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Sustained metabolic control and low rates of severe hypoglycaemic episodes in preschool diabetic children treated with continuous subcutaneous insulin infusion
Author(s) -
Pańkowska Ewa,
Szypowska Agnieszka,
Lipka Maria,
Skórka Agata
Publication year - 2007
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2007.00301.x
Subject(s) - medicine , diabetic ketoacidosis , metabolic control analysis , insulin , pediatrics , ketoacidosis , diabetes mellitus , type 1 diabetes , retrospective cohort study , insulin pump , surgery , endocrinology
Aim: To evaluate the safety and efficacy of continuous subcutaneous insulin infusion (CSII) in children under 7 years of age. Methods: One hundred and ten children, aged 0.9–7 years, who had received CSII therapy for at least 6 months, were studied for 237 patient‐years by a retrospective chart review. Charts were reviewed for glycosylated hemoglobin (HbA1c), severe hypoglycaemia (SH), ketoacidosis (DKA), height, weight and insulin requirement. In 69 cases (children aged 1.6–7 years) CSII was administered after at least 3 months of insulin therapy with pens. In this group, data from the year from before CSII administration were compared with values recorded during 1 year of CSII treatment. Results: Mean HbA1c decreased from 7.8 ± 0.9 before CSII to 7.5 ± 1.0 after 6 and 12 months of pump therapy (p = 0.04). In the whole group, the mean HbA1c after 6 months of CSII was 7.5 ± 1.0 and remained unchanged for up to 4 years of follow‐up. Some episodes of SH—4.2 per 100 patient‐years, and DKA—5.7 per 100 patient‐years were recorded. No increase in BMI z‐score occurred. Conclusions: In the youngest children, CSII therapy lowers HbA1c values and provides sustained metabolic control without increases in hypoglycaemia or ketoacidosis episodes.