[Previous Months][Date Index][Thread Index][Join - Register][Login]   Help@Insulin-Pumpers.org
  [Message Prev][Message Next][Thread Prev][Thread Next]   for subscribe/unsubscribe assistance
 
 

[IP] Insulin Pump Therapy in Young Children with Diabetes



 <A
HREF="http://www.attendeeinteractive.com/shows/ada0302/index.cfm?fuseaction=L
ocator.PreviewAbstract&popup=yes&NoLayout=Yes&AbstractID=829">63rd Scientific
Sessions</A>

A Two Center Randomized Controlled Trial of Insulin Pump Therapy in Young
Children with Diabetes
 
Abstract Information
Abstract Number:    1745-P
Authors:    DARRELL M. WILSON, BRUCE A. BUCKINGHAM, ELIZABETH L. KUNSELMAN,
MARY M. SULLIVAN, HELEN U. PAGUNTALAN, STEPHEN E. GITELMAN
Institution:    Stanford, CA; San Francisco, CA
Results:    The use of continuous subcutaneous insulin infusion (CSII) in
young children is controversial with some arguing that CSII is unproven and
potentially dangerous in young children with diabetes. We are conducting a
randomized one year trial comparing CSII to continued multiple daily
injections (MDI)
in preschool children less than 6 years of age with Type 1 diabetes for at
least 6 months. 19 children with post-randomization data form the basis for
this
analysis. Prospective outcome measures included the incidence of diabetic
ketoacidosis (DKA), severe hypoglycemia (Hypo), the Diabetes Quality of Life
(DQoL) questionnaire (1=very satisfied to 5=very dissatisfied), hemoglobin A1c
(HA1c, DCA 2000+), as well as the percent of glucose meter values below 70
mg/dL.[br]The subjects[rsquo] ages ranged from 1.7 to 6.1 (mean 3.6) yr,
duration of
diabetes ranged from 0.6 to 2.6 (mean 1.4) yr, and baseline HA1c ranged from
6.7 to 9.6 (mean 7.9%). 7 were male. 9 were randomized to start CSII and 10 to
continue on MDI. All baseline characteristics were well balanced. All subjects
have completed at least 12 weeks and the delta in the table includes subjects
who have at least 28 weeks of data (n=16). Delta equals most recent (at least
28 wk) minus baseline.[table1]Overall metabolic control (HA1C), quality of
life (DQoL), and the incidence of hypoglycemia have been similar in the two
groups. To date, no subject has had DKA while one subject on CSII has had an
episode of severe hypoglycemia. No CSII subject has discontinued using the
pump
during the study. Of the 8 who have already completed the study, 2 of 5
randomized to MDI have switched CSII, while 3 on CSII have elected to remain
on the
pump. CSII can be a safe and effective method to delivery insulin in young
children.
Category:   Pediatrics
Tables:         MDI 0 wk    CSII 0 wk   MDI 28 wk   CSII 28 wk  MDI Delta
CSII Delta
DQoL    2.3 (0.6)   2.3 (0.3)   2.2 (0.5)   2.2 (0.4)   -0.1 (0.2)  -0.2
(0.3)
HA1c    7.8 (1.0)   8.0 (1.1)   7.6 (0.7)   7.6 (0.8)   -0.3 (0.6)  -0.3
(0.7)
[lt]70 mg/dL    11% 8%  10% 8%  0%  3%
----------------------------------------------------------
for HELP or to subscribe/unsubscribe, contact:
HELP@insulin-pumpers.org