ESPE Abstracts (2016) 86 P-P2-265

Efficacy and Safety of Continuous Subcutaneous Insulin Infusion Treatment in Pre-schoolers. Long Term Experience of a Tertiary Care Centre in Spain

Esmeralda Colino, Beatriz Villafuerte, María Martín, Belén Roldán, Ángeles Álvarez, Rosa Yelmo & Raquel Barrio


Unidad de Diabetes Pediátrica, Hospital Universitario Ramón y Cajal, Universidad de Alcalá\., Madrid, Spain


Background: There is limited knowledge in children younger than 6 years of age about the safety and efficacy of CSII treatment during long periods of time.

Objective and hypotheses: Evaluate the efficacy and safety of CSII treatment in pre-schoolers with T1D, assess if ISPAD/ADA criteria for good metabolic control are achieved and define general and specific characteristics of the treatment in this range of age.

Method: Charts of patients younger than 6 who started CSII treatment between 2003 and 2014 were reviewed. The cohort consisted of 27 patients (age 4 (2.9–4.7) years, 56% males). Age at start, T1D duration, HBA1c (HPLC, Menarini, normal value 5.1±0.31%), insulin dose, number of capillary blood glucose measurements (CBG), number of basal rates (BR) per day, % basal/total insulin (B/TI), insulin ratios at different meals, severe hypoglycaemia (SH episodes/100 patients years), DKA events, percentages of normoglycaemia (70–180 mg/dl) and hypoglycaemia (<70 mg/dl) (N/H%), average glycemia and SD (GLSD) were analysed. Statistical analysis was performed by SPSS.

Results: HbA1c decreased to 6.8% in the first year. Afterwards, it remained under 6.8% during the follow-up (median 5 (3–6), range 1–9 years). Prior to CSII, 74% of children met ISPAD criteria. At one year, 96% had HbA1c <7.5%. CBG median per day was 10 (9–11). Total insulin dose did not change significantly. There was 1 episode of DKA and 1 episode of SH. Insulin needs at breakfast were higher (first year 0.92 vs 0.55, 0.6 and 0.5).

Table 1. (for abstract P2-P265)
Prior n=271y n=272y n=243y n=204y n=175y n=13
HbA1c6.9 (6.7–7.5)6.8 (6.4–7.1)*6.6 (6.3–7)*6.7 (6.2–6.9)*6.6 (6.2–7.1)*6.7 (6.2–7.1)*
(B/TI)40 (36–50)29 (24–42)*34 (29–44)39 (27–46)37 (30–45)34 (27–47)
N/H%48/954/1155/952/1156/1058/9
BR7 (6–8)7.5 (6–8)8 (7–9)7 (7–8)6.5 (5–7)
*P<0.05.

Conclusion: CSII is effective and safe in pre-schoolers. It allows to achieve and maintain good metabolic control (based on ISPAD/ADA criteria) during long periods of time without increasing adverse effects.

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