Premium
A cross‐sectional international survey of continuous subcutaneous insulin infusion in 377 children and adolescents with type 1 diabetes mellitus from 10 countries
Author(s) -
Danne Thomas,
Battelino Tadej,
Kordonouri Olga,
Hanas Ragnar,
Klinkert Christof,
Ludvigsson Johnny,
Barrio Raquel,
Aebi Christine,
Gschwend Sylvia,
Mullis PrimusE.,
Schumacher Urs,
Zumsteg Urs,
Morandi Anita,
Rabbone Ivana,
Cherubini Valentino,
Toni Sonia,
De Beaufort Carine,
Hindmarsh Peter,
Sumner Alex,
Van Waarde Willie M.,
Van Den Berg Norbert,
Phillip Moshe
Publication year - 2005
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-543x.2005.00131.x
Subject(s) - medicine , type 1 diabetes , insulin , insulin pump , diabetes mellitus , pediatrics , hypoglycemia , cross sectional study , bolus (digestion) , endocrinology , pathology
Objective: To document current practices using continuous subcutaneous insulin infusion (CSII) by downloading electronically the 90‐d pump data held within the pump memory and relating that to clinical data from children and adolescents in different pediatric diabetes centers from Europe and Israel. Methods: Data of patients (1–18 yr) treated with CSII in 23 centers from nine European countries and Israel were recorded with the encapture software (PEC International, Frankfurt, Germany). The number of patients who participated was 377 (48% female; mean diabetes duration ± SD: 6.8 ± 3.7 yr; age: 12.9 ± 3.8 yr, preschool n = 33; prepubertal n = 95; adolescent n = 249; CSII duration: 1.6 ± 1.2 yr; local HbA1c: 8.1 ± 1.2%). Results: The total insulin dose was lower than previously reported for injection therapy (0.79 ± 0.20 U/kg/d). Covariance coefficient of daily total insulin was high in all age groups (adolescents 19 ± 9%, prepubertal 18 ± 8 and preschool 17 ± 8). The distribution of basal insulin infusion rates over 24 hr (48 ± 12% of total dose) varied significantly between centers and age groups. The number of boluses per day (7 ± 3) was not significantly different between the age groups (average daily bolus amount: 0.42 ± 0.16 U/kg). The rate of severe hypoglycemia (coma/convulsions) was 12.4 episodes per 100 patient‐years and the number of diabetes‐related hospital days was 124 per 100 patient‐years. Discussion: Pediatric CSII patients show a high variability in their insulin therapy. This relates both to age‐dependent differences in the distribution of basal insulin as to the age‐independent day‐to‐day variation in prandial insulin.