Endocrine Abstracts

Introduction: Continuous subcutaneous insulin infusion (CSII) can improve glycaemic control and quality of life in Type 1 Diabetes patients. It is uncommon for paediatric patients to discontinue CSII and return to multiple daily insulin injections (MDI) often due to concerns regarding worsening metabolic control. However a trial off CSII is a requirement before transition to the adult clinic. We review the outcomes of those who discontinued CSII in our centre (total 248 patients with ~50% on CSII).

Methods: Between 01/04/2014 and 31/03/2016, 7 patients<19 years old discontinued CSII. Data were collected from electronic patient records. Differences between groups were explored using paired t-tests. P value <0.05 (2- tailed) was considered significant.

Results: Seven (2 male) patients out of 112 pump patients (61 male) discontinued CSII and changed to MDI. The median (range) age of starting CSII was 11.3 (9.3–12.7) years and discontinuing CSII at 14.3 (11.8–18.5)years. Median (range) duration of CSII was 4 (1.8–7.9) years. Six of the seven patients chose to remain on MDI. 57.1% (4 patients) personally chose to discontinue CSII. Other reasons cited from the remaining 3 patients include poor control, physician recommendation and technology difficulties. Following CSII discontinuation, HbA1c remained unchanged for the first 12 months and fell over the 2nd 12 months (Table 1).

Conclusion: We describe outcomes in seven young people who discontinued CSII. Majority remained off CSII with no deterioration in control. Indeed, control improved after stopping CSII for 2 years although this cannot be directly attributed to coming off CSII. These data could give confidence to families and diabetes teams when making the choice to trial off insulin pump in preparation for transition.