Aim: The insulin pump has an important contribution to quality of life and individualized insulin therapy. However, studies that observe clinical criteria can sometimes only reveal marginal benefits or minor differences. The use of insulin pump in our country has become recently widespread. Therefore, we aimed to share our clinical experience and to examine the effect of the pump on individual cases.
Method: The records of 167 patients who were treated with pump therapy in our child diabetes center were examined. Patients were included if diagnosed at least one year before the use of insulin pump, followed at least one year after pump insertion and anthropometric measurements as well as metabolic examinations are available at the control visits. HbA1C levels, lipid profiles, body mass index (BMI), microalbumin/creatinine ratio and total insulin requirement (IU/kg/day) were compared. Descriptive statistics of all the data in the study were calculated. Kolmogorov-Smirnov and Shapiro Wilk tests were used for normality assumption control of quantitative variables. While Paired Samples t test was used to compare the normal distribution variables measured at different visits, Wilcoxon test was used to compare the non-normally distributed variables.
Results: The mean age, diabetes and insulin infusion pump usage duration of 56 patients (27girls, 29 boys) were 12.8±3.6 years, 6±3 years and 2.5±1.5 years, respectively. The HbA1c values were significantly lower at the individual visits and on average compared to the one-year average prior to the use of the insulin infusion pump (P<0,001). On the other hand, BMI values were significantly higher in individual visits and on average compared to the one-year average before the use of insulin infusion pump (P<0.001). There was no significant difference in LDL, triglyceride microalbumin/creatinine ratio before and after infusion pump. To look at the insulin requirements Carelink download system was used during the pump period. During the pre-pump period, only 30 patients could be compared because those with just carbohydrate/insulin ratio records were excluded. The mean insulin dose was 0.73±0.26 before the pump and 0.60±0.27 during pump therapy. There was a nonsignificant decrease in insulin doses after the pump.
Conclusion: HbA1C levels regressed steadily after the use of insulin infusion pumps, however, BMI was found to increase steadily. Although the decrease in total insulin requirement is not statistically significant, regarding the higher BMI and lower HbA1C it may still significant from the clinical point of view.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology