Tags

Type your tag names separated by a space and hit enter

Long-term benefits of continuous subcutaneous insulin infusion in children with Type 1 diabetes: a 4-year follow-up.
Diabet Med. 2006 Aug; 23(8):900-6.DM

Abstract

AIM

To determine the safety and effectiveness of continuous subcutaneous insulin infusion (CSII) in attaining long-term glycaemic control in paediatric patients with Type 1 diabetes and to compare the results with those previously recorded in the same patients taking multiple daily injections (MDI) (four injections a day).

METHODS

Forty-two patients (mean age 12.2 +/- 3.4 years; range 4.5-17 years; 24 males; mean duration of Type 1 diabetes 5.1 +/- 3.0 years) were studied. The following parameters were assessed in the year before starting CSII treatment (during MDI treatment) and during the 4 years of insulin pump treatment: annual mean HbA1c, insulin requirements (U/kg per day), annual mean of body mass index (BMI) z scores, and adverse events (severe hypoglycaemia and diabetic ketoacidosis/patient per year). Two patients discontinued pump therapy (after 1-year and 2-year follow-up, respectively) because of non-compliance with CSII therapy.

RESULTS

Compared with the annual mean HbA1c observed prior to CSII therapy (8.9 +/- 1.0%), the mean HbA1c levels were lower during the first (8.2 +/- 0.9%; P = 0.00), second (8.6 +/- 1.0%; P = 0.05), third (8.4 +/- 0.9%; P = 0.01) and fourth (8.2 +/- 1%; P = 0.00) year of CSII therapy. The insulin requirements (U/kg per day) decreased during CSII treatment compared with MDI treatment. Compared with the annual mean of BMI z scores prior to CSII therapy, BMI z scores were significantly lower during the third and fourth years of CSII therapy. Through the first, second, third and fourth years of follow-up the number of episodes of severe hypoglycaemia (20.0, 20.0, 20.0 and 0 episodes/1000 patient-years, respectively) and diabetic ketoacidosis (0.05, 0.00, 0.03 and 0.00 episodes/patient per year, respectively), events were similar to that in the year preceding CSII therapy (20.0 and 0.03, respectively).

CONCLUSION

In this population of selected patients in our clinic, CSII appears to be a safe and effective therapeutic alternative to MDI treatment. This therapy may ensure a stable improvement in long-term glycaemic control in paediatric patients, with no increase in diabetic ketoacidosis and severe hypoglycaemic events and, on the other hand, with a trend of reduction in BMI z scores.

Links

Aggregator Full Text

Authors+Show Affiliations

Sulli N
Department of Paediatrics-Diabetes Centre, La Sapienza University of Rome, Rome, Italy.
Shashaj B
No affiliation info available

MeSH

ChildChild, PreschoolDiabetes Mellitus, Type 1FemaleFollow-Up StudiesHumansHypoglycemiaHypoglycemic AgentsInjections, SubcutaneousInsulinMaleTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16911629

Citation

Sulli, N, and B Shashaj. "Long-term Benefits of Continuous Subcutaneous Insulin Infusion in Children With Type 1 Diabetes: a 4-year Follow-up." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 23, no. 8, 2006, pp. 900-6.
Sulli N, Shashaj B. Long-term benefits of continuous subcutaneous insulin infusion in children with Type 1 diabetes: a 4-year follow-up. Diabet Med. 2006;23(8):900-6.
Sulli, N., & Shashaj, B. (2006). Long-term benefits of continuous subcutaneous insulin infusion in children with Type 1 diabetes: a 4-year follow-up. Diabetic Medicine : a Journal of the British Diabetic Association, 23(8), 900-6.
Sulli N, Shashaj B. Long-term Benefits of Continuous Subcutaneous Insulin Infusion in Children With Type 1 Diabetes: a 4-year Follow-up. Diabet Med. 2006;23(8):900-6. PubMed PMID: 16911629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term benefits of continuous subcutaneous insulin infusion in children with Type 1 diabetes: a 4-year follow-up. AU - Sulli,N, AU - Shashaj,B, PY - 2006/8/17/pubmed PY - 2007/3/30/medline PY - 2006/8/17/entrez SP - 900 EP - 6 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 23 IS - 8 N2 - AIM: To determine the safety and effectiveness of continuous subcutaneous insulin infusion (CSII) in attaining long-term glycaemic control in paediatric patients with Type 1 diabetes and to compare the results with those previously recorded in the same patients taking multiple daily injections (MDI) (four injections a day). METHODS: Forty-two patients (mean age 12.2 +/- 3.4 years; range 4.5-17 years; 24 males; mean duration of Type 1 diabetes 5.1 +/- 3.0 years) were studied. The following parameters were assessed in the year before starting CSII treatment (during MDI treatment) and during the 4 years of insulin pump treatment: annual mean HbA1c, insulin requirements (U/kg per day), annual mean of body mass index (BMI) z scores, and adverse events (severe hypoglycaemia and diabetic ketoacidosis/patient per year). Two patients discontinued pump therapy (after 1-year and 2-year follow-up, respectively) because of non-compliance with CSII therapy. RESULTS: Compared with the annual mean HbA1c observed prior to CSII therapy (8.9 +/- 1.0%), the mean HbA1c levels were lower during the first (8.2 +/- 0.9%; P = 0.00), second (8.6 +/- 1.0%; P = 0.05), third (8.4 +/- 0.9%; P = 0.01) and fourth (8.2 +/- 1%; P = 0.00) year of CSII therapy. The insulin requirements (U/kg per day) decreased during CSII treatment compared with MDI treatment. Compared with the annual mean of BMI z scores prior to CSII therapy, BMI z scores were significantly lower during the third and fourth years of CSII therapy. Through the first, second, third and fourth years of follow-up the number of episodes of severe hypoglycaemia (20.0, 20.0, 20.0 and 0 episodes/1000 patient-years, respectively) and diabetic ketoacidosis (0.05, 0.00, 0.03 and 0.00 episodes/patient per year, respectively), events were similar to that in the year preceding CSII therapy (20.0 and 0.03, respectively). CONCLUSION: In this population of selected patients in our clinic, CSII appears to be a safe and effective therapeutic alternative to MDI treatment. This therapy may ensure a stable improvement in long-term glycaemic control in paediatric patients, with no increase in diabetic ketoacidosis and severe hypoglycaemic events and, on the other hand, with a trend of reduction in BMI z scores. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/16911629/Long_term_benefits_of_continuous_subcutaneous_insulin_infusion_in_children_with_Type_1_diabetes:_a_4_year_follow_up_ L2 - https://doi.org/10.1111/j.1464-5491.2006.01935.x DB - PRIME DP - Unbound Medicine ER -