Endocrine Abstracts

Introduction: CSII is considered to be a more comfortable therapy and provide the best glycemic control. However, studies concerning of the long-term effects of pump therapy yield conflicting results, some of them reported beneficial long-term effect on metabolic control (reduction of HbA1c), whilst others have shown effects for a short period of time, not exceeded 1 year.

The aim of the study was evaluation of the long-term effect of insulin pump therapy on metabolic control in children with type 1 DM.

Methods: 46 children with type 1 DM from 4.2 years, mean age 12.5±2.7 years, mean HbA1c 8.4±1.6 entered the study. The total patient population was divided into two groups based on the age at the start of pump therapy: group A, 4–10 years old and group B, 11–18 years old. Anthropometric data (age and BMI), HbA1c, and insulin requirement have been evaluated at baseline (at the start of CSII therapy) and every 6 months intervals for 5 years during pump therapy.

Results: At baseline, the mean HbA1c level was 8.68 in the group of younger children and 8.22 in the group of older children. In both groups of patients, significant (P<0.05) improvement of the HbA1c level was shown only during the first 6 months of observation, 6.9 and 7.1 respectively with gradual deterioration in subsequent years, up to the level of HbA1c 8.11 and 8.56 respectively.

No significant difference has been shown concerning BMI, insulin requirement, DKA episodes from baseline throughout the follow-up.

Conclusions: Our study has shown that insulin pump therapy helped achieve lower HbA1c in a relatively short period of time. Interestingly, in the group of the younger children, the metabolic control was slightly better. It seems that better parental control of the younger children may influence the observed differences in the HbA1c level.