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[IP] Safety and Effectiveness of Insulin Pump Therapy in Children and Adolescents Wit
Diabetes Care 2003 Apr;26(4):1142-1146 >Links</A>
Safety and Effectiveness of Insulin Pump Therapy in Children and Adolescents
With Type 1 Diabetes.
Plotnick LP, Clark LM, Brancati FL, Erlinger T.
Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland.
Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health,
Baltimore, Maryland. Welch Center for Prevention, Epidemiology and Clinical
Research, Baltimore, Maryland.
OBJECTIVE-To evaluate the safety and effectiveness of insulin pump therapy in
children and adolescents with type 1 diabetes. RESEARCH DESIGN AND
METHODS-All 95 patients who began insulin pump therapy at Johns Hopkins
Hospital between January 1990 and December 2000 were included in the study.
The mean age was 12.0 years (range 4-18), and 29% of the patients were <10
years old. Data were obtained by chart review beginning 6-12 months before
pump start. The median duration of follow-up was 28 months. RESULTS:-There
was a small but significant decrease in HbA(1c) at 3-6 months after pump
start (7.7 vs. 7.5%; P = 0.03). HbA(1c) levels then gradually increased and
remained elevated after 1 year of follow-up; however, this association was
confounded by age and diabetes duration, both of which were associated with
higher HbA(1c) levels. After adjusting for duration and age, mean HbA(1c)
after pump start was significantly lower than before pump start (7.7 vs.
8.1%; P < 0.001). The number of medical complications (diabetic ketoacidosis,
emergency department visits) was similar before and after pump start. There
were fewer hypoglycemic events after pump start (12 vs. 17, rate ratio 0.46,
95% CI 0.21-1.01). CONCLUSIONS:-This study suggests that pump therapy is safe
and effective in selected children and adolescents with type 1 diabetes.
PMID: 12663587 [PubMed - as supplied by publisher]
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