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Prospective assessment of continuous subcutaneous insulin infusion therapy in young children with type 1 diabetes

Mariola Minkina-Pedras1, Przemyslawa Jarosz-Chobot, Joanna Polanska

  • 1Department of Paediatric Endocrinology and Diabetes, Upper Silesia Centre for Child's Health, Katowice, Poland. mariolam@mp.pl

Diabetes Research and Clinical Practice
|June 23, 2009
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) in children with type 1 diabetes showed better metabolic control and lower insulin needs compared to multiple daily injections (MDI). This diabetes treatment is safe and supports healthy child development.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes mellitus (T1DM) requires lifelong management.
  • Continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) are primary treatment modalities.
  • Assessing long-term efficacy and safety in children is crucial for optimal T1DM care.

Purpose of the Study:

  • To compare the 3.5-year efficacy of CSII versus MDI in well-controlled pediatric T1DM patients.
  • To evaluate metabolic control (HbA1c), insulin requirements, and acute complications.
  • To assess the impact on physical development and anthropometry.

Main Methods:

  • A prospective study involving 76 children with T1DM (CSII group: 40, MDI group: 36).
  • Age-matched cohorts with T1DM duration >1 year were followed for 3.5 years.
  • Data collected included HbA1c, daily insulin requirement (DIR), acute complications (DKA, hypoglycemia), and physical development every 6 months.

Main Results:

  • Mean HbA1c and DIR were significantly lower in the CSII group compared to the MDI group over the study period (p<0.05).
  • Lower HbA1c levels were observed in the CSII group at 6 and 42 months (p<0.05).
  • DIR was consistently lower in the CSII group, with no significant differences in complications or anthropometry between groups.

Conclusions:

  • CSII provides near-normal metabolic control and reduces insulin requirements in children with T1DM compared to MDI.
  • CSII is a safe and effective treatment option for pediatric T1DM, promoting normal physical development.
  • Continuous subcutaneous insulin infusion offers advantages for long-term diabetes management in children.

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