Conference Resources | Abstracts
September 3
rd
– 6
th
, 2014 | Toronto, Canada |
228
P138
An evaluation of the Manitoba Pediatric Insulin Pump Program
N. Van Walleghem
1
, T. Hoilett
1
, S. Marks
1
1
Diabetes Education Resource for Children and Adolescents, Winnipeg, Canada
In 2012, provincial funding was announced for the new Manitoba Pediatric Insulin Pump (MPIP)
program, which includes coverage for the cost of insulin pumps for children with type 1 diabetes who
meet the program's eligibility criteria. Components of the program include an individual clinical
assessment, two group pump education classes and an individual pump start.
Objectives:
This quality audit examined changes in glycemic control, BMI, incidence of acute
complications and rates of discontinuation in youth (n=50) initiating continuous subcutaneous insulin
infusion (CSII) between October 2012 and March 2014 through the MPIP program.
Methods:
A1c was evaluated at CSII initiation, 6 months after CSII start and annually after CSII start
using paired t tests. BMI z-scores were evaluated at CSII initiation and annually after CSII start using
paired t tests.
Results:
At CSII start, the children (50% male) had a mean age of 13.1 years (range 3.0-17.5). As of
March 2014, 27/50 youth have used CSII for at least 6 months; A1c significantly decreased by 0.44%,
from 7.98 to 7.54% (p< 0.05) from CSII start to 6 months post-CSII start. 14/50 youth have used the
pump for 1 year or more. Although A1c decreased 0.45% from CSII start to 1 year post-CSII, this was
not statistically significant likely due to small sample size. In females, BMI z-score significantly
increased during the year of CSII from 0.91 to 1.09 (p< 0.05). There was 1 case of DKA (3.2 cases per
100 pt-yrs) and no severe hypoglycaemia. 2/50 (4.0%) youth have discontinued CSII.
Conclusions:
The MPIP program is a new, standardized approach to assessment, education,
initiation and follow-up of CSII. Although in the early stages, CSII has improved glycemic control.
Increasing BMI z-scores in our female pumpers is worrisome and warrants further review.
