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Metabolic control in newly diagnosed type 1 diabetic children. Effect of continuous subcutaneous infusion
Insights
Continuous subcutaneous insulin infusion (CSII) and conventional insulin treatment (CIT) in children with insulin-dependent diabetes showed similar long-term results. Further research is needed to confirm CSII
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Management
Background:
- Type 1 diabetes in children requires effective insulin therapy.
- Continuous subcutaneous insulin infusion (CSII) and intensified conventional insulin treatment (CIT) are treatment options.
Purpose of the Study:
- To compare the efficacy of CSII versus CIT in newly diagnosed insulin-dependent diabetic children.
Main Methods:
- Randomized trial with 15 children.
- 10-day treatment period with CSII or CIT.
- 1-year follow-up assessing glycemic control and insulin needs.
Main Results:
- Near-normal blood glucose achieved faster with CSII (24h) than CIT (3 days).
- Both groups showed similar reductions in HbA1c levels and insulin requirements over 1 year.
- No significant increase in C-peptide secretion was observed in either group.
Conclusions:
- CSII does not show a clear advantage over CIT in the long term for pediatric diabetes.
- The long-term benefits of CSII in this population require further investigation.
Abstract:
15 insulin-dependent diabetic children at onset were randomly allocated to one of two different therapeutical protocols: continuous subcutaneous insulin infusion (CSII) and intensified conventional insulin treatment with three daily insulin injections (CIT). Both treatments were performed for 10 days; the initial insulin dose was 1.5 U/kg/day and thereafter the insulin dosage was modified in order to obtain a satisfactory control. Near-normal blood glucose levels were obtained after 24 h in the CSII group, and after 3 days in the CIT group. All subjects underwent 1 year of follow-up. HbA1 levels and insulin requirements decreased similarly in the two groups; C-peptide secretion did not increase significantly in both groups. A clear advantage of CSII cannot be assumed, and the usefulness of this therapeutical approach needs to be confirmed by further investigations.