Pump Therapy and Use of Technologies

Neonatal Diabetes Mellitus (NDM) treatment and clinical management still represent a strong challenge for pediatricians and diabetologists. Therefore, many authors have shown increasing interest in the use of technology in routine clinical practice, especially in newborns owing to their greater risk of complications (both hypoglycemia and hyperglycemia events which have been linked to adverse neurological outcomes). Certainly, Continuous Subcutaneous Insulin Infusion (CSII) as well as Continuous Glucose Monitoring (CGM) systems are a stimulating therapeutic alternative to Multiple Daily Injections (MDI) for the management of NDM. In particular, CSII efficacy has been well evaluated in adults and its safety and feasibility have made it a well-accepted method for pediatric diabetes as well. However, only a few reports based on personal observations and small case series described the use of technology in NDM. The best therapeutic strategy should therefore be tailored according to center-specific experience and the newborn’s characteristics, with the ultimate objectives of achieving optimal glucose control, normal neurodevelopmental growth, and avoiding diabetes-related acute and long-term complications.