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

C Hasselmann1, E Bonnemaison, N Faure

  • 1Service de médecine pédiatrique, université François-Rabelais, CHRU de Tours, Tours, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|May 16, 2012
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) in children with type 1 diabetes (T1D) led to better glycemic control and fewer hospital admissions compared to multiple daily injections (MDI). This improved metabolic outcome was achieved without increasing severe hypoglycemia or diabetic ketoacidosis.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • The Diabetes Control and Complications Trial highlighted the importance of blood glucose control in preventing long-term complications of type 1 diabetes (T1D).
  • Intensive insulin therapy, using either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII), is key to achieving glycemic control in T1D.
  • Comparing the efficacy of CSII and MDI in pediatric T1D populations is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To compare the effectiveness of continuous subcutaneous insulin infusion (CSII) versus multiple daily insulin injections (MDI) in managing glycemic control in children with type 1 diabetes (T1D).

Main Methods:

  • A retrospective study comparing 38 T1D children using CSII with 38 T1D children using MDI, matched for age, gender, and diabetes duration.
  • Data collected included insulin dosage, HbA1c levels, BMI, and severe hypoglycemia/admission rates over a 3-year follow-up period.
  • Statistical analysis was performed to identify significant differences in glycemic control and complication rates between the CSII and MDI groups.

Main Results:

  • Children treated with CSII demonstrated significantly lower HbA1c levels (7.5% vs. 8.0%) and reduced hospital admission rates (0.07 vs. 0.17 events/patient/year) compared to those on MDI.
  • CSII group required lower daily insulin doses (0.78 vs. 0.87 IU/kg/d).
  • No significant differences were observed in body mass index or severe hypoglycemia episodes between the groups; no diabetic ketoacidosis occurred in either cohort.

Conclusions:

  • Continuous subcutaneous insulin infusion (CSII) offers superior metabolic control in children with type 1 diabetes compared to multiple daily injections (MDI).
  • CSII therapy can achieve better glycemic outcomes with lower insulin doses and without an increased risk of acute complications.
  • These findings support CSII as an effective treatment option for pediatric T1D management.
Abstract

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