Endocrine Abstracts

Abstract

Continuous subcutaneous insulin infusion (insulin pump therapy) is recommended as a treatment option for patients with type 1 diabetes where multiple-dose insulin therapy has failed. These patients are looked after by a specialist multi-disciplinary team and those receiving this treatment should have the commitment and competence to use the pump effectively.

We carried out a retrospective study on 33 paediatric type 1 diabetic patients on insulin pump therapy by comparing their HbA1C levels before and after starting the therapy. We also compared the change in HbA1C levels in males vs females and in different age groups.

Our patient group had an almost equal gender distribution. The age at diagnosis was <5 years of age in the majority (52%). The majority of patients were greater than 14 years when insulin pump therapy was initiated (43%).

We found an improvement of HbA1C of greater than 0.5% in 49% of our patient group. However in 42% there was no improvement.

We also noticed a greater improvement in boys and in those older than 14 years. We concluded that older children have a better outcome due to better understanding and ability to use the pumps effectively.

In the group of patients that did not show any improvement, we speculate a multifactorial cause including poor compliance, poor dietary control and likely lack of understanding. Through our multidisciplinary team we will focus on this group of patients on re-education of their management.