ESPE Abstracts (2014) 82 P-D-3-1-699

Efficacy and Safety of CSII Treatment in Paediatric Age: Long Term Experience of a Tertiary Care Centre in Spain

Belen Roldan, Esmeralda Colino, Maria Martin-Frias, Angeles Alvarez, Rosa Yelmo & Raquel Barrio


Ramon y Cajal Hospital, Alcala University, Madrid, Spain


Aims: The aims of the study are to evaluate the efficacy and safety of CSII treatment in paediatric patients, to determine if ISPAD criteria for good metabolic control are achieved and to define the general and specific characteristics depending on age and pubertal stage.

Methods: Charts of all the patients who started CSII in the last 10 years were reviewed. The cohort consisted of 90 patients (age 10.1±4.4 years, 58% males). Age at start, DM duration, pubertal stage, HBA1c (HPLC (Menarini) (normal value 5.1±0.31%), insulin dose decrease (IDd), number of glycemic controls (GC), number of basal rates (BR), % basal/total insulin (B/TI), insulin to carbohydrate ratio at different meals, severe hypoglycaemia (SH episodes/100 patients years) and DKA events were analyzed. Subgroup analysis based on age and pubertal stage was made. Statistical analysis was performed by SPSS.

Results: HbA1c decreased the first year to 6.7%. Afterwards, it remained under 7% during the follow-up (mean 3.5±1.8, range 1–8 years). Prior to CSII, 76% of the subjects met ISPAD criteria. At 1 year, 96% had HbA1c<7.5%. GC per day were 8.7±1.7. BR were 5.6±1.8 at 1 year, increasing progressively to 6.7±2.1 at 5 years of CSII. There were only two episodes of DKA. Insulin needs at breakfast were bigger for all the subgroups.

Table 1.
Prior HbA1cHbA1c 1 yearHbA1c 4 yearPrior SHSH CSIIIDd %B/TI % 1y% Hb<7.5 CSII follow
Total7.0±0.86.7±0.5*6.9±0.718.96.9164191
<6 year7.1±0.86.8±0.4*6.8±0.94.8003594
6 year-Tann26.8±0.66.6±0.56.7±0.77.15.3163791
≥Tanner27.1±0.96.7±0.5*7.0±0.634.112204791

Conclusions: CSII is effective and safe in the paediatric age. It allows to achieve and maintain good metabolic control (based on ISPAD criteria) without increasing adverse effects. Smaller children need less basal insulin. *statistically significant.

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