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A Comparison of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Insulin Injection in Children with Type I Diabetes in Kuwait: Glycemic Control , Insulin Requirement , and BMI
Objective: Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) are two methods currently used to manage type I diabetes mellitus (T1DM). Here we compare our experiences with CSII and MDI in a large cohort of pediatric patients in Kuwait. Methods: Data on 326 p...
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Published in: | Oman medical journal 2015-09, Vol.30 (5), p.336-343 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that cite this one |
Online Access: | Get full text |
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Summary: | Objective: Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin
injections (MDI) are two methods currently used to manage type I diabetes mellitus
(T1DM). Here we compare our experiences with CSII and MDI in a large cohort of
pediatric patients in Kuwait. Methods: Data on 326 patients with T1DM who were started
on CSII between 2007 and 2012 were retrospectively compared with those of 326 patients
on MDI. They were matched for sex, age at diagnosis, T1DM duration, glycemic control,
insulin requirement, and body mass index (BMI). Data were collected at baseline and
every three months and included glycated hemoglobin (HbA1c), insulin dose, and adverse
events (severe hypoglycemia, diabetic ketoacidosis, and skin problems). Results: The main
reason for switching to CSII was to achieve better glycemic control (37%), followed by
reducing hypoglycemia, and improving the quality of life (13.3% each). Although HbA1c
decrease was most significant in the first year, it continued to be significantly lower in
the CSII group compared to the MDI throughout the study period. Total daily insulin
requirements were significantly lower in the CSII group. BMI increased in both groups,
but the difference was significant only at the end of the fifth year. There was no significant
change in the rate of diabetic ketoacidosis in either group. The CSII patients had more
severe hypoglycemic episodes at baseline; however, it significantly decreased throughout
the study period. Only five patients discontinued CSII therapy and two of these restarted
within three months. Conclusion: CSII is a safe intensive insulin therapy in youngsters
with T1DM and achieved markedly fewer severe hypoglycemic episodes and lower daily
insulin requirements. |
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ISSN: | 1999-768X 2070-5204 |
DOI: | 10.5001/omj.2015.69 |