Premium
Glycaemic variability in paediatric patients with type 1 diabetes on continuous subcutaneous insulin infusion ( CSII ) or multiple daily injections ( MDI ): a cross‐sectional cohort study
Author(s) -
Schreiver C.,
Jacoby U.,
Watzer B.,
Thomas A.,
Haffner D.,
Fischer D.C.
Publication year - 2013
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12093
Subject(s) - medicine , insulin , diabetes mellitus , type 2 diabetes , endocrinology , insulin pump , type 1 diabetes , cohort
Summary Objective This cross‐sectional observational cohort study was designed to investigate i) whether glycaemic variability in paediatric patients with type 1 diabetes is lower in those using an insulin pump ( CSII ) compared with those using multiple daily insulin injections ( MDI ) and ii) whether urinary F 2 ‐isoprostanes and/or urinary prostaglandin F 2 excretion as surrogate marker of oxidative stress and cyclooxygenase activity are associated with glycaemic variability. Methods 48 paediatric patients with type 1 diabetes (22 using an insulin pump) underwent an ambulatory 3‐day continuous glucose monitoring. All patients continued with normal daily activities and collected urine for two consecutive 24 h periods. The glucose pentagon was used to calculate the glycaemic risk parameter. Results Insulin requirements, HDL ‐cholesterol, the mean of glycaemic excursions ( P < 0·01) and the standard deviation of mean glucose concentration ( P < 0·05) were significantly lower in patients with CSII compared with those using MDI . By contrast, averaged HbA 1c during the last twelve months as well as at the time of sensor insertion did not differ significantly between both groups. Summarizing characteristic parameter of acute and long‐term metabolic control into the glucose pentagon revealed a significantly lower glycaemic risk parameter in CSI patients compared with both, healthy subjects and patients using MDI ( P < 0·05). Conclusions Paediatric patients with type 1 diabetes using an insulin pump presented with lower glycaemic variability and a concomitantly lower glycaemic risk parameter compared with those using MDII . Whether these findings translate into a lower risk of diabetes associated cardiovascular complications remains to be elucidated.