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Title: NICE Issues Final Guidance on Insulin Pump Therapy
URL: http://www.pslgroup.com/dg/2269A6.htm
Doctor's Guide
July 29, 2008


LONDON -- July 29, 2008 -- The National Institute for Health and Clinical Excellence (NICE) has published its final guidance on the use of continuous subcutaneous insulin infusion (CSII) therapy. This replaces the guidance published in February 2003.

The review and reappraisal of the use of continuous subcutaneous insulin infusion for the treatment of diabetes has resulted in a change to the recommendation on the use of continuous subcutaneous insulin infusion in children aged younger than 12 years with type 1 diabetes.

For children aged younger than 12 years with type 1 diabetes, the guidance recommends the use of insulin pump therapy as a possible treatment if treatment with multiple daily injections is not practical or is not considered appropriate.

Children who use insulin pump therapy should have a trial of multiple daily injections when they are between the ages of 12 and 18 years.

For adults and children aged 12 years and older with type 1 diabetes, the guidance recommends insulin pump therapy as a treatment option provided that:

· Attempts to reach target haemoglobin A1C (Hb A1C) levels with multiple daily injections result in the person having "disabling hypoglycaemia" or
· Hb A1C levels have remained high (8.5% or above) with multiple daily injections (including using long-acting insulin analogues, if appropriate) despite the person and/or their carer carefully trying to manage their diabetes."

Insulin pump therapy should only be continued in adults and children aged 12 years and older if there has been a sustained improvement in the control of their blood glucose levels.

For the complete guideline review, please see: http://www.nice.org.uk/TA151

SOURCE: National Institute for Health and Clinical Excellence

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