Objective: Continuous subcutaneous insulin therapy (CSII) and therapy with insulin analogues are considered to provide physiological insulin replacement, which results in improvement of diabetes control. Rate metabolic compensation of diabetes mellitus (DM) in children on IPT and basal-bolus insulin therapy on the level HbA1c and self-control of glycemia.
Methods: We analyzed retrospectively 88 histories of disease children with type 1 DM. The patients were divided into three groups: group 1 CSII users (19 patients, age 13.02±3.75 yrs, DM duration 5.36±4.11 years, duration of CSII using 1.25±1.15 years); group 2 BPR-A users (39 patients, age 10.70±4.08 years, DM duration 5.34±3.68 years, duration of BPR-A using 2.58±2.14 years), group 3 BPR-H users (31 patients, age 13.99±3.54 years, DM duration 4.47±3.29 years). HbA1C levels; frequency of blood glucose measuring; the presence of hypo-, hyperglycemia and diabetic coma were evaluated. The statistical analysis were made using Excel 2010. The results were statistically significant if P<0.05.
Results: After transition to CSII, group 1 children showed to have lower HbA1C levels (6.99±0.74% vs 7.81±0.86%, P=0.004). We didnt find difference of HbA1C levels before and after transition to BPR-A in group 2 (7.68±1.20% vs 7.78±2.04%, P>0,05). BPR-H users had higher HbA1C levels in comparison with CSII (9.04±2.29%, P=0.0001). The frequency of blood glucose measuring were significantly higher in CSII users (9.00±3.60 times a day) than in BPR-A (5.32±1.52, P=0.0001) and BPR-H users (4.37±0.98, P=0.0001). BPR-H users had five cases of ketoacidosis, BPR-A users one case of severe hypoglycemia and none in CSII users.
Conclusions: CSII was the only way of insulin supply that resulted in decrease of HbA1C levels, absence of severe hypoglycemia and diabetic coma.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology