International Society for Pediatric and Adolescent Diabetes
ISPAD 2014 | 40th Anniversary |
231
P141
Continuous subcutaneous insulin infusion (CSII) in children and young people with type 1
diabetes (TID) commenced at diagnosis compared to those who commenced CSII one year or
more after diagnosis
D.C. Foskett
1
, E. Lang
2
, D. Price
3
, M. Miller
4
, S. Dunn
5
1
Insulin Pump Angels, Helensvale, Australia,
2
Private Practice Brisbane, Briabane, Australia,
3
Pacific
Private Clinic, Southport, Australia,
4
Cunningham Street Specialist Centre, Ipswich, Australia,
5
Charles
Darwin University, Darwin, Australia
Objectives:
To evaluate clinical outcomes and quality of life (QOL) in children and young people with
T1 Diabetes managed on CSII. It compares those who started CSII at diagnosis with those who
started at 1 year or more.
Methods:
Commencement of CSII within 30 days of diagnosis (G1) was compared to those who
commenced > 12 months after diagnosis (G 2). Data was collected retrospectively including
anthropometric data, HBA1c, episodes of diabetes ketoacidosis (DKA), severe hypoglycaemic
episodes, total daily insulin doses.
Differences between the 2 groups were compared by t test.
Results:
G1, n=49 patients (female n= 18) , G 2, n=37 patients (female n= 18) . Mean age at
diagnosis for G1 was 9.02 y(± 4.81) (mean ± SD ) and G 2; 4.9 y(±2.9), The age at pump start for G1
was 9.04 y (± 4.81) and G2 9.12 y(± 3.2). The mean basal insulin dose for G1was 0.70 ± 0.234
compared to 0.78 ± 0.179 for G2.
There was no significant difference between the two groups other than their duration of diabetes at
pump start G1; 5.59 (±7.19) days and G2; 4.72 (±3.2) y.
Glycemic control between the two groups was statistically different at each time point over the 48
months with HbA1c in G1< G2. Mean HbA1c for G1 6.68% compared to 6.93% in G2.
21 patients in G, 25 patients in G2 ≥13 years. At each time point over 48 months the HbA1c in G1 was
statistically lower than G2.
No episodes of DKA occurred in G1 or G2 once CSII started. Severe hypoglycaemic episodes were
decreased in G2 by 75%.
QOL Inventory data showed that there were no significant differences between the two groups with
both parents and the children. Parents mean 80.0 SD±2, children mean 81.5 SD+1.5.
Conclusions:
Starting insulin pump therapy within 1 month of diagnosis resulted in improvement in
HbA1c, reduced rate of hypoglycaemia, no episodes of DKA and no detrimental effect on quality of
life. In subjects aged ≥ 13y who started CSII at diagnosis there were better outcomes than those who
started after or equal to 12 months.
