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[IP] CSII in children and adolescents



 J Pediatr Endocrinol Metab 2003 Mar;16(3):393-9 <A
HREF="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Display&dopt=pubmed_pubmed&from_uid=12705364">Related
Articles,</A> >Links</A>

Continuous subcutaneous insulin infusion in children and adolescents with 
diabetes mellitus: decreased HbA1c with low risk of hypoglycemia.

Sulli N, Shashaj B.

Istituto di Clinica Pediatrica, Servizio di Diabetologia Pediatrica, 
Policlinico Umberto I, Universita di Roma "La Sapienza", Rome, Italy. 
email @ redacted

AIM: To evaluate blood glucose and HbA1c levels, insulin dosage, hypoglycemia 
rate and body mass index (BMI) at baseline, and at 3 and 6 months after 
initiation of continuous subcutaneous insulin infusion (CSII) in children and 
youth with type 1 diabetes mellitus (DM). METHODS: A 6-month trial of pump 
therapy was carried out in 40 patients with type 1 DM and one with cystic 
fibrosis (CF) induced DM (25 males), aged 4-25 years (mean 13.5 +/- 4.2 [SD]; 
4-8 years, n = 6; 8-10 years, n = 8; 10-12 years, n = 4; 12-15 years, n = 11; 
>15 years, n = 12). RESULTS: HbA1c was significantly reduced from 9.5 +/- 
1.7% to 8.6 +/- 1.2% at 3 months (p < 0.03), and at 6 months 8.8 +/- 1.5% (p <
 0.05). The mean daily values of blood glucose, as well as individual mean 
values of blood glucose at fasting and before lunch, also exhibited a 
significant reduction (p < 0.05) at 3 and 6 months. There was a significant 
reduction in the number of hypoglycemic events (level of plasma glucose <3.3 
mmol/l, calculated as number of events per patient/30 days) at 3 months (6.5 
+/- 5.5 vs 2.8 +/- 3.3; p = 0.02) and at 6 months (6.5 +/- 5.5 vs 3.5 +/- 
3.0; p = 0.04). The insulin requirement dropped by 27.2% (1.03 +/- 0.30 
U/kg/day before starting CSII; 0.75 +/- 020 U/kg/day on insulin pump therapy 
onset; 0.76 +/- 0.18 U/kg/day at 3 months; 0.75 +/- 0.21 U/kg/day at 6 
months). During the follow-up 0.10 events of diabetic 
ketoacidosis/patient/year were recorded. The patients exhibited no increase 
in BMI during the 6 months of follow-up. CONCLUSION: CSII was safe and 
effective in improving short- and medium-term metabolic control in young 
adults, adolescents and younger children with DM.

PMID: 12705364 [PubMed - in process]    

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Very sincerely yours,
Ellen H. Ullman ;


How wonderful it is that nobody need wait a single moment before starting
to improve the world? -Anne Frank, Holocaust diarist (1929-1945)
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