19: 155–163.
  13. Bally L, Thabit H, Kojzar H, et al. Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study. Lancet diabetes Endocrinol 2017; 5: 261–270.
  14. Stewart ZA, Wilinska ME, Hartnell S, et al. Closed-Loop Insulin Delivery during pregnancy in women with Type 1 Diabetes. N Engl J Med 2016; 375: 644–654.
  15. Dovc K, Macedoni M, Bratina N, et al. Closed-loop glucose control in young people with type 1 diabetes during and after unannounced phy-
  16. sical activity: a randomised controlled crossover trial. Diabetologia 2017; 60 (11): 2157–2167.
  17. Cengiz E, Bode B, Van Name M, et al. Moving toward the ideal insulin for insulin pumps. Expert Rev Med Devices 2016; 13: 57–69.
  18. El-Khatib FH, Balliro C, Hillard MA, et al. Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial. Lancet 2017; 389 (10067): 369–380.
  19. Weisman A, Bai JW, Cardinez M, et al. Effect of artificial pancreas systems on glycaemic control in patients with type 1 diabetes: a systematic review and meta-analysis of outpatient randomised controlled trials. Lancet Diabetes Endocrinol 2017; 5 (7): 501–512.
  20. Sumnik Z, Venhacova J, Skvor J, et al. Improvement of diabetes control in Czech children: data from the National Childhood Diabetes register ČENDA. Pediatr Diabetes 2017; 18 (Suppl 1): 153.
Neonatology Paediatrics General practitioner for children and adolescents
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account