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[IP] Benefits of continuous subcutaneous insulin infusion in children with type 1 dia


J Pediatr. 2003 Dec;143(6):796-801. Related Articles, Links 

Benefits of continuous subcutaneous insulin infusion in children with type 1 

Willi SM, Planton J, Egede L, Schwarz S.

Division of Endocrinology, Department of Pediatrics, and the General Clinical 
Research Center, Medical University of South Carolina, Charleston, South 
Carolina, USA.

OBJECTIVE: To examine the effect of continuous subcutaneous insulin infusion 
(CSII) therapy on parameters affecting long-term outcome in type 1 
 diabetes.Study design Height, weight, body mass index, insulin dose,
 hemoglobin (HbA(1C)), and blood glucose data from home meter downloads were
prospectively for analysis in 51 children (age, 10.7+/-3.1 years, mean+/-SD) 
throughout the 12 months before and after introducing CSII. RESULTS: Before 
pump initiation, HbA(1C) was relatively stable, but it fell to 7.7+/-0.2% 
 (P<.001) within 3 months of CSII and remained decreased (7.9+/-0.1%) at 12
(P<.01). In contrast, weight standard deviation score increased before CSII 
 (from 0.50+/-0.13 to 0.60+/-0.13, P<.05), but remained unchanged (0.61+/-0.11)
the year thereafter. Although severe hypoglycemia (<50 mg/dL) was reduced in 
the entire cohort, HbA(1C) improved primarily in young children and teenagers. 
Comparison of glycemic responders (HbA(1C) <7.5, or a decrease >1% on CSII, 
n=23) with nonresponders demonstrated no differences with respect to gender, 
 socioeconomic status, weight standard deviation score, body mass index, initial
HbA(1C), frequency of hypoglycemia, or number of education visits before CSII. 
CONCLUSION: Continuous subcutaneous insulin infusion is effective in lowering 
HbA(1C) and the occurrence of severe nocturnal hypoglycemia without excessive 
weight gain in most children with type 1 diabetes. HbA(1C) response to CSII is 
poorer in preadolescents than in young children or teenagers.

PMID: 14657831 [PubMed - as supplied by publisher] 
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