Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study

Aims/hypothesis We determined the impact of insulin pump therapy on long-term glycaemic control, BMI, rate of severe hypoglycaemia and diabetic ketoacidosis (DKA) in children. Methods Patients on pump therapy at a single paediatric tertiary hospital were matched to patients treated by injections on the basis of age, duration of diabetes and $ HbA_{1c} $ at the time of pump start. $ HbA_{1c} $, anthropometric data, episodes of severe hypoglycaemia and rates of hospitalisation for DKA were collected prospectively. Results A total of 345 patients on pump therapy were matched to controls on injections. The mean age, duration of diabetes at pump start and length of follow-up were 11.4 (± 3.5), 4.1 (± 3.0) and 3.5 (± 2.5) years, respectively. The mean $ HbA_{1c} $ reduction in the pump cohort was 0.6% (6.6 mmol/mol). This improved $ HbA_{1c} $ remained significant throughout the 7 years of follow-up. Pump therapy reduced severe hypoglycaemia from 14.7 to 7.2 events per 100 patient-years (p < 0.001). In contrast, severe hypoglycaemia increased in the non-pump cohort over the same period from 6.8 to 10.2 events per 100 patient-years. The rate of hospitalisation for DKA was lower in the pump cohort (2.3 vs 4.7 per 100 patient-years, p = 0.003) over the 1,160 patient-years of follow-up. Conclusions/interpretation This is the longest and largest study of insulin pump use in children and demonstrates that pump therapy provides a sustained improvement in glycaemic control, and reductions of severe hypoglycaemia and hospitalisation for DKA compared with a matched cohort using injections..

Medienart:

E-Artikel

Erscheinungsjahr:

2013

Erschienen:

2013

Enthalten in:

Zur Gesamtaufnahme - volume:56

Enthalten in:

Diabetologia - 56(2013), 11 vom: 21. Aug., Seite 2392-2400

Sprache:

Englisch

Beteiligte Personen:

Johnson, Stephanie R. [VerfasserIn]
Cooper, Matthew N. [VerfasserIn]
Jones, Timothy W. [VerfasserIn]
Davis, Elizabeth A. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Adolescents
Children
Continuous subcutaneous insulin infusion
Hypoglycaemia
Insulin pump
Metabolic control
Type 1 diabetes

RVK:

RVK Klassifikation

Anmerkungen:

© Springer-Verlag Berlin Heidelberg 2013

doi:

10.1007/s00125-013-3007-9

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2096721989

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