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Published on: June 11, 2012

Long-term efficacy of insulin pump therapy in children with type 1 diabetes mellitus

Ruby Joshi Batajoo1, Catherine R Messina, Thomas A Wilson

  • 1Stony Brook University, Department of Pediatrics, Stony Brook, NY, USA.

Journal of Clinical Research in Pediatric Endocrinology
|September 19, 2012
PubMed

Insights

Continuous insulin infusion pump therapy (CSII) in pediatric patients with type 1 diabetes mellitus (T1DM) showed no long-term improvement in glycemic control compared to multiple daily insulin injections (MDI). Glycated hemoglobin (HbA1c) levels did not significantly differ between the two methods over time.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pediatric Care

Background:

  • Insulin pumps are established for diabetes management.
  • Long-term efficacy of insulin pump therapy remains a question.
  • Continuous subcutaneous insulin infusion (CSII) is an alternative to multiple daily injections (MDI).

Purpose of the Study:

  • To evaluate the long-term efficacy of CSII in pediatric patients with type 1 diabetes mellitus (T1DM).
  • To compare glycemic control (HbA1c) between CSII and MDI in children and adolescents.

Main Methods:

  • Retrospective observational study of 131 T1DM patients transitioning from MDI to CSII.
  • Data collected for 30 months post-transition, including HbA1c and insulin requirements.
  • Analysis focused on 45 patients with complete 6-monthly data.

Main Results:

  • Mean HbA1c was 8.0% pre-CSII, with transient improvements to 7.7% at 6 months and 7.8% at 1 year.
  • HbA1c returned to 8.0% at 30 months.
  • Transient HbA1c improvements were observed only in older patients (>11 years) or those with higher insulin needs (>0.75 u/kg/day), not persisting beyond one year.

Conclusions:

  • CSII did not demonstrate long-term significant differences in glycemic control compared to MDI in pediatric T1DM patients.
  • The benefits of CSII, if any, were transient and limited to specific subgroups.
  • Further research may be needed to identify patient profiles that benefit long-term from CSII.
Abstract

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