Differences in Metabolic Control Between Different Insulin Use Patterns in Pediatric Patients with Type 1 Diabetes...

Area of Science:

• Endocrinology
• Pediatric Diabetes Management
• Medical Technology

Background:

• Intermittent glucose monitoring (isCGM) with insulin pumps offers an alternative for resource-limited settings or self-managed treatment adjustments.
• This approach warrants further investigation, particularly for pediatric patients with Type 1 diabetes.

Purpose of the Study:

• To evaluate the effectiveness of isCGM combined with continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) in pediatric Type 1 diabetes patients.
• To compare metabolic control parameters, including time in range (TIR) and HbA1c, between CSII and MDI groups.

Main Methods:

• A prospective, single-center study involving pediatric patients with Type 1 diabetes.
• Data collection occurred at 3 months and 1 year post-isCGM implantation, with patients categorized by insulin regimen (CSII vs. MDI).

Main Results:

• CSII demonstrated statistically significant improvements in stricter TIR (70-140 mg/dl) at both 3 months and 1 year compared to MDI.
• After one year, 75% of CSII patients achieved HbA1c < 7% versus 34.6% in the MDI group.
• The CSII group experienced a higher coefficient of variation and more hypoglycemic episodes, with initially higher daily glucose measurements.

Conclusions:

• CSII showed superior metabolic control over MDI in pediatric Type 1 diabetes after one year of isCGM use.
• Despite improvements, TIR values remained below optimal control ranges, prompting discussion on optimal timing and integration of CSII.
• The findings suggest CSII may be beneficial in specific scenarios or when integrated into closed-loop systems.