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Published on: June 11, 2012
Continuous subcutaneous insulin infusion in preschool children: butt or tummy, which is the best infusion set site?
Angela Zanfardino1, Dario Iafusco, Alessia Piscopo
11 Department of Pediatrics, Second University of Naples , Naples, Italy .
Insights
For young children with type 1 diabetes using insulin pump therapy, placing the infusion set on the buttock significantly improves glycemic control compared to the abdomen. This site selection is crucial for better diabetes management in preschoolers.
Area of Science:
- Pediatric Endocrinology
- Diabetes Technology
- Metabolic Research
Background:
- Infusion set site selection is critical for optimal glycemic control in children with type 1 diabetes.
- Preschoolers using insulin pump therapy require careful consideration of infusion site placement.
- Limited research exists on the impact of infusion site location in very young children with type 1 diabetes.
Purpose of the Study:
- To compare the effectiveness of the buttock versus the abdomen as an infusion set site in preschool children with type 1 diabetes.
- To evaluate the impact of infusion site location on glycemic control parameters in pediatric patients.
- To identify the optimal infusion site for insulin pump therapy in young children.
Main Methods:
- A crossover study was conducted in six preschool children (ages 4-6) with type 1 diabetes on insulin pump therapy.
- Infusion sets were placed on the buttock and abdomen for 3 days each, in a randomized order.
- Key glycemic metrics including mean glucose, area under the curve (AUC) for hyperglycemia and hypoglycemia, and mean amplitude of glucose excursions (MAGE) were analyzed.
Main Results:
- Mean glycemic values, AUC for hyperglycemia (>140 mg/dL), and MAGE were significantly lower with buttock infusion site compared to the abdomen.
- The buttock site resulted in improved glycemic control, with lower glucose variability.
- Conversely, AUC for hypoglycemia (<70 mg/dL) was higher with the buttock site, indicating a potential need for closer monitoring.
Conclusions:
- The buttock infusion site appears to be superior to the abdomen for improving glycemic control in preschool children with type 1 diabetes using insulin pump therapy.
- Site selection for insulin pump infusion sets can significantly impact diabetes management outcomes in young children.
- Further research may be warranted to optimize infusion site strategies and minimize hypoglycemia risk.
Background:
Choosing the right infusion set site can be an important factor in obtaining good glycemic control, especially in very young children. In an attempt to identify the best infusion site, we performed a crossover study in six preschool children with type 1 diabetes using insulin pump therapy.
Subjects And Methods:
We enrolled six patients 5.2±0.7 years old (range, 4-6 years), with type 1 diabetes for more than 1.5 years, using insulin pump therapy for at least 6 months. For each patient, body mass index, glycated hemoglobin, and all data downloaded from the system were evaluated on two occasions: the first with the infusion set placed on the buttock and the second on the abdomen, each for 3 days. The order of infusion set placement was randomized. Mean capillary blood glucose, mean continuous glycemia, mean area under the curve (AUC) using the trapezoidal rule for both >140 mg/dL and <70 mg/dL, insulin daily dose, carbohydrate/insulin ratio, total basal insulin, total bolus insulin, and mean amplitude of glucose excursions (MAGE) were evaluated.
Results:
Mean glycemic values, mean AUC >140 mg/dL, and MAGE were significantly lower when the infusion set was placed on the buttock versus the abdomen (144.6±31.9 mg/dL vs. 166.0±34.8 mg/dL [P=0.000], 28.4±18.3% vs. 48.8±28.2% [P=0.000], and 32±10 vs. 60±15 mg/dL [P<0.001], respectively), whereas mean AUC <70 mg/dL was higher (1.47±2.77% vs. 0.87±1.03% [P<0.001]).
Conclusions:
The present findings suggest that preschool children with type 1 diabetes using insulin pump therapy could benefit from inserting the infusion set in the buttock instead of the abdomen.
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