ESPE Abstracts (2016) 86 P-P1-191

ESPE2016 Poster Presentations Diabetes P1 (72 abstracts)

Insulin Pump Does Not Allow a Better Control than Injections in Childhood Type 1 Diabetes (T1d) in the ISIS-Diab Cohort

Sophie Le Fur b , Anne Laure Castell a , Philippe Lucchini a , Pierre Bougnères b & ISIS-Diab Network b


aPediatric Endocrinology, Bicêtre, France; bISIS-Diab Network, Whole France, France


Background: The use of insulin pumps is rapidly spreading within the paediatric T1D community. A few small studies have promoted pump usage, while large registries have shown almost no advantage of this treatment.

Objectives: Compare the results of treatment with insulin pump (‘Pump’) with insulin injections (‘Inj’) in a large cohort of children with T1D in field conditions.

Patients: We studied 3137 children of the ISIS-Diab cohort with ≥1 year of T1D duration recruited by 99 diabetes centers of various size covering all French regions. HbA1c, severe hypoglycemia (SH), ketoacidosis (DKA), and weight were compared between ‘Pump’ (n=694) and ‘Inj’ (n=2443) groups of children over their last 6 months of treatment.

Results: The ratio of ‘Pump’/‘Inj’ varied from 0 to 65% across centers. ‘Pump’ children were slightly younger (9.2±3.9 years vs 10.6±3.4 years for ‘Inj’, P=2.10−6), and had comparable socio-educational level than ‘Inj’. Mean HbA1c was 7.8±1.0% in ‘Pump’ and 7.9±1.2% in ‘Inj’ (NS). SH occurred in 3.5% of ‘Pump’ and 5.4% of ‘Inj’ (P=0.053). DKA occurred in 2.7% of ‘Pump’ and 2.7% of ‘Inj’. Overweight was present in 10.7% of ‘Pump’ and 10.4% of ‘Inj’. Insulin dosage was 0.82±0.28 U/k.d in ‘Pump’ and 0.95±0.29 U/k.d in ‘Inj’ (P<2.10−16). Large expert centers had the same pump results than small centers (HbA1c 7.8±1% vs 7.8±1.0%).

Conclusion: In field conditions, insulin pump shows no clear superiority. The choice of this costly and more demanding mode of treatment should thus be balanced at the individual and public health level.

Article tools

My recent searches

No recent searches.