Long-term use of insulin pump vs pens in treating young children with type 1 diabetes

Ashraf Soliman; Fawzia Alkhalaf; Mahmoud Alzyoud; Noura Alhumaidi; Ahmed Elawwa; Aml Sabt; Fawzia Alyafie; Nagwa Aldersy

doi:10.1530/endoabs.37.EP403

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Endocrine Abstracts (2015) 37 EP403 | DOI: 10.1530/endoabs.37.EP403

ECE2015 Eposter Presentations Diabetes (complications & therapy) (143 abstracts)

Long-term use of insulin pump vs pens in treating young children with type 1 diabetes

Ashraf Soliman ^1, , Fawzia Alkhalaf ¹ , Mahmoud Alzyoud ¹ , Noura Alhumaidi ¹ , Ahmed Elawwa ^1, , Aml Sabt ¹ , Fawzia Alyafie ¹ & Nagwa Aldersy ¹

Err

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¹Hamad Medical Centre, Doha, Qatar; ²University of Alexandria, Alexandria, Egypt.

Introduction: Unequivocal evidence for the benefit of MDI, the analogs and CSII-treatment in children is lacking. This study assesses the effects of insulin pump (CSII) vs pens in treating children with type 1 diabetes for more than 2 years.

Research design and methods: Diabetes control and anthropometric data of 94 children with type 1 diabetes who were on continuous s.c. insulin therapy using insulin pump were compared with those for 40 children with type 1 diabetes mellitus who were on multiple injections using basal insulin (Lantus) and prandial insulin (Novo-rapid) (three to four shots/day) for more than 2 years. Mean HbA1c, mean blood glucose (MBG), hypoglycemia and DKA frequency were recorded.

Results: Patients using pump therapy were older than patients on pen injections. However, the duration of diabetes did not differ between the two groups. Patients on CSII had significantly lower HbA1c, MBG, and insulin dose/kg compared with children using insulin pens. The frequency of severe hypoglycemia, ketoacidosis, or hospitalization was similar between groups at this time period. The majority (90/94) of patients on CSII expressed their desire to continue on CSII and appreciated its value as easier way to adjust insulin dose to their variable daily requirements.

Discussion: CSII is safe and well tolerated in young children with diabetes and may have positive effects on QOL. In addition, CSII improved diabetes control using less insulin/kg compared with pen injections. However, children on CSII had higher weight gain and BMI.

Conclusion: Our data indicate that CSII is safe and well tolerated in this population. The proper use of CSII in children with type 1 diabetes mellitus appears to improve glycaemic control using less s.c. insulin/kg per day and their quality of life. However, excessive weight gain should be avoided.