Tags

Type your tag names separated by a space and hit enter

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.
Diabet Med. 2008 Jan; 25(1):80-5.DM

Abstract

AIMS

To conduct a multicentre, matched-pair cohort analysis comparing glycaemic control and adverse events of continuous subcutaneous insulin infusion (CSII) with multiple daily injections (MDI) in paediatric patients.

METHODS

Using standardized computer-based prospective documentation, HbA(1c), insulin dose, body mass index-standard deviation score (BMI-SDS), rate of hypoglycaemia, rate of diabetic ketoacidosis (DKA) and intensity of care were analysed in 434 matched pairs during a follow-up period of 3 years after initiation of MDI or CSII.

RESULTS

HbA(1c) was significantly lower in the CSII group during the first year of new regimen (CSII 7.5 +/- 0.05 vs. MDI 7.7 +/- 0.06; P < 0.05), but rose to the same level as in the MDI group during year 3. Insulin requirement remained significantly lower in the CSII group. The BMI-SDS increased in both study groups, with no significant difference. The rate of severe hypoglycaemia decreased significantly after the change of regimen (CSII 17.87 +/- 2.85 vs. MDI 25.14 +/- 3.79; P < 0.05) and during year 3 of the regimen, particularly when compared with baseline (-21% vs. -16%). The rate of DKA was lower at baseline in the CSII group and remained significantly lower over all 3 years. Intensity of care was the same in both subsets.

CONCLUSIONS

Employing a large cohort, this matched-pair analysis has demonstrated over a 3-year study period that CSII is a safe form of intensive insulin therapy with similar glycaemic effects, but with significantly reduced rates of hypoglycaemia and DKA and a lower insulin requirement when compared with MDI.

Authors+Show Affiliations

Catholic Children's Hospital Wilhelmstift, Hamburg, Germany. jakisch@t-online.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18199134

Citation

Jakisch, B I., et al. "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 : a Journal of the British Diabetic Association, vol. 25, no. 1, 2008, pp. 80-5.
Jakisch BI, Wagner VM, Heidtmann B, et al. 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. Diabet Med. 2008;25(1):80-5.
Jakisch, B. I., Wagner, V. M., Heidtmann, B., Lepler, R., Holterhus, P. M., Kapellen, T. M., Vogel, C., Rosenbauer, J., & 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 : a Journal of the British Diabetic Association, 25(1), 80-5. https://doi.org/10.1111/j.1464-5491.2007.02311.x
Jakisch BI, et al. 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. Diabet Med. 2008;25(1):80-5. PubMed PMID: 18199134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Jakisch,B I, AU - Wagner,V M, AU - Heidtmann,B, AU - Lepler,R, AU - Holterhus,P-M, AU - Kapellen,T M, AU - Vogel,C, AU - Rosenbauer,J, AU - Holl,R W, AU - ,, PY - 2008/1/18/pubmed PY - 2008/4/26/medline PY - 2008/1/18/entrez SP - 80 EP - 5 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 25 IS - 1 N2 - AIMS: To conduct a multicentre, matched-pair cohort analysis comparing glycaemic control and adverse events of continuous subcutaneous insulin infusion (CSII) with multiple daily injections (MDI) in paediatric patients. METHODS: Using standardized computer-based prospective documentation, HbA(1c), insulin dose, body mass index-standard deviation score (BMI-SDS), rate of hypoglycaemia, rate of diabetic ketoacidosis (DKA) and intensity of care were analysed in 434 matched pairs during a follow-up period of 3 years after initiation of MDI or CSII. RESULTS: HbA(1c) was significantly lower in the CSII group during the first year of new regimen (CSII 7.5 +/- 0.05 vs. MDI 7.7 +/- 0.06; P < 0.05), but rose to the same level as in the MDI group during year 3. Insulin requirement remained significantly lower in the CSII group. The BMI-SDS increased in both study groups, with no significant difference. The rate of severe hypoglycaemia decreased significantly after the change of regimen (CSII 17.87 +/- 2.85 vs. MDI 25.14 +/- 3.79; P < 0.05) and during year 3 of the regimen, particularly when compared with baseline (-21% vs. -16%). The rate of DKA was lower at baseline in the CSII group and remained significantly lower over all 3 years. Intensity of care was the same in both subsets. CONCLUSIONS: Employing a large cohort, this matched-pair analysis has demonstrated over a 3-year study period that CSII is a safe form of intensive insulin therapy with similar glycaemic effects, but with significantly reduced rates of hypoglycaemia and DKA and a lower insulin requirement when compared with MDI. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/18199134/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_ L2 - https://doi.org/10.1111/j.1464-5491.2007.02311.x DB - PRIME DP - Unbound Medicine ER -