Background: Childhood type 1 diabetes (T1DM) is associated with poor quality of life and significant family burden. Children, parents, extended family members and teachers were invited to a novel 2 day structured educational programme, Pump SchooI, delivered by a Consultant Led multidisciplinary team. Each Pump School included two age-matched children.
Objective and hypotheses: To evaluate the effect of continuous s.c. insulin infusion (CSII) in a cohort of children and adolescents with T1DM through the assessment of glycaemic control, quality of life (QOL) and family burden.
Method: A prospective study of suitable pump candidates (Kaufman Competency (5/8)) with T1DM was conducted over 12 months. Children (n=22; 11 female) ranging in age from 3 to 17 (mean=10.5) years who were previously treated with multiple daily injections (MDI), started CSII. HbA1c, QOL (Diabetes Quality of Life for Youths) and family burden (Hvidoere questionnaire) measurements were obtained at baseline, 3, 6 and 12 months following pump school.
Results: Mean HbA1c reduction at 3/12 was 6.1 mmol/mol (0.6%; P<0.01). A non-statistically significant upward trend in HbA1c was evident at 12 -month follow-up. Those with highest baseline HbA1c (>68.3 mmol/mol (8.4%)) had the largest HbA1c reduction at 3/12 (8.0 mmol/mol (0.7%); P<0.01). A significant increase on baseline QOL scores (P <0.05) and decrease on baseline family burden scores (P<0.05) was obtained at 6 and 12 months, indicating sustained improvement. Pump therapy was associated with a decline in the perceived impact of diabetes on activities (P<0.05). Children and their carers expressed a high level of satisfaction with the Pump School training programme.
Conclusion: Findings suggest a substantial improvement in biopsychosocial functioning. Glycaemic control improved at 3/12. QOL and family burden were improved 1 year after Pump School. Further research is warranted to ascertain whether these outcomes are maintained at 18 and 24 months.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology