BSPED2011 Poster Presentations (1) (84 abstracts)
Educating children in continuous subcutaneous insulin infusion (CSII) therapy; are we improving diabetes control?
Alice Lee 2 , Judith Campbell 1 , Marie Marshall 1 , Sue Ainsworth 1 , Louise Salisbury 1 , Mark Bone 1 , Ian Doughty 1 & Sarah Ehtisham 1
1Royal Manchester Children’s Hospital, Manchester, UK; 2University of Manchester, Manchester, UK.
Background: Continuous subcutaneous insulin infusion (CSII) is proving superior in reducing HbA1c compared to multiple daily injections (MDI) in both the adult and paediatric populations. This study aims to compare the two methods, and evaluate the importance of education when starting insulin pump therapy in children.
Design: Patients who attended a ‘pump school’ provided by the Royal Manchester Children’s Hospital between January 2010 and 2011 were included in the study. Five key aspects of diabetes control were assessed for a year before and a year after starting on CSII. Pump school was compared against current NICE recommendations for education and patient voice was gained through user satisfaction surveys.
Results: Twenty patients attended pump school, with 17 going on to CSII long term. The median age at starting pump therapy was 10 years (IQR 8.5–12). Fourteen patients were on MDI prior to CSII, three were on twice daily injections and all but one attended group education sessions at the hospital.
Average HbA1c decreased by 0.85% (S.D. 0.8) after starting pump therapy (P<0.001). CSII also decreased the number and severity of episodes of hypoglycaemia (P<0.04) and increased quality of life with 100% of patients strongly agreeing that it increases flexibility in diet. Pump school follows closely NICE recommendations, and all patients feel confident to use a pump when leaving the school; however 30% of patients felt that the number of sessions could be condensed. 63% of patients felt a yearly revision session would be beneficial, and this should combat an increase in HbA1c after the initial drop.
Conclusion: Pump therapy is successful in decreasing HbA1c and hypoglycaemic episodes in comparison to MDI. Thorough training is provided when NICE guidelines are followed, however a review of number of sessions as well as a yearly revision session should be considered.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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