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Benefits of continuous subcutaneous insulin infusion in children with type 1 diabetes. J Pediatr 2003 Dec;143(6):796-801 PMID: 14657831

Pubmed ID

14657831

Abstract

OBJECTIVE: To examine the effect of continuous subcutaneous insulin infusion (CSII) therapy on parameters affecting long-term outcome in type 1 diabetes. Study design Height, weight, body mass index, insulin dose, glycosylated hemoglobin (HbA(1C)), and blood glucose data from home meter downloads were collected prospectively for analysis in 51 children (age, 10.7+/-3.1 years, mean+/-SD) throughout the 12 months before and after introducing CSII.

RESULTS: Before pump initiation, HbA(1C) was relatively stable, but it fell to 7.7+/-0.2% (P<.001) within 3 months of CSII and remained decreased (7.9+/-0.1%) at 12 months (P<.01). In contrast, weight standard deviation score increased before CSII (from 0.50+/-0.13 to 0.60+/-0.13, P<.05), but remained unchanged (0.61+/-0.11) in the year thereafter. Although severe hypoglycemia (<50 mg/dL) was reduced in the entire cohort, HbA(1C) improved primarily in young children and teenagers. Comparison of glycemic responders (HbA(1C) <7.5, or a decrease >1% on CSII, n=23) with nonresponders demonstrated no differences with respect to gender, socioeconomic status, weight standard deviation score, body mass index, initial HbA(1C), frequency of hypoglycemia, or number of education visits before CSII.

CONCLUSION: Continuous subcutaneous insulin infusion is effective in lowering HbA(1C) and the occurrence of severe nocturnal hypoglycemia without excessive weight gain in most children with type 1 diabetes. HbA(1C) response to CSII is poorer in preadolescents than in young children or teenagers.

Author List

Willi SM, Planton J, Egede L, Schwarz S

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-0345095448   103 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Blood Glucose
Child
Child, Preschool
Diabetes Mellitus, Type 1
Female
Follow-Up Studies
Glycated Hemoglobin A
Humans
Hypoglycemia
Hypoglycemic Agents
Infant
Infusions, Parenteral
Insulin
Insulin Infusion Systems
Male
Weight Gain
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e