[Insulin therapy using a portable pump in children. Apropos of a pediatric experience]

Area of Science:

• Pediatric Endocrinology
• Metabolic Disorders
• Medical Device Technology

Background:

• Insulin-dependent diabetes mellitus (IDDM) requires intensive management.
• Insulin pumps represent a continuous subcutaneous insulin infusion therapy option.
• Evaluating long-term efficacy and safety in pediatric populations is crucial.

Purpose of the Study:

• To report on the experience with insulin pump therapy in pediatric patients with IDDM.
• To assess the long-term metabolic control and adverse events associated with insulin pump use.
• To determine the overall efficacy of insulin pumps as a treatment alternative.

Main Methods:

• Retrospective analysis of 17 pediatric patients with IDDM treated with insulin pumps.
• Follow-up data collected for up to four years for seven patients.
• Monitoring of metabolic control (e.g., HbA1c), hypoglycemia, ketoacidosis, and ketosis events.

Main Results:

• Significant metabolic control improvement observed in only 4 of 17 patients, limited to the first year.
• Overall improvement in metabolic control was not statistically significant across the cohort.
• Severe hypoglycemia (0.27/patient-year) and ketoacidosis (0.08/patient-year) were rare.
• Transient ketosis was the most common adverse event, often linked to technical issues and requiring patient education.

Conclusions:

• Insulin pump therapy can be a viable alternative for pediatric IDDM patients unresponsive to conventional treatments.
• Long-term significant metabolic control benefits may not be universally achieved.
• Patient education is critical for managing adverse events like transient ketosis and technical problems.