Endocrine Abstracts

Aims: To understand whether insulin treatment for type 1 diabetes mellitus (T1DM) in the paediatric population is most effective at providing diabetic control when delivered by Multiple Daily Injections (MDI) as compared to Continuous Subcutaneous Insulin Infusion (CSII).

Methods: A District General Hospital’s submissions to the National Paediatric Diabetes Audit (NPDA) between 2012 and 2018 were analysed to establish if either method of insulin delivery is superior. Patients newly diagnosed with type T1DM and established on a single treatment regimen, either CSII or MDI, for a minimum of 2 years were identified. Over the 6 years of NPDA submissions analysed, a total of 43 patients newly diagnosed with T1DM, established on a single treatment regimen for a minimum of 2 years were identified. Data for patients treated for 3, 4 and 5 years was also obtained, however as length of treatment increased, the number of patients eligible for inclusion decreased.

Results: MDI and CSII produce similar reductions in levels of glycated haemoglobin, and similar attainment of national targets between two and five years post diagnosis, whilst patients are established on a single insulin regimen. There was no statistical significance between the CSII and MDI results at 2 and 3 years. Four and 5-year datasets were too small to be statistically analysed.

Conclusion: There is no significant difference in diabetic control achieved by multiple daily injections of insulin and continuous subcutaneous insulin infusions. To improve the reliability and validity of these results, readily available data could be obtained from other units across England and Wales, using NPDA submissions, to increase the sample size. With larger samples, it will be possible to further analyse the data, for example according to age and sex, to ascertain whether there are superior treatment options for specific groups of patients.