Background: Consistent use of insulin pump therapy and continuous glucose monitoring (CGM) has been shown to improve glycemic control and reduce hypoglycemia.
Objective and hypotheses: The aim this study compared multiple daily injection (MDI) therapy to pump insulin therapy (CSII) in children and adolescents.
Method: A total of 28 children (aged 712) and 34 adolescents (aged 1318) participated in this study. The participants were randomized to either CSII or MDI therapy. Quarterly A1C values were obtained from all participants. One week CGM studies were obtained at baseline, 6 months, and 12 months on all subjects.
Results: Subjects with similar A1c values were randomly assigned to the CSII (8.10.55%) and MDI groups (8.300.53%). All subsequent A1c values showed a significant difference (P<0.05), favoring CSII therapy. Compared to the MDI group, subjects in the CSII group were more likely to achieve their age-appropriate A1c goals and had lower values of hyperglycemia without an increased risk of hypoglycemia. Glucose variability improved in the CSII group compared to the MDI group. Children ages 712 years old were more likely to wear the CGM sensors and reach age-specific A1c goals than the adolescents (1318 years old).
Conclusion: Both children and adolescents with inadequately controlled type 1 diabetes can benefit from CSII therapy, allowing them to reduce A1c values, hyperglycemic excursions, and glycemic variability in a sustainable and safe way.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology