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Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based

Stephanie R Johnson1, Matthew N Cooper, Timothy W Jones

  • 1Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Roberts Road, Subiaco, Perth, WA, Australia, 6008.

Diabetologia
|August 22, 2013
PubMed

Insights

Insulin pump therapy in children significantly improves long-term blood sugar control and reduces severe hypoglycemia and diabetic ketoacidosis (DKA) hospitalizations compared to injections. This study shows sustained benefits over seven years.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Insulin pump therapy (IPT) is an alternative to multiple daily injections for managing type 1 diabetes in children.
  • Long-term outcomes of IPT in pediatric populations require further investigation.

Purpose of the Study:

  • To evaluate the long-term impact of insulin pump therapy on glycemic control, body mass index (BMI), and rates of severe hypoglycemia and diabetic ketoacidosis (DKA) in children.
  • To compare these outcomes between children using insulin pumps and those using multiple daily injections.

Main Methods:

  • A matched-cohort study comparing 345 pediatric patients on insulin pump therapy with controls on injections.
  • Matching was based on age, diabetes duration, and HbA1c at the start of pump therapy.
  • Prospective data collection included HbA1c, anthropometric data, severe hypoglycemia episodes, and DKA hospitalizations.

Main Results:

  • Insulin pump therapy led to a sustained mean HbA1c reduction of 0.6% (6.6 mmol/mol) over seven years.
  • Severe hypoglycemia events decreased significantly in the pump group (14.7 to 7.2 per 100 patient-years) while increasing in the injection group (6.8 to 10.2 per 100 patient-years).
  • Hospitalization rates for DKA were lower in the pump cohort (2.3 vs 4.7 per 100 patient-years).

Conclusions:

  • Insulin pump therapy offers sustained improvements in glycemic control for children with type 1 diabetes.
  • IPT significantly reduces the incidence of severe hypoglycemia and DKA hospitalizations compared to traditional injection therapy.
  • This study represents the longest and largest evaluation of insulin pump use in pediatric diabetes management.
Abstract

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