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[IP] CSIIin young children with type 1 diabetes

Abstract #:
    Abstract Type:  Oral Abstract Presentation: Pediatric Diabetes, Insulin
Pumps and Quality Control Issues (10:15 - 12:15 PM)   
    Abstract Category:  Pediatrics    
    Continuous Subcutaneous Insulin Infusion Therapy in Young Children with
Type 1 Diabetes

    Continuous subcutaneous insulin infusion (CSII) therapy has been reported
to reduce hypoglycemia risk and improve metabolic control in adolescents with
type 1 diabetes. There is little published data available about CSII in
younger children. In the past year, we have initiated CSII in 10 young
children with type 1 diabetes (age between 5 and 12 years). We have compared
the occurrence of hypoglycemia, glycemic control, and patient and parent
satisfaction with treatment in the CSII patients and 10 age-matched patients
with type 1 diabetes treated with multiple daily injections (MDI) over the
same time period. All patients were treated with MDI prior to pump therapy
and CSII was begun in the out-patient Center. CSII was initiated because of
recurrent hypoglycemia in 5 children and because of a desire for increased
flexibility for timing of meals, snacks and exercise in the remaining 5
children. After initiation of pump therapy, no child had severe hypoglycemia
requiring glucagon treatment or associated with seizure. Mean hemoglobin A1c
at baseline was similar in the 2 groups of patients, CSII: 7.94% and MDI:
7.83%. CSII, while associated with reduction of hypoglycemia, did not lead to
a change in overall glycemic control as reflected in the glycosylated
hemoglobin. Mean A1c was 7.81% at 3 months and 7.90% at 6 months after
starting CSII. Glycemic control remained unchanged in the MDI group as well,
7.99% at 3 months and 7.95% at 6 months. There were no episodes of DKA in
either group or of pump site infection in the CSII group. All parents and
patients in the CSII group reported improved satisfaction with therapy and no
patient discontinued CSII. In summary, CSII in10 young children with type 1
diabetes led to reduction of hypoglycemia and improved satisfaction with
therapy. We conclude that CSII should be considered as an alternative to MDI
in some young children with type 1 diabetes.
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