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Continuous subcutaneous insulin infusion attenuated glycemic instability in preschool children with type 1 diabetes

Ramin Alemzadeh1, Paola Palma-Sisto, M Holzum

  • 1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. ralemzad@mcw.edu

Diabetes Technology & Therapeutics
|August 21, 2007
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) improved glycemic instability in preschool children with type 1 diabetes mellitus (DM). This therapy enhanced glycemic control without affecting hypoglycemia or quality of life compared to flexible multiple daily insulin (FMDI).

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Continuous subcutaneous insulin infusion (CSII) is hypothesized to improve glycemic control and quality of life in children with type 1 diabetes mellitus (DM) compared to traditional insulin injection regimens.
  • Evaluating the efficacy of CSII in a pediatric population, specifically preschool-aged children, is crucial for optimizing diabetes management strategies.

Purpose of the Study:

  • To assess the impact of CSII on glycemic control indices, including hemoglobin A1c (HbA1c), mean blood glucose (MBG), and mean amplitude of glycemic excursion (MAGE).
  • To evaluate the frequency and duration of hypoglycemic events in preschool children with DM using CSII.
  • To determine the effect of CSII on the quality of life of young children with DM, as perceived by their parents.

Main Methods:

  • A cohort of 14 preschool children (3.9 +/- 0.8 years) with type 1 DM were transitioned from flexible multiple daily insulin (FMDI) to CSII.
  • Glycemic control was monitored quarterly for one year using HbA1c and continuous glucose monitoring (CGM) to determine MBG, MAGE, and hypoglycemic events.
  • Parental quality of life questionnaires (TAPQoL) were administered at baseline and after one year of CSII therapy.

Main Results:

  • CSII significantly reduced MAGE (210 +/- 31 vs. 168 +/- 22 mg/dL, P < 0.005), indicating improved glycemic stability.
  • No significant changes were observed in HbA1c, MBG, or the frequency and duration of hypoglycemic events compared to FMDI.
  • Quality of life scores, as assessed by parental questionnaires, remained unchanged after the transition to CSII.

Conclusions:

  • CSII effectively improves glycemic instability in preschool children with type 1 DM without negatively impacting HbA1c or hypoglycemia.
  • CSII represents a viable alternative to FMDI therapy for managing type 1 DM in young children, offering improved glycemic control.
  • While CSII enhances glycemic stability, it does not alter parental perception of their child's quality of life in this age group.
Abstract

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