Background: CSII has some potential advantages and disadvantages for young children. For many young patients, it is easier and more convenient to take multiple daily doses of insulin with CSII than with a syringe or insulin pen.
Objective and hypotheses: The growing popularity of type 1 diabetes (DM1) treatment based on continuous subcutaneous insulin infusion (CSII) raises a question of the group of patients that benefit most from the treatment.
Method: Clinical observation was carried out in 285 1-18-year-old patients diagnosed with DM1 treated with CSII. Every 3 months, HbA1c was determined by an agglutination inhibition immunoassay. The patients were followed for 610 years.
Results: The greatest benefits from the treatment with CSII using an insulin pump were noted in type 1 diabetes children aged 15: the mean HbA1c decreased in these patients from 7.98% to 6.75% (P<0.01) over 6 years. Slightly lesser outcomes were noted in the group of 610-year olds: the mean HbA1c value increased slightly from 7.6% before the CSII to 7.89% after 6 years of treatment (P>0.01). Somewhat worse outcomes were reported in the group of 1115-year-old children: HbA1c increased from 8.05% to 8.72% (P>0.01). The lowest outcomes were found in the group of the 1619-year-old patients, as HbA1c rose from 7.8% to 8.82% (P<0.01) over 6 years. The children receiving the CSII treatment as early as in the first year of treatment exhibited better diabetes control (HbA1c 8.1% declined after 6 years to do 7.1%, P<0.01) than patients who received CSII at an older age (HbA1c increased from 7.92% to 8.2%, P<0.01).
Conclusion: The CSII on offers the greatest benefits for patients aged 15 and those with the treatment commenced in the first year after diagnosis of type 1 diabetes. The best results this group of children achieved 6 or more years after start of the pump therapy.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology