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A randomized controlled trial of insulin pump therapy in young children with type 1 diabetes

Larry A Fox1, Lisa M Buckloh, Shiela D Smith

  • 1Nemours Children's Clinic, NE Florida Pediatric Diabetes Center, 807 Children's Way, Jacksonville, FL 32207, USA. lfox@lwpes.org

Diabetes Care
|May 28, 2005
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) is safe for young children with type 1 diabetes and may improve quality of life. However, CSII did not enhance diabetes control compared to injections and led to more mild hypoglycemia.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes (T1D) management in young children presents unique challenges.
  • Insulin pump therapy, or continuous subcutaneous insulin infusion (CSII), is an alternative to multiple daily injections.
  • Assessing the impact of CSII on glycemic control and family well-being in this age group is crucial.

Purpose of the Study:

  • To evaluate the efficacy and safety of CSII compared to conventional insulin injections in children aged 1-6 years with T1D.
  • To assess the effects of CSII on diabetes control, hypoglycemia, quality of life (QOL), and parental adjustment.

Main Methods:

  • A randomized controlled trial involving 26 children with T1D, comparing CSII to standard injection therapy for 6 months.
  • Key outcomes measured included HbA(1c), mean blood glucose (MBG), hypoglycemia frequency, diabetes-related QOL, and parental adjustment.
  • Participants were monitored for changes from baseline over the study period.

Main Results:

  • No significant differences in HbA(1c) or MBG were observed between CSII and injection groups at 6 months.
  • CSII was associated with an increase in mild/moderate hypoglycemia, but severe events remained similar.
  • Improvements in diabetes-related QOL were noted in fathers of children on CSII, while mothers on conventional therapy experienced increased distress.

Conclusions:

  • CSII is a safe and well-tolerated treatment option for very young children with T1D.
  • While CSII may offer benefits to parental QOL, it did not demonstrate superior glycemic control over injections in this cohort.
  • Careful consideration of benefits, risks, and realistic expectations is essential before initiating CSII in this population.
Abstract

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