Panza Raffaella, Cattivera Valentina, Colella Jacopo, Baldassarre Maria Elisabetta, Capozza Manuela, Zagaroli Luca, Iezzi Maria Laura, Laforgia Nicola, Delvecchio Maurizio
Section of Neonatology and NICU, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124, Bari, Italy.
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy.
Diabetes Ther. 2024 Nov;15(11):2293-2308. doi: 10.1007/s13300-024-01653-z. Epub 2024 Sep 18.
Neonatal diabetes mellitus is a rare disorder of glucose metabolism with onset within the first 6 months of life. The initial treatment is based on insulin infusion. The technologies for diabetes treatment can be very helpful, even if guidelines are still lacking. The current study aimed to provide a comprehensive review of the literature about the safety and efficacy of insulin treatment with technology for diabetes to support clinicians in the management of infants with neonatal diabetes mellitus. A total of 22 papers were included, most of them case reports or case series. The first infants with neonatal diabetes mellitus treated with insulin pumps were described nearly two decades ago. Over the years, continuous glucose monitoring systems were added to treat these individuals, allowing for a better customization of insulin administration. Insulin was diluted in some cases to further minimize the doses. Improvement in technology for diabetes prompted clinicians to use new devices and algorithms for insulin delivery in infants with neonatal diabetes as well. These systems are safe and effective, may shorten hospital stay, and help clinicians weaning insulin during the remission phase in the transient forms or switching from insulin to sulfonylurea when suggested by the molecular diagnosis. New technologies for insulin delivery in infants with neonatal diabetes can be used safely and closed-loop algorithms can work properly in these situations, optimizing blood glucose control.
新生儿糖尿病是一种罕见的葡萄糖代谢紊乱疾病，在出生后的前6个月内发病。初始治疗基于胰岛素输注。糖尿病治疗技术可能非常有帮助，即使目前仍缺乏相关指南。本研究旨在全面回顾有关糖尿病技术胰岛素治疗的安全性和有效性的文献，以支持临床医生管理新生儿糖尿病患儿。共纳入22篇论文，其中大部分为病例报告或病例系列。近二十年前就描述了首例使用胰岛素泵治疗的新生儿糖尿病患儿。多年来，连续血糖监测系统被用于治疗这些患儿，从而能更好地定制胰岛素给药方案。在某些情况下，胰岛素会被稀释以进一步减少剂量。糖尿病技术的进步促使临床医生也将新设备和算法用于新生儿糖尿病患儿的胰岛素给药。这些系统安全有效，可能缩短住院时间，并有助于临床医生在短暂型缓解期减少胰岛素用量，或在分子诊断提示时从胰岛素转换为磺脲类药物。用于新生儿糖尿病患儿胰岛素给药的新技术可以安全使用，闭环算法在这些情况下也能正常工作，优化血糖控制。
