Adolescent use of insulin and patient-controlled analgesia pump technology: a 10 –year food and drug administration retrospective study of adverse events.

To this end, in a large multicenter Italian study we have observed a CSII drop-out rate of 7% (nearly 1100 patients with CSII, aged 0–18 years [ie, 11% of the total population studied]). Adolescents represent the group in which the drop-out rate was higher (67%), showing once again that adolescence is a challenging period. Beyond patient indications, both the diabetes team and patient/family have to show specific prerequisites.3 In Italy, to start CSII it is essential that all hospitals show these characteristics and be integrated into the Italian Health Organisation. Moreover, to fulfill the most recent Italian law indications, we decided to propose an “informed therapeutic agreement” for the use of CSII between the patient and his or her family and the diabetic team3 to reinforce their motivation. As physicians involved in the care of children with diabetes (some of whom might use insulin pumps), we always recommend remaining involved in children’s care, and we would suggest working together to review pump therapy periodically or as a child’s situation changes. The pump itself does not hurt; it is the misuse of it that does.