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[IP] Glycemic, auxologic and seasonal aspects of CSII in children and young adults

Diabetes Technol Ther. 2003;5(2):175-81.    >Links</A>
Glycemic, auxologic, and seasonal aspects of continuous subcutaneous insulin
infusion therapy in children and young adults with type 1 diabetes.

Hathout EH, McClintock T, Sharkey J, Kytsenko D, Hartwick N, Hadley-Scofield
M, Torgeson S, Mace JW.

Pediatric Diabetes Center, Loma Linda University Children's Hospital, Loma
Linda, California.

Use of continuous subcutaneous insulin infusion (CSII) therapy has increased
among patients with type 1 diabetes. This study was performed: (1) to evaluate
the effect of CSII on diabetes control in children and young adults, (2) to
detect effects of CSII on weight, body mass index (BMI), and insulin
requirements, (3) to investigate seasonal variation in diabetes control during
therapy, and (4) to investigate the effect of season of initiation of CSII on
glycemic control. Thirty-nine patients, ranging in age from 10.1 to 20.5
with type 1 diabetes were studied. Quarterly data over 12 months preceding and
following CSII initiation were obtained retrospectively. Variables were
compared over similar time periods. SAS was used for descriptive and paired t
analysis. (1) Mean blood glucose level was significantly lower at 3 months but
not different from baseline at 6, 9, and 12 months post-CSII. (2) Glycosylated
hemoglobin (HbA1c) was significantly lower at 3 and 6 months but not at 9 and
12 months post-CSII. (3) There was no significant difference in the frequency
of hypoglycemia or hyperglycemia at any of the time periods studied. (4) There
was an initial but unsustained decrease in daily weight-adjusted insulin
requirements after CSII. (5) There was a rapid, sustained increase in weight
BMI following CSII in females. (6) Frequency of ketoacidosis decreased in two
patients. (7) There was no seasonal variation in weight change, HbA1c, or
frequency of measured hypoglycemic episodes with CSII. (8) There was some
effect of
the season of initiation of CSII therapy on glycemic control. Thus, (1) CSII
glycemic benefits may not be sustained, (2) weight gain is a significant
effect of CSII in adolescent females, and (3) CSII may be a means of
ketoacidosis episodes, and eliminating seasonal variability in diabetes

PMID: 12871607 [PubMed - in process]
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