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Comparison of continuous subcutaneous insulin infusion and multiple daily injection regimens in children with type 1

Naomi Weintrob1, Hadassa Benzaquen, Avinoam Galatzer

  • 1Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. nweintrob@clalit.org.il

Pediatrics
|September 2, 2003
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) offer similar diabetes control in children with type 1 diabetes. CSII showed higher treatment satisfaction and improved BMI, with comparable safety profiles.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes (T1D) requires intensive insulin therapy for optimal glycemic control.
  • Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) are primary treatment modalities.
  • Comparing the efficacy and feasibility of CSII versus MDI in pediatric T1D populations is crucial.

Purpose of the Study:

  • To compare the efficacy and feasibility of CSII versus MDI in children with type 1 diabetes.
  • To evaluate diabetic control, adverse events, insulin requirements, BMI, treatment satisfaction, and quality of life.

Main Methods:

  • An open randomized crossover study involving 23 children (9.4-13.9 years) with T1D.
  • Comparison of 3.5 months of CSII therapy against 3.5 months of MDI therapy.
  • Assessment of HbA1c, fructoseamine, adverse events, insulin dose, BMI SDS, treatment satisfaction, and quality of life.

Main Results:

  • No significant differences in HbA1c or fructoseamine levels between CSII and MDI.
  • Similar frequencies of symptomatic hypoglycemic and hyperglycemic events; low rates of severe hypoglycemia.
  • Higher treatment satisfaction reported with CSII; BMI SDS decreased with CSII and increased with MDI.

Conclusions:

  • Both CSII and MDI are safe and effective intensive insulin therapies for pediatric T1D.
  • Similar glycemic control and low adverse event rates observed for both treatment modes.
  • Availability of both CSII and MDI allows for personalized therapy selection in pediatric T1D management.
Abstract

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