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Benefits of continuous subcutaneous insulin infusion in children with type 1 diabetes

Steven M Willi1, Jonathan Planton, Leonard Egede

  • 1Department of Pediatrics, and the General Clinical Research Center, Medical University of South Carolina, Charleston, South Carolina 29425, USA. willis@musc.edu

The Journal of Pediatrics
|December 6, 2003
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) effectively lowers HbA1c and reduces severe hypoglycemia in children with type 1 diabetes without significant weight gain. Glycemic control improved most in younger children and teenagers.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes (T1D) management in children requires optimizing glycemic control to prevent long-term complications.
  • Continuous subcutaneous insulin infusion (CSII) offers a potential alternative to multiple daily injections for T1D management.
  • Assessing the impact of CSII on metabolic parameters and long-term outcomes in pediatric populations is crucial.

Purpose of the Study:

  • To evaluate the efficacy of CSII in improving glycemic control (HbA1c) and other relevant parameters in children with T1D.
  • To assess changes in weight, body mass index, and insulin dosage following CSII initiation.
  • To investigate the occurrence of severe hypoglycemia before and after CSII therapy.

Main Methods:

  • Prospective collection of data including height, weight, BMI, insulin dose, HbA1c, and blood glucose levels.
  • Analysis of data from 51 children with T1D over 12 months prior to and following CSII initiation.
  • Comparison of glycemic responders and non-responders to CSII based on predefined criteria.

Main Results:

  • CSII significantly reduced HbA1c levels within 3 months (7.7%) and maintained this reduction at 12 months (7.9%), compared to pre-CSII levels.
  • Weight standard deviation score increased prior to CSII but remained stable thereafter, indicating no excessive weight gain.
  • Severe hypoglycemia decreased across the cohort, with primary HbA1c improvement observed in younger children and teenagers.

Conclusions:

  • CSII is an effective therapeutic option for children with T1D, leading to improved glycemic control and reduced severe nocturnal hypoglycemia.
  • The therapy is not associated with excessive weight gain in this pediatric cohort.
  • Preadolescents showed a less favorable HbA1c response to CSII compared to younger children and teenagers.
Abstract

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