Fluent Essays

1 2 A Review of Full Title of Report Student’s Name Fayetteville Technical Community College Abstract Begin your Abstract here. In about 150-200 words, summarize the study you reviewed. Keep the tips you learned about writing summaries in mind, like writing in 3rd person and offering main points instead of details. Use the APA guidelines found in this student sample paper to help you format your report: https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/documents/20200128APA7StudPaper.pdf Full Title of Report Your introduction will begin here. Provide background (history) about the study you want to discuss/review, and why.  Why is it important? What are the important aspects of the study (what was it meant to find, and why was it important?), and how does it relate to similar studies? Note: Your thesis for the review will be placed at the end of your introductory paragraph as a brief summary of the proceeding discussion information. Methods The Methods section will begin here. How did the scientists/doctors/researchers conduct their experiment(s)? What process did they follow? What research materials did you use (including print, web, databases, etc.) to supplement your reading of the study (you must review at least 4 other scholarly sources on the topic of the study)? How did that research help you better understand the study you chose? How did this study influence other scientific/medical/research endeavors, and how could/have methods vary(ied) to yield different results? Results The Results section will begin here. What were the specific findings of the studies? Were there any variations in results, and if so, did changes in the process influence variations? Discussion The Discussion section will begin here. What conclusions can you make about the sufficiency/adequacy/usefulness of the study you reviewed, and why? How do similar experiments supplement/negate your selected study? How has your study influenced the specific discipline to which it belongs? Be sure to provide judgments about the validity of the study/experiment you reviewed based on your personal knowledge of the topic or the research you did to help you write this report. Do you believe (using your supplemental research as a guide) that the results are accurate or flawed in some way? If similar studies were conducted, how did they compare to the study you chose? Explain. References Begin your list of references here. Use the APA guidelines found here to assist you: https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html Research Report Guidelines List of Topics: 1. Infectious or genetic diseases and their cures or preventative measures. 2. Climate change and its effects on the environment or landscapes. 3. Pollution and its effects on wildlife or humans. 4. Prescription drug use resulting in addiction. 5. The neurological effects of traumatic brain injuries. 6. Renewable energies and their efficacy. 7. The logistics of genetic engineering in either humans or food. 8. Space exploration - how it has changed or new limitations or theories in the field. The goal of the Research Report project is to find a research study focused on a topic from the list above and translate it into your own words. That means you must understand the study. For example, if you choose “prescription drug use and addiction” as your topic, you might stumble on a study that tested the benefits of in-patient treatment programs for people who are addicted to prescription drugs. Its important to find a study that includes a METHODS, RESULTS, and DISCUSSION section. Some studies may include additional sections, but those three sections are required. Once you find the study you want to use, read it and take notes. Then, open the Research Report Template, and use it to write your discussion. Go through each section of the template and use the questions I included to guide you in writing your report. You will need to find additional research (at least four secondary sources from the library research databases or .gov/.edu/.org websites only) on the topic of the study, not the study itself. That research can be used to develop any part of the discussion. Thats it. Sounds simple, right? The four secondary sources must come from library research databases, or .gov/.edu/.org websites only (no exceptions). Your 1,200 – 1,800 word paper should follow the structure of the template. You must use APA format for this report: https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/ref erence_list_basic_rules.html Sample APA paper: https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/do cuments/20200128APA7StudPaper.pdf Your audience will be your classmates – make sure your audience can understand your report. https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/documents/20200128APA7StudPaper.pdf https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/documents/20200128APA7StudPaper.pdf 1 A Review of A Detailed Comparison of Continuous Subcutaneous Insulin Infusion and Multiple- Daily Injection Treatments on Type 1 Diabetic Children Jane Student Fayetteville Technical Community College 2 Abstract A comparison of two different types of insulin therapies in Type 1 diabetic children revealed more than glycemic control and quality of life through data gathered by many health care professionals and etymologists in Poland. Treatment involving continuous subcutaneous insulin infusion (CSII) and multiple daily injections were used to compare glycated hemoglobin levels (HbA1c) in children with Type 1 diabetes. Hospital visits, acute sickness and HbA1c levels were documented within a three year span. The associated risk of hypoglycemia (low blood sugar) and Diabetic Ketoacidosis (severe high blood sugar) in CSII and MDI therapies has been previously documented but were outdated due to the introduction of new types of fast and slow acting insulin along with newer models of insulin pumps (CSII). It made the new study necessary to analyze the risks and benefits of both uses. The new results debunked the previous consensus of CSII insulin pumps having a higher risk of DKA and hypoglycemia. The new pump models were documented for comparison and MDI stood relatively the same as it only uses syringes or pens to insert insulin directly into the bloodstream. Unfortunately there was not enough variables to fine tune MDI usage to improve HbA1c levels and left this particular therapy to feel a bit outdated. 3 A Detailed Comparison of Continuous Subcutaneous Insulin Infusion and Multiple-Daily Injection Treatments on Type 1 Diabetic Children With the accessibility of insulin in the 1920s the once deadly Type 1 diabetes has been dramatically changed and has improved the lives of millions. It is commonly confused with Type 2 diabetes, a metabolic disease that accounts for over 90\% of diabetics (Chase, 2002). Although the disease itself has not been cured, medical advancements have brought us closer to a future where diabetes related complications are minimized thus vastly improving the lives of diabetics (Russell, 2014). Diabetes Type 1 is a chronic condition that causes the pancreas to produce little to no insulin (Chase, 2002). It was formerly known as insulin-dependent diabetes or juvenile diabetes. Although it is typically discovered during adolescence and childhood, adults are also susceptible to the disease. Various factors that cause the disease have made it difficult to find a cure. These factors range from genetics or an exposure to a certain virus that has not yet been documented. All factors are part of an ongoing study to find a cure and due to these circumstances the current priority is HbA1C (also referred to as hemoglobin A1c or simply A1C) control. For individuals with diabetes this is vital as the higher the HbA1c, the greater the risk of developing diabetes-related complications (Fendler, 2011). There are two main forms of insulin therapy that is used to control the persons A1C. Continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) are forms of therapy that allow insulin to enter the bloodstream. They have been vastly studied mainly to find the best way possible to treat the disease to an individual. Both have risks and benefits associated with the treatment but it is important to focus on the quality care of these patients. As a mother of a Type 1 diabetic I have 4 used both treatments on my daughter and although I have personal experience to compare the different types of insulin therapies, I want more information using a controlled environment with well documented results to compare my hypothesis to those who have studied the disease for years. Methods Patients were treated with CSII or MDI under a controlled three year study that involved 90\% of the Polish population’s diabetic children (Fendler, 2011). The study was supervised by the Lodz region center’s diabetes epidemiology database and later manually curated. There were no restrictions to patients and they were given the choice between therapies they or their guardian saw fit, but were later encouraged to CSII if management or related complications became an issue. Candidates were encouraged to used CSII as opposed to MDI when faced with high A1C levels, recurrent hypoglycemia, chronic illness, or willingness to improve their quality of life. The introduction to CSII for parents or patients that were using MDI allowed them to choose a different therapy in view of more freedom in their lifestyles and less scrutiny with food intake to insulin ratios. The CSII patients used insulin pumps manufactured by, Roche, Deltec and Medtronic using either human or analogues insulin. At the end of the three year study HbA1c levels, hospital visits and diabetes related illnesses were documented. Other scholarly journals related to CSII and/or MDI were used to supplement and compare the advancements of current therapies, even those currently going through a trial period. Current advancements are focusing on CSII as opposed to MDI although successful A1C control is based on the individual managing the disease. 5 Results 231 CSII and 233 MDI patients were studied and documented for any hospitalizations due to A1C control, hyperglycemia with diabetic ketoacidosis (DKA) and hypoglycemia (severe low blood sugar). Assessments were observed solely on age of initial visit. MDI patients saw a rise in their A1C levels while CSII users had no significant change in their A1C. Hospital visit rates due to acute causes did not differ between CSII and MDI treated patients as well as the average duration of their stay although those treated with CSII had significantly less total hospitals visits annually. CSII offered better metabolic control but did not translate into the risk of future hospitalizations. Although earlier studies suggested that CSII added an additional risk to hypoglycemia or DKA (Nathan, 1982), current studies show no difference between those therapies. As the study progressed, some patients using insulin pumps added more challenging approaches like the dual wave bolus, but the effects of the combinations was not studied and the factor was refrained from the CSII group. Discussion The study gave me sufficient evidence that shows CSII therapy is beneficial to those suffering from Type 1 diabetes. It has become more common and is now the standard of treatment for young children recently diagnosed (Nabhan, 2008). It proved that CSII is a safe form of intensive insulin therapy with similar A1C glycemic effects as MDI users have, but a significantly lower rate of Hypoglycemia and DKA even with a lower insulin requirement. Even though it is common and almost expected for diabetic patients to increase their insulin dosage (Jakisch, 2008) the CSII patient’s dosage remained significantly less than MDI users. Although it can be argued that the use of dual wave boluses and changes in pump settings to fine tune their 6 insulin needs changed the results in favor of CSII pumps, there was not enough documentation and evidence to make a conclusion based on this particular study. Using other resources further proved the advancements of pump therapy are on the rise and MDI cannot be completely eliminated as they are used by CSII pump users in an emergency in case their pump malfunctions (Chase, 2002). New ways of CSII are being tested at this moment in the form of a bionic pancreas and being introduced through trials and controlled studies (Russell, 2014) but have not been used in unrestricted outpatient conditions. The bionic pancreas would have been a great supplement in favor of CSII, showing glycemic improvement even compared to CSII insulin pumps (Russell, 2014), but could not be included in the study without further studies and approval for public use. There was also a comparison to past uses of CSII using an older model of insulin pumps that were too big and complex to use in an uncontrolled setting (Nathan, 1982). It was often discussed amongst experts if these forms of therapy were vital to the discussion of insulin therapy advancement (Rizza, 1986). It has become apparent to me that CSII is here to stay and new medical advances are making room for a higher quality of life to diabetics and reduced complications caused by this horrible disease. 7 References Chase, H. (2002). Understanding diabetes (10th ed.). Denver, Colo.: Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center:. Fendler, W., Baranowska, A. I., Mianowska, B., Szadkowska, A., & Mlynarski, W. (2012). Three-year comparison of subcutaneous insulin pump treatment with multi-daily injections on HbA1c, its variability and hospital burden of children with type 1 diabetes. Acta diabetologica, 49(5), 363-370. Jakisch, B. I., Wagner, V. M., Heidtmann, B., Lepler, R., Holterhus, P. M., Kapellen, T. M., ... & Holl, R. W. (2008). Comparison of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) in paediatric Type 1 diabetes: a multicentre matched-pair cohort analysis over 3 years. Diabetic Medicine, 25(1), 80-85. Nabhan, Z. M., Kreher, N. C., Greene, D. M., Eugster, E. A., Kronenberger, W., & DiMeglio, L. A. (2009). A randomized prospective study of insulin pump vs. insulin injection therapy in very young children with type 1 diabetes: 12-month glycemic, BMI, and neurocognitive outcomes. Pediatric diabetes, 10(3), 202-208. Nathan, D. M., LOU, P., & AVRUCH, J. (1982). Intensive conventional and insulin pump therapies in adult type I diabetes: a crossover study. Annals of internal medicine, 97(1), 31-36. Rizza, R. A. (1986). New modes of insulin administration: do they have a role in clinical diabetes?. Annals of internal medicine, 105(1), 126-129. 8 Russell, S. J., El-Khatib, F. H., Sinha, M., Magyar, K. L., McKeon, K., Goergen, L. G., ... & Damiano, E. R. (2014). Outpatient glycemic control with a bionic pancreas in type 1 diabetes. New England Journal of Medicine, 371(4), 313-325. 1 A Review of Full Title of Report Institution Student’s Name Course Instructor Date Abstract There is a scarcity of research studies on the fast-spreading outbreak of type-2 diabetes in Sub-Saharan Africa. Therefore, researchers performed a study on glycemic and lipid profiles and related predisposing factors in Eritrea. The study included 309 participants with diabetes mellitus who were on routine follow-up. The researchers gathered data on diagnostic chemistry and anthropometric factors and evaluated the link involving selected variables using Fischers exact test. Researchers used multivariable logistic regression to find the parameters linked to higher probabilities of unsatisfactory glucose and specific lipid panel subfractions. Waist measurement, gender, high blood pressure, and HbA1c proportion were all possible causes of aberrant lipid levels.  According to the researchers, the standard of healthcare in the context, as judged by glycemic and particular lipid objectives, was unsatisfactory in this investigation. As a result, advances in both measures were urgently needed, necessitating evidence-based refinement of pharmaceutical and lifestyle approaches. As a result, further investigations on several features of DM with lengthy follow-up were recommended. The study sought ethical approval and followed the ethical requirements concerning its participants. Factors associated with poor lipid and glycemic levels in type 2 diabetes patients From February to May 2017, scientists performed this research in the Halibut Regional Referral Hospital in Asmara, the capital city of Eritrea. The study targeted only patients with type 2 diabetes. The study was published in the year 2020. I have found the study to be significant in providing care for diabetic patients, as it illustrates particular variables that need to be controlled to manage type 2 diabetes. Several scholars have studied this topic following the increased prevalence of diabetes worldwide, particularly in the US. In addition, inadequate knowledge about the management of diabetes and the burden to the healthcare setting has triggered scientists and other individuals to study the topic. The study was meant to find factors that have contributed to the development of complications related to diabetes. These factors affected the lipids and glycemic levels directly. Therefore, it was important to find out these associated risk factors as this would help develop holistic interventions in care for patients with type 2 diabetes and management of the disease. This aspect would help in reducing the burden of diabetes on the healthcare system. This study relates to a study on diabetes mellitus and covid-19. A study on clinical findings in diabetic Mellitus patients with COVID-19 found that most of the COVID-19 patients with DM were vulnerable to severe disease. The study concluded that a high glycemic index was among the risk factors for severe COVID-19 in patients with diabetes mellitus. In this report, we will review the methods employed in the study and discuss the study results. Methods The scientists obtained data on the age of the patients, the duration of the disease, and the presence of comorbidities from patients records. They employed questionnaires that incorporated questions to establish information on lifestyle-related diabetic Mellitus risk factors such as alcohol consumption, smoking, and engagement in physical exercise. The scientists sampled blood specimens from each patient, subsequently tested for fasting blood sugar, hemoglobin A1c, LDL-c, HDL-c, total cholesterol, and triglycerides. Thus, participants received adequate information on the study, with the benefits and the potential risks. I further searched on the internet and published books such as the Diabetes Code by Dr. Jason Fung as a supplement to the information to this study. I discovered the interrelationship between diabetes and lipids and how particular lifestyle factors contributed to poor lipid levels and subsequent development of diabetes. Due to the COVID-19 outbreak, this study influenced how diabetes contributes to severe illness and increased mortality due to covid-19. This need was necessitated by the increased severity of covid-19 in patients with underlying conditions such as diabetes and hypertension. However, the study could have incorporated individuals from different races to determine whether race was a factor in developing the disease. Results On the sociodemographic factors, the duration of diabetes mellitus in the patients was 12.1 years, and the mean age was 57.8. The mean values of BMI were greater than the normal, that is, 24.6. From the data analysis, 70.6\% of the research clients had higher waist circumference and were overweight. 76.7\% of the study participants had a poor glycemic index and was witnessed in the majority of the participants who consumed alcohol and those who had hypertension. 30.7\% of the participants had high-risk serum concentrations and in more females than males. 43.7\% of the study participants had high triglycerides, with more males than females affected. A quarter had high LDL-c while 40\% had high HDL-c. 45.3\% of the population had an elevated risk of suboptimal TG/HDL ratios. The findings indicate that most of these abnormal parameters were associated with sex, as demonstrated by multivariate analysis. Discussion The most significant finding was that 76.7 percent of those surveyed had inadequate glycemic control. Comparable percentages have been observed in a related study from various nations in SSA: 80\% in Ethiopia (Tekalegn et al., 2018), 73.52 percent in Uganda (Kibirig et al., 2014), and 69.5 percent in Kenya (Otieno et al., 2017). Despite the adoption of different HbA1c cut-offs, these figures are lower than those reported in several advanced nations: 38 percent in the United States (Umpierrez et al., 2002) and 43.4 percent in Korea (Choi et al., 2018). Surprisingly, past investigations conducted in the same hospital in 2009 found that 29.9\% of registered patients met the optimum HbA1c limits (Seyum et al., 2010). As a result, it is possible to conclude that the standard of DM healthcare in this country deteriorated. This report validates the study findings due to the slow growth witnessed in the country during the past years. This populations clinical manifestation of T2DM was marked by the elevated incidence of numerous features related to metabolic syndromes like dyslipidemia, abnormal waist circumference, and hypertension. This finding points to insufficient organizational initiatives or individual issues, such as lifestyles and therapeutic compliance. As a result, advances in the control of both hyperglycemia and dyslipidemia are urgently required. This reality will necessitate the refinement of non - pharmacological and pharmacological therapies that are evidence-based. The information can also correlate demographic, clinical, and laboratory characteristics with hyperglycemia and lipid panel data. The research provided some important information for future research. REFERENCES Achila, O. O., Ghebretinsae, M., Kidane, A., Simon, M., Makonen, S., & Rezene, Y. (2020). A cross-sectional study is associated with poor glycemic and lipid levels in ambulatory diabetes mellitus type 2 patients in Asmara, Eritrea. Journal of diabetes research, 2020. https://www.hindawi.com/journals/jdr/2020/5901569/ Umpierrez, G. E., Isaacs, S. D., Bazargan, N., You, X., Thaler, L. M., & Kitabchi, A. E. (2002). Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. The Journal of Clinical Endocrinology & Metabolism, 87(3), 978-982. https://academic.oup.com/jcem/article/87/3/978/2846522?login=true Choi, W. H., Seo, Y. M., & Ha, Y. (2018). Evaluation of factors related to glycaemic control among South Korean patients with type 2 diabetes. International journal of nursing practice, 24(1), e12616. https://onlinelibrary.wiley.com/doi/full/10.1111/ijn.12616 Guo, T., Shen, Q., Ouyang, X., Guo, W., Li, J., He, W., ... & Peng, H. (2021). Clinical Findings in Diabetes Mellitus Patients with COVID-19. Journal of Diabetes Research, 2021. https://www.hindawi.com/journals/jdr/2021/7830136/ A Review of A Detailed Comparison of Continuous Subcutaneous Insulin Infusion and MultipleDaily Injection Treatments on Type 1 Diabetic Children Jane Student Fayetteville Technical Community College Abstract A comparison of two different types of insulin therapies in Type 1 diabetic children revealed more than glycemic control and quality of life through data gathered by many health care professionals and etymologists in Poland. Treatment involving continuous subcutaneous insulin infusion (CSII) and multiple daily injections were used to compare glycated hemoglobin levels (HbA1c) in children with Type 1 diabetes. Hospital visits, acute sickness and HbA1c levels were documented within a three year span. The associated risk of hypoglycemia (low blood sugar) and Diabetic Ketoacidosis (severe high blood sugar) in CSII and MDI therapies has been previously documented but were outdated due to the introduction of new types of fast and slow acting insulin along with newer models of insulin pumps (CSII). It made the new study necessary to analyze the risks and benefits of both uses. The new results debunked the previous consensus of CSII insulin pumps having a higher risk of DKA and hypoglycemia. The new pump models were documented for comparison and MDI stood relatively the same as it only uses syringes or pens to insert insulin directly into the bloodstream. Unfortunately there was not enough variables to fine tune MDI usage to improve HbA1c levels and left this particular therapy to feel a bit outdated. A Detailed Comparison of Continuous Subcutaneous Insulin Infusion and Multiple-Daily Injection Treatments on Type 1 Diabetic Children With the accessibility of insulin in the 1920s the once deadly Type 1 diabetes has been dramatically changed and has improved the lives of millions. It is commonly confused with Type 2 diabetes, a metabolic disease that accounts for over 90\% of diabetics (Chase, 2002). Although the disease itself has not been cured, medical advancements have brought us closer to a future where diabetes related complications are minimized thus vastly improving the lives of diabetics (Russell, 2014). Diabetes Type 1 is a chronic condition that causes the pancreas to produce little to no insulin (Chase, 2002). It was formerly known as insulin-dependent diabetes or juvenile diabetes. Although it is typically discovered during adolescence and childhood, adults are also susceptible to the disease. Various factors that cause the disease have made it difficult to find a cure. These factors range from genetics or an exposure to a certain virus that has not yet been documented. All factors are part of an ongoing study to find a cure and due to these circumstances the current priority is HbA1C (also referred to as hemoglobin A1c or simply A1C) control. For individuals with diabetes this is vital as the higher the HbA1c, the greater the risk of developing diabetes-related complications (Fendler, 2011). There are two main forms of insulin therapy that is used to control the persons A1C. Continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) are forms of therapy that allow insulin to enter the bloodstream. They have been vastly studied mainly to find the best way possible to treat the disease to an individual. Both have risks and benefits associated with the treatment but it is important to focus on the quality care of these patients. As a mother of a Type 1 diabetic I have 4 used both treatments on my daughter and although I have personal experience to compare the different types of insulin therapies, I want more information using a controlled environment with well documented results to compare my hypothesis to those who have studied the disease for years. Methods Patients were treated with CSII or MDI under a controlled three year study that involved 90\% of the Polish population’s diabetic children (Fendler, 2011). The study was supervised by the Lodz region center’s diabetes epidemiology database and later manually curated. There were no restrictions to patients and they were given the choice between therapies they or their guardian saw fit, but were later encouraged to CSII if management or related complications became an issue. Candidates were encouraged to used CSII as opposed to MDI when faced with high A1C levels, recurrent hypoglycemia, chronic illness, or willingness to improve their quality of life. The introduction to CSII for parents or patients that were using MDI allowed them to choose a different therapy in view of more freedom in their lifestyles and less scrutiny with food intake to insulin ratios. The CSII patients used insulin pumps manufactured by, Roche, Deltec and Medtronic using either human or analogues insulin. At the end of the three year study HbA1c levels, hospital visits and diabetes related illnesses were documented. Other scholarly journals related to CSII and/or MDI were used to supplement and compare the advancements of current therapies, even those currently going through a trial period. Current advancements are focusing on CSII as opposed to MDI although successful A1C control is based on the individual managing the disease. Results 231 CSII and 233 MDI patients were studied and documented for any hospitalizations due to A1C control, hyperglycemia with diabetic ketoacidosis (DKA) and hypoglycemia (severe low blood sugar). Assessments were observed solely on age of initial visit. MDI patients saw a rise in their A1C levels while CSII users had no significant change in their A1C. Hospital visit rates due to acute causes did not differ between CSII and MDI treated patients as well as the average duration of their stay although those treated with CSII had significantly less total hospitals visits annually. CSII offered better metabolic control but did not translate into the risk of future hospitalizations. Although earlier studies suggested that CSII added an additional risk to hypoglycemia or DKA (Nathan, 1982), current studies show no difference between those therapies. As the study progressed, some patients using insulin pumps added more challenging approaches like the dual wave bolus, but the effects of the combinations was not studied and the factor was refrained from the CSII group. Discussion The study gave me sufficient evidence that shows CSII therapy is beneficial to those suffering from Type 1 diabetes. It has become more common and is now the standard of treatment for young children recently diagnosed (Nabhan, 2008). It proved that CSII is a safe form of intensive insulin therapy with similar A1C glycemic effects as MDI users have, but a significantly lower rate of Hypoglycemia and DKA even with a lower insulin requirement. Even though it is common and almost expected for diabetic patients to increase their insulin dosage (Jakisch, 2008) the CSII patient’s dosage remained significantly less than MDI users. Although it can be argued that the use of dual wave boluses and changes in pump settings to fine tune their 6 insulin needs changed the results in favor of CSII pumps, there was not enough documentation and evidence to make a conclusion based on this particular study. Using other resources further proved the advancements of pump therapy are on the rise and MDI cannot be completely eliminated as they are used by CSII pump users in an emergency in case their pump malfunctions (Chase, 2002). New ways of CSII are being tested at this moment in the form of a bionic pancreas and being introduced through trials and controlled studies (Russell, 2014) but have not been used in unrestricted outpatient conditions. The bionic pancreas would have been a great supplement in favor of CSII, showing glycemic improvement even compared to CSII insulin pumps (Russell, 2014), but could not be included in the study without further studies and approval for public use. There was also a comparison to past uses of CSII using an older model of insulin pumps that were too big and complex to use in an uncontrolled setting (Nathan, 1982). It was often discussed amongst experts if these forms of therapy were vital to the discussion of insulin therapy advancement (Rizza, 1986). It has become apparent to me that CSII is here to stay and new medical advances are making room for a higher quality of life to diabetics and reduced complications caused by this horrible disease. References Chase, H. (2002). Understanding diabetes (10th ed.). Denver, Colo.: Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center:. Fendler, W., Baranowska, A. I., Mianowska, B., Szadkowska, A., & Mlynarski, W. (2012). Three-year comparison of subcutaneous insulin pump treatment with multi-daily injections on HbA1c, its variability and hospital burden of children with type 1 diabetes. Acta diabetologica, 49(5), 363-370. Jakisch, B. I., Wagner, V. M., Heidtmann, B., Lepler, R., Holterhus, P. M., Kapellen, T. M., ... & Holl, R. W. (2008). Comparison of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) in paediatric Type 1 diabetes: a multicentre matched-pair cohort analysis over 3 years. Diabetic Medicine, 25(1), 80-85. Nabhan, Z. M., Kreher, N. C., Greene, D. M., Eugster, E. A., Kronenberger, W., & DiMeglio, L. A. (2009). A randomized prospective study of insulin pump vs. insulin injection therapy in very young children with type 1 diabetes: 12-month glycemic, BMI, and neurocognitive outcomes. Pediatric diabetes, 10(3), 202-208. Nathan, D. M., LOU, P., & AVRUCH, J. (1982). Intensive conventional and insulin pump therapies in adult type I diabetes: a crossover study. Annals of internal medicine, 97(1), 31-36. Rizza, R. A. (1986). New modes of insulin administration: do they have a role in clinical diabetes?. Annals of internal medicine, 105(1), 126-129. Russell, S. J., El-Khatib, F. H., Sinha, M., Magyar, K. L., McKeon, K., Goergen, L. G., ... & Damiano, E. R. (2014). Outpatient glycemic control with a bionic pancreas in type 1 diabetes. New England Journal of Medicine, 371(4), 313-325.