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Glycaemic control improves after continuous subcutaneous insulin infusion therapy: results from an Irish regional centre for paediatric type 1 diabetes mellitus

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Abstract

Objectives

The use of continuous subcutaneous insulin infusion (CSII) in the management of paediatric patients with type 1 diabetes mellitus (T1DM) has increased substantially in the last decade. The aim of this study was to evaluate and compare glycaemic control in a population of paediatric patients with T1DM before commencing CSII compared with 2 years after commencing CSII.

Methods

This is a retrospective study with data collection from diabetes clinic records. Complete data were obtained on 34/45 eligible patients. Glycosylated haemoglobin (HbA1c) and body mass index (BMI) were compared 6 months pre- and 2 years post CSII commencement. Data were stratified in 6-month blocks.

Results

Mean HbA1c improved over 2 years post CSII with the lowest value in the first 6 months post-commencement. When gender, age, time since diagnosis and time on pump were added as covariates, results became non-significant, with only age exhibiting a statistically significant influence on glycaemic control (p = 0.03). This improved glycaemic control is associated with some increment in BMI which showed no statistical significance in the first year post-CSII.

Conclusion

CSII commencement is associated with significantly improved glycaemic control most notably in the first 6 months after CSII commencement. There is association between CSII commencement and increased BMI noted to be statistically significant in the second year.

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References

  1. Batajoo RJ (2012) Efficacy of insulin pump therapy in children. J Clin Res Pediatr Endocrinol 4(3):127–131. https://doi.org/10.4274/Jcrpe.751

    Article  PubMed  Google Scholar 

  2. Jakisch BI, Wagner VM, Heidtmann B et al Comparison of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) in paediatric type 1 diabetes: a multicentre matched-pair cohort analysis over 3 years. https://doi.org/10.1111/j.1464-5491.2007.02311.x

  3. Jeitler K, Horvath K, Berghold A et al (2008) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia 51:941–951

    Article  CAS  Google Scholar 

  4. Brorsson (2015) Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? A retrospective case-control study. Pediatr Diabetes 16:546–553. https://doi.org/10.1111/pedi.12209

    Article  CAS  PubMed  Google Scholar 

  5. Hughes CR, McDowell N, Cody D, Costigan C (2012) Sustained benefits of continuous subcutaneous insulin infusion. Arch Dis Child 97:245–247

    Article  CAS  Google Scholar 

  6. Miller KM, Foster NC, Beck RW et al (2015) Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D exchange clinic registry. Diabetes Care 38(6):97978. https://doi.org/10.2337/dc15-0078

    Article  Google Scholar 

  7. O’Riordan S, Turner G (2012) Model of care for the provision of continuous subcutaneous insulin infusion for the treatment of type 1 diabetes in the under five age group, (July)

  8. Philip M, Battelino T, Rodriguez H, for the consensus forum participant* et al Use of insulin pump therapy in the paediatric age-group

  9. Nimri R, Weintrob N, Benzaquen H et al (2006) Insulin pump therapy in youth with type 1 diabetes: a retrospective paired study. Pediatrics 117:2126–2131

    Article  Google Scholar 

  10. Plotnick LP, Clark LM, Brancati FL, Erlinger T (2003) Safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes. Diabetes Care 26:1142–1146

    Article  Google Scholar 

  11. Maniatis AK, Klingensmith GJ, Slover RH et al (2001) Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care. Pediatrics 107:351–356

    Article  CAS  Google Scholar 

  12. Sulli N, Shashaj B (2006) Long-term benefits of continuous subcutaneous insulin infusion in children with type 1 diabetes: 4 years follow up. https://doi.org/10.1111/j.1464-5491.2006.01935

  13. Moore JM, Snell-Bergeon JK (2019) Trajectories of hemoglobin A1c and body mass index z-score over four decades among 2 to 18 year olds with type 1 diabetes. Pediatr Diabetes 20(5):594–603. https://doi.org/10.1111/pedi.12862

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. The DCCT/EDIC Research Group Intensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: the DCCT/EDIC Study 30-year follow-up. Diabetes Care 2016, 39(5):686–693

  15. Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study Stephanie R. Johnson & Matthew N. Cooper & Timothy W. Jones & Elizabeth A. Davis

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Authors and Affiliations

  1. Paediatric Registrar, University Hospital Limerick, Limerick, Ireland

    Khubaib Ahmed & Marguerite Lawler

  2. Paediatric Department, University Hospital Limerick, Limerick, Ireland

    Clodagh S. O’Gorman, Orla M. Neylon, Anne Quinn, Marry Norris, Maria Conroy-Kelly & Therese Dunne

  3. Statistical Consulting Unit/CSTAR, University of Limerick, Limerick, Ireland

    Jean Saunders

Authors
  1. Khubaib Ahmed
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  2. Clodagh S. O’Gorman
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  3. Orla M. Neylon
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  4. Jean Saunders
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  5. Marguerite Lawler
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  6. Anne Quinn
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  7. Marry Norris
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  8. Maria Conroy-Kelly
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  9. Therese Dunne
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Corresponding author

Correspondence to Khubaib Ahmed.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Study was granted ethical approval from research ethics committee university hospital limerick REC ref. 033/17.

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Ahmed, K., O’Gorman, C.S., Neylon, O.M. et al. Glycaemic control improves after continuous subcutaneous insulin infusion therapy: results from an Irish regional centre for paediatric type 1 diabetes mellitus. Ir J Med Sci 190, 151–154 (2021). https://doi.org/10.1007/s11845-020-02281-9

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  • DOI: https://doi.org/10.1007/s11845-020-02281-9

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