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Is Insulin Pump Therapy More Effective Than Multiple Daily Insulin Injections in Preventing Subclinical Cardiac

Ayşe Güler Eroğlu1, Berfin Altaş Özgür1, Nida Gülderen Kalay Şentürk1

  • 1Cerrahpaşa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Turkey.

Echocardiography (Mount Kisco, N.Y.)
|August 3, 2026
PubMed

Insights

Children with type 1 diabetes mellitus (T1DM) on insulin pump therapy (IPT) showed better regional heart muscle mechanics than those on multiple daily insulin injections (MDIIT), despite similar overall heart function. This suggests subtle differences in cardiac health based on insulin delivery method.

Area of Science:

  • Cardiology
  • Pediatrics
  • Endocrinology

Background:

  • Subclinical myocardial dysfunction can occur in pediatric patients with type 1 diabetes mellitus (T1DM).
  • The impact of different insulin delivery methods on myocardial mechanics in T1DM is not well understood.
  • Conventional cardiac function may be preserved despite early cardiac changes.

Purpose of the Study:

  • To compare echocardiographic findings between pediatric T1DM patients using insulin pump therapy (IPT) and multiple daily insulin injections therapy (MDIIT).
  • To assess global and regional myocardial strain using three-dimensional speckle-tracking echocardiography (3D-STE) in relation to insulin delivery modality.

Main Methods:

  • A cross-sectional study involving 56 children and adolescents with T1DM.
  • Participants were divided into IPT (n=27) and MDIIT (n=29) groups.
  • Evaluations included conventional echocardiography, tissue-Doppler imaging, 3D echocardiography, and 3D-STE to analyze strain parameters.

Main Results:

  • No significant differences in global strain parameters or ejection fraction between IPT and MDIIT groups.
  • Patients on IPT demonstrated more favorable regional anteroseptal circumferential and radial strain.
  • The E'/A' ratio was significantly higher in the IPT group.

Conclusions:

  • Both IPT and MDIIT groups showed comparable conventional and global 3D-STE cardiac function.
  • Regional strain differences suggest subtle myocardial abnormalities in MDIIT patients.
  • Further research is needed to determine the clinical significance of these regional differences.
Abstract

Keywords:
diabetes mellitusmyocardial strainspeckle‐tracking echocardiographythree‐dimensional echocardiography

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