Endocrine Abstracts

Background: Insulin pump therapy has been linked to improved HbA1c levels, reduced frequency of severe hypoglycaemic episodes and reduced rates of Diabetic Ketoacidosis compared to treatment with multiple daily injections. Insulin pump therapy was started in 2008 in our unit.

Aims: To compare the metabolic effect of insulin pump therapy vs multiple daily injections via pen devices in children with type 1 diabetes in our unit.

Method: • Retrospective audit.

• Twinkle Database search for all patients with type 1 diabetes attending our unit between June and December 2015.

• Recorded age, sex, type of therapy and last HbA1c result in 2015.

Results: • 218 patients identified (99 female), Age range: 2–17 years, (mean 12.5).

• 25% of total patients using pumps (50% <12 years, 26% >12 years of age).

• 100% of patients aged <4 years were using pump therapy.

• Patients aged ≥12 years had a higher mean HbA1c in both pump and pen groups.

• Pump patients had a lower mean HbA1c in all groups.

• The percentage of patients with an HbA1c of ≤58 mmol/mol decreased significantly in the older pump patient group.

• Girls aged ≥12 years using pumps were less likely to have an HbA1c of ≤58 mmol/mol (31% compared to 64% boys).

Conclusions: • Pump therapy leads to significant reduction in HbA1c in all age groups.

• Patients aged <12 years tend to have lower HbA1c results, likely due to increased parental supervision.

• The percentage of patients with an HbA1c of ≤58 mmol/mol is lower in older pump patients, particularly girls.

Recommendations: • Pump therapy should be offered to as many suitable patients as possible, considering patient choice.

• Greater attention should be focussed on teenage patients, particularly girls, to try and prevent an increase in HbA1c levels.