Endocrine Abstracts

Objectives: The use of CSII in very young diabetic children was initially limited. The criteria for continued use are better long term glycaemic control and reduced hypoglycaemia episodes. The objective of this study was to evaluate the benefits of CSII on glycaemic control, acute complications and quality of life of diabetic patients.

Methods: Retrospective analyses of data from patients with type 1 diabetes from our database that were started on CSII from 2007 to 2012 were done. Their glycosylated hemoglobin (HbA1c), hypoglycaemic episodes, diabetic ketoacidosis and reported quality of life were documented in the year before CSII and compared post-CSII.

Results: There were 17 patients, 9 males, 8 females with mean age at diagnosis of diabetes at 5.1 (range 1.5–10) years. Mean age at CSII initiation was 9.9 (range 3–15) years and mean time taken for transferring a patient from MDI to CSII was 4.8 years.

Mean basal insulin dose before CSII was 0.45 units/kg, reduced to 0.3 units/kg at CSII initiation. At 1 and 3 years post-CSII, 0.33 units/kg and 0.38/kg respectively. Mean basal insulin was significantly higher in girls than boys (26.8 vs 16.8 P=0.018) before CSII initiation and not significantly different at start and 3 years post-CSII.

Mean HbA1c was 66 mmol at CSII initiation, decreased to 64.5, a month later and continued to improve 3 years post-CSII except in 3 patients >12 years with initial decrease but no significant difference 3 years post-CSII.

There was significantly less blood sugar excursions, diabetic ketoacidosis and hypoglycemic episodes post-CSII with improved quality of life measured by flexibility, autonomy, socialization and sleep.

Conclusions: CSII use was associated with improved reported quality of life. It is effective in providing lasting benefits such as optimizing glycaemic control and reducing acute complications in children with type 1 diabetes particularly in younger children and girls.