Classifying insulin regimens--difficulties and proposal for comprehensive new definitions.
Identifieur interne : 002442 ( Ncbi/Merge ); précédent : 002441; suivant : 002443Classifying insulin regimens--difficulties and proposal for comprehensive new definitions.
Auteurs : A. Neu [Allemagne] ; K. Lange [Allemagne] ; T. Barrett [Royaume-Uni] ; F. Cameron [Australie] ; H. Dorchy [Belgique] ; H. Hoey [Irlande (pays)] ; P. Jarosz-Chobot [Pologne] ; H B Mortensen [Danemark] ; J-J Robert [France] ; K. Robertson [Koweït] ; C. De Beaufort [Luxembourg (pays)]Source :
- Pediatric diabetes [ 1399-5448 ] ; 2015.
Descripteurs français
- KwdFr :
- Adolescent, Association de médicaments (normes), Association médicamenteuse, Calendrier d'administration des médicaments, Consensus, Diabète de type 1 (traitement médicamenteux), Enfant, Guides de bonnes pratiques cliniques comme sujet, Humains, Hypoglycémiants (administration et posologie), Hypoglycémiants (usage thérapeutique), Insuline (administration et posologie), Insuline (usage thérapeutique), Médecine de l'adolescent (), Médecine individualisée, Pédiatrie (), Référenciation, Terminologie comme sujet.
- MESH :
- administration et posologie : Hypoglycémiants, Insuline.
- normes : Association de médicaments.
- traitement médicamenteux : Diabète de type 1.
- usage thérapeutique : Hypoglycémiants, Insuline.
- Adolescent, Association médicamenteuse, Calendrier d'administration des médicaments, Consensus, Enfant, Guides de bonnes pratiques cliniques comme sujet, Humains, Médecine de l'adolescent, Médecine individualisée, Pédiatrie, Référenciation, Terminologie comme sujet.
English descriptors
- KwdEn :
- Adolescent, Adolescent Medicine (methods), Benchmarking, Child, Consensus, Diabetes Mellitus, Type 1 (drug therapy), Drug Administration Schedule, Drug Combinations, Drug Therapy, Combination (standards), Humans, Hypoglycemic Agents (administration & dosage), Hypoglycemic Agents (therapeutic use), Insulin (administration & dosage), Insulin (therapeutic use), Pediatrics (methods), Practice Guidelines as Topic, Precision Medicine, Terminology as Topic.
- MESH :
- chemical , administration & dosage : Hypoglycemic Agents, Insulin.
- chemical , therapeutic use : Hypoglycemic Agents, Insulin.
- chemical : Drug Combinations.
- drug therapy : Diabetes Mellitus, Type 1.
- methods : Adolescent Medicine, Pediatrics.
- standards : Drug Therapy, Combination.
- Adolescent, Benchmarking, Child, Consensus, Drug Administration Schedule, Humans, Practice Guidelines as Topic, Precision Medicine, Terminology as Topic.
Abstract
Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.
DOI: 10.1111/pedi.12275
PubMed: 25865149
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<front><div type="abstract" xml:lang="en">Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.</div>
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<Abstract><AbstractText>Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.</AbstractText>
<CopyrightInformation>© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Neu</LastName>
<ForeName>A</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Children's Hospital, University Hospital Tuebingen, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lange</LastName>
<ForeName>K</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Medical Psychology OE5430, Hannover Medical School, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Barrett</LastName>
<ForeName>T</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Institute of Child Health, University of Birmingham, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cameron</LastName>
<ForeName>F</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dorchy</LastName>
<ForeName>H</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Clinique de Diabetologie, Hopital Universitaire des Enfants, Brussels, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hoey</LastName>
<ForeName>H</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Department of Paediatrics, University of Dublin, Trinity College, Ireland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jarosz-Chobot</LastName>
<ForeName>P</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, Katowice, Poland.</Affiliation>
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<ForeName>H B</ForeName>
<Initials>HB</Initials>
<AffiliationInfo><Affiliation>Faculty of Health Science, University of Copenhagen, Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Robert</LastName>
<ForeName>J-J</ForeName>
<Initials>JJ</Initials>
<AffiliationInfo><Affiliation>Department of Diabetes in Children and Adolescents, Hôpital Necker - Enfants Malades, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
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<ForeName>K</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Paediatrics, DCRTD, Kuwait.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Diabetes, Royal Hospital for Sick Children, Glasgow, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>de Beaufort</LastName>
<ForeName>C</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>DECCP, Clinique Pédiatrique/CHL, Luxembourg.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><CollectiveName>Hvidoere Study Group</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016454">Review</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2015</Year>
<Month>04</Month>
<Day>10</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Denmark</Country>
<MedlineTA>Pediatr Diabetes</MedlineTA>
<NlmUniqueID>100939345</NlmUniqueID>
<ISSNLinking>1399-543X</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D004338">Drug Combinations</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007004">Hypoglycemic Agents</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007328">Insulin</NameOfSubstance>
</Chemical>
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<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
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<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
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</MeshHeading>
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</MeshHeading>
<MeshHeading><DescriptorName UI="D032921" MajorTopicYN="N">Consensus</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003922" MajorTopicYN="N">Diabetes Mellitus, Type 1</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004334" MajorTopicYN="N">Drug Administration Schedule</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004338" MajorTopicYN="N">Drug Combinations</DescriptorName>
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<MeshHeading><DescriptorName UI="D004359" MajorTopicYN="N">Drug Therapy, Combination</DescriptorName>
<QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
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<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
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</MeshHeading>
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</MeshHeading>
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<Keyword MajorTopicYN="N">type 1 diabetes</Keyword>
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<ForeName>H J</ForeName>
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<Initials>J</Initials>
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<ForeName>L</ForeName>
<Initials>L</Initials>
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<ForeName>C</ForeName>
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<Investigator ValidYN="Y"><LastName>Robert</LastName>
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<Investigator ValidYN="Y"><LastName>Robertson</LastName>
<ForeName>K J</ForeName>
<Initials>KJ</Initials>
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<Investigator ValidYN="Y"><LastName>Roche</LastName>
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<Investigator ValidYN="Y"><LastName>Schönle</LastName>
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<Initials>S</Initials>
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<PubMedPubDate PubStatus="revised"><Year>2015</Year>
<Month>03</Month>
<Day>04</Day>
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