Related Experiment Video

Updated: Mar 17, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry

Agnieszka Szypowska¹, Anke Schwandt^2,3, Jannet Svensson⁴

¹Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland. agnieszka.szypowska@gmail.com.

Pediatric Diabetes

|July 16, 2016

Insights

Continuous subcutaneous insulin infusion (CSII) is used by 44.4% of children with type 1 diabetes (T1D). Pump therapy is linked to better metabolic control, especially in younger patients, though usage varies by treatment center.

Area of Science:

Pediatric Endocrinology
Metabolic Disorders
Diabetes Management

Background:

Intensified insulin delivery is crucial for managing type 1 diabetes (T1D) in children.
Multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII) are primary treatment methods.
Achieving optimal metabolic control is a key goal in pediatric T1D management.

Purpose of the Study:

To determine the prevalence of insulin pump (CSII) use among children with T1D within the SWEET registry.
To compare the metabolic control outcomes between children using CSII versus MDI.
To investigate factors influencing the adoption of CSII therapy in pediatric diabetes care.

Main Methods:

Analysis of data from 16,570 children with T1D in the prospective, multicenter SWEET registry.
Inclusion of aggregated treatment data from the most recent year for each patient, up to March 2016.
A survey was conducted to assess the organizational aspects of insulin pump therapy.

Main Results:

44.4% of T1D children utilized CSII, with pump usage varying significantly across centers.
CSII use decreased with increasing age and was associated with center size and per capita diabetes expenditure.
Children on CSII demonstrated significantly lower HbA1c levels and daily insulin doses compared to those on MDI (P < .0001).

Conclusions:

Insulin pump therapy is widely available in SWEET centers, but its utilization varies.
Center-specific factors influence the adoption rate of modern diabetes technologies like insulin pumps.
Despite variations in treatment approaches, T1D children generally achieve good metabolic control, particularly younger patients and those using insulin pumps.

Read full analysis

Abstract

Background:

Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control.

Objective:

To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI.

Methods:

This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out.

Results:

Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P < .0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P < .0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P < .0001).

Conclusions:

Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

Keywords:

CSII MDI childhood diabetes continuous subcutaneous insulin infusion multiple daily injections

More Related Videos

Measuring Relative Insulin Secretion using a Co-Secreted Luciferase Surrogate

Measuring Relative Insulin Secretion using a Co-Secreted Luciferase Surrogate

Published on: June 25, 2019

Transplantation of Pancreatic Islets Into the Kidney Capsule of Diabetic Mice

Transplantation of Pancreatic Islets Into the Kidney Capsule of Diabetic Mice

Published on: October 31, 2007

Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...

Diabetes Mellitus: Overview and Type I Subtype

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...

Insulin Formulations: Types and Delivery

Insulin Formulations: Types and Delivery

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...

Diabetes Mellitus: Type 2 and Gestational

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...

Diabetes: Management and Pharmacotherapy

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

Insulin: The Receptor and Signaling Pathways

Insulin: The Receptor and Signaling Pathways

Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but...

Articles linked to this work by shared authors, journal, and citation graph.

Feasibility of Fast Turnaround Genetic Screening for Type 1 Diabetes Risk in Newborns-Recruiting Infants for the Global Platform for the Prevention of Autoimmune Diabetes Primary Prevention Study Supplementation with B ifidobacterium infantis for Mitigation of Type 1 Diabetes Autoimmunity.

Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme·2026

The transition of youth with diabetes from paediatric to adult diabetes care services: a consensus report of the joint working group of the International Society for Pediatric and Adolescent Diabetes (ISPAD), the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA).

Hormone research in paediatrics·2026

The Transition of Youth With Diabetes From Pediatric to Adult Diabetes Care Services: A Consensus Report of the Joint Working Group of the International Society for Pediatric and Adolescent Diabetes (ISPAD), the European Association for the Study of Diabetes (EASD), and the American Diabetes Association (ADA).

Diabetes care·2026

The transition of youth with diabetes from paediatric to adult diabetes care services: a consensus report of the joint working group of the International Society for Pediatric and Adolescent Diabetes (ISPAD), the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA).

Diabetologia·2026

Preserving beta cell function in children and adolescents with newly diagnosed stage 3 type 1 diabetes: per-protocol population analysis from the PROTECT randomised trial.

Diabetologia·2026

International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process.

Diabetologia·2026

See all related articles