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[IP] Diabetic Children Prefer Pump Over Injections

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Diabetic Children Prefer Pump Over Injections 
Fri September 5, 2003 12:52 PM ET 
NEW YORK (Reuters Health) - Intensive insulin therapy is feasible and safe 
for children with type 1 diabetes, investigators report in the medical journal 
 Pediatrics. They found that in a small trial, more children preferred treatment
with continuous subcutaneous insulin infusion (CSII) over multiple daily 
 insulin injections.Dr. Naomi Weintrob, of Schneider Children's Medical Center
Israel in Petah Tikva, and colleagues conducted what they believe is the first 
trial in which children with type 1 diabetes, also referred to as "juvenile 
diabetes," were randomly assigned to one of the two treatment methods. After 
receiving one treatment the 23 participants, who ranged in age from 8 to 14 
years, were then switched over to the other treatment.

Glucose control increased significantly between an initial educational 
 session and the start of the trial. At the end of the seven-month trial,
 levels did not differ significantly between treatment arms. However, total
insulin dose decreased during CSII therapy and increased during MDI, the 
report indicates.

According to scores on Diabetes Treatment Satisfaction Questionnaires, 
 patients preferred using the pump (average score 30.6) compared with multiple
insulin injections (average score 21.4). Sixteen subjects preferred CSII 
 because of greater flexibility with meal times, the perception of glucose
and avoidance of the pain of injections.

Among those who preferred multiple daily insulin injections, the reasons for 
not liking the pump device included poorer glucose control and fear of weight 
gain. Other reasons were scarring at the infusion site, fear of insertion of 
the device, and shame about wearing the pump.

Weintrob and colleagues recommend that both treatment modes be made available 
to diabetes treatment teams and their patients to better tailor therapy.

SOURCE: Pediatrics, September 2003.
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