Background: Few data exist for young children regarding the proper site for insulin catheter insertion for pump (CSII) users.
Objective and hypotheses: To evaluate the proper site for catheter insertion in very young children (<8 year old) with T1D and CSII.
Method: The study comprised 10 children [7 females, median age 4.43 years (range 2.37.18), median disease duration 1.65 years] with T1D who were on CSII. Ultrasound measurement of subcutaneous (SC) depth at different sites where insulin catheter was inserted was performed by a linear 915 Mz transducer. Distance from the end of insulin infusion after a bolus to muscular fascia was measured. Weight, height, BMI, waist and hip circumference, upper arm and thigh mid circumference diameter were measured. Skin folds at catheter insertion site were also taken. All children used the 6 mm catheter.
Results: The buttock (mean 1.56±S.D. 0.55 cm) and the side upper third of the thigh (SUTT) (mean 1.49±S.D. 1.00 cm) were the sites with the deepest SC fat compared with the upper (mean 0.39±S.D. 0.20 cm), the lower (mean 0.60±S.D. 0.37 cm) abdomen, the front (mean 0.69±S.D. 0.16 cm) and back side (mean 0.96±S.D. 0.27 cm) of the arm [buttock vs upper (P<0.0005) vs lower abdomen (P=0.002) vs front of the arm (P=0.006) and SUTT vs upper (P<0.0005) vs lower (P=0.010) abdomen vs front of the arm (P=0.024)]. The distance from the end of insulin infusion to muscular fascia was significantly less in the abdomen compared with the buttock (P=0.020), reaching the muscular fascia in all children with the abdominal catheter. BMI, waist circumference and skin folds were not different between those with the distance of the bolus to fascia <0.5 cm vs >0.5 cm.
Conclusion: In very young children with T1D and CSII the buttock and the SUTT are better sites for catheter placement compared with the abdomen and the arm.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology