Prospective assessment of continuous subcutaneous insulin infusion therapy in young children with type 1 diabetes

• Published in: Diabetes research and clinical practice 2009-08, Vol.85 (2), p.153-158
• Main Authors: Minkina-Pedras, Mariola, Jarosz-Chobot, Przemyslawa, Polanska, Joanna, Kalina, Maria Aleksandra, Marcinkowski, Adrian, Malecka-Tendera, Ewa
• Format: Article
• Language: English
• Subjects: Age of Onset; Child; Child, Preschool; Children; Continuous subcutaneous insulin infusion; Diabetes mellitus type 1; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Endocrinology & Metabolism; Female; Glycated Hemoglobin A - metabolism; Humans; Infusions, Subcutaneous; Injections, Subcutaneous; Insulin - administration & dosage; Insulin - therapeutic use; Insulin Infusion Systems; Male; Patient Education as Topic; Prospective Studies
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2009.05.016

Abstract The study assessed 3.5-year treatment with continuous subcutaneous insulin infusion (CSII) in well-controlled children with duration of type 1 diabetes mellitus longer than 1 year. Following groups were observed: the CSII group—40 children and the multiple injections (MDI) group—36 patients (age-matched, the mean of 6.5 ± 2.1 and 7.1 ± 1.8 years, respectively). At the onset of the follow-up both groups were comparable in age, HbA1c, daily insulin requirement (DIR), body weight, height and BMI. They were followed from the start, and every 6 months in relation to DIR, HbA1c, acute complications (DKA, hypoglycaemia) and physical development. Mean HbA1c and DIR for the whole study period were lower in the CSII versus MDI group (6.90 ± 0.54 vs 7.22% ± 0.16 and 0.75 ± 0.16 vs 0.88 ± 0.13 U/kg/d; p < 0.05). HbA1c was lower in the CSII versus MDI group in months 6 and 42 (6.95 vs 7.29%, and 6.91 vs 7.43%, respectively; p < 0.05). DIR was significantly lower at most intervals in the CSII group. No significant differences regarding number of complications and anthropometry were found. CSII allows for near-normal metabolic control and lower insulin requirement comparing to the MDI method. CSII is safe treatment, assuring harmonious child's development.