Both children and adults with difficult to control type-1 diabetes could be eligible for continuous subcutaneous insulin infusion (CSII).

But patients with type-2 diabetes cannot be given the therapy.

Under-11s can be given the treatment if multiple-dose insulin (MDI) therapy is inappropriate and the child or carers are considered competent to use CSII.

Older patients are eligible for CSII if they find it impossible to maintain a HbA1c of 8.5 per cent or less using MDI or they suffer from recurrent and unpredictable hypoglycaemic events, says NICE.

CSII uses an external pump to continuously deliver insulin to the patient. It can be programmed to ensure insulin is delivered at higher rates at meal times, or has different basal rates in the day or night.

The NICE appraisal committee says evidence shows CSII has a valuable effect on HbA1c levels and can reduce the rate of hypoglycaemic episodes.

CSII can only be initiated by specialist teams, says NICE.

rachel.liddle@haymarket.com

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