Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: Experience of the PedPump Study in 17 countries

T. Danne*, T. Battelino, P. Jarosz-Chobot, O. Kordonouri, E. Pánkowska, J. Ludvigsson, E. Schober, E. Kaprio, T. Saukkonen, M. Nicolino, N. Tubiana-Rufi, C. Klinkert, H. Haberland, A. Vazeou, L. Madacsy, D. Zangen, V. Cherubini, I. Rabbone, S. Toni, C. De BeaufortW. Bakker-van Waarde, N. Van Den Berg, I. Volkov, R. Barrio, R. Hanas, U. Zumsteg, B. Kuhlmann, C. Aebi, U. Schumacher, S. Gschwend, P. Hindmarsh, M. Torres, N. Shehadeh, M. Phillip

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

114 Scopus citations

Abstract

Aims/hypothesis: To assess the use of paediatric continuous subcutaneous infusion (CSII) under real-life conditions by analysing data recorded for up to 90 days and relating them to outcome. Methods: Pump programming data from patients aged 0-18 years treated with CSII in 30 centres from 16 European countries and Israel were recorded during routine clinical visits. HbA 1c was measured centrally. Results: A total of 1,041 patients (age: 11.8±4.2 years; diabetes duration: 6.0±3.6 years; average CSII duration: 2.0±1.3 years; HbA1c: 8.0±1.3% [means±SD]) participated. Glycaemic control was better in preschool (n=142; 7.5±0.9%) and pre-adolescent (6-11 years, n=321; 7.7±1.0%) children than in adolescent patients (12-18 years, n=578; 8.3±1.4%). There was a significant negative correlation between HbA1c and daily bolus number, but not between HbA1c and total daily insulin dose. The use of <6.7 daily boluses was a significant predictor of an HbA1c level >7.5%. The incidence of severe hypoglycaemia and ketoacidosis was 6.63 and 6.26 events per 100 patient-years, respectively. Conclusions/ interpretation: This large paediatric survey of CSII shows that glycaemic targets can be frequently achieved, particularly in young children, and the incidence of acute complications is low. Adequate substitution of basal and prandial insulin is associated with a better HbA1c.

Original languageAmerican English
Pages (from-to)1594-1601
Number of pages8
JournalDiabetologia
Volume51
Issue number9
DOIs
StatePublished - Sep 2008
Externally publishedYes

Keywords

  • Adolescents
  • Children
  • Diabetic
  • HbA
  • Hypoglycaemia
  • Insulin infusion systems
  • Ketoacidosis
  • Type 1 diabetes mellitus

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