Three-year comparison of subcutaneous insulin pump treatment with multi-daily injections on HbA1c, its variability and hospital burden of children with type 1 diabetesReport as inadecuate




Three-year comparison of subcutaneous insulin pump treatment with multi-daily injections on HbA1c, its variability and hospital burden of children with type 1 diabetes - Download this document for free, or read online. Document in PDF available to download.

Acta Diabetologica

, Volume 49, Issue 5, pp 363–370

First Online: 01 October 2011Received: 20 July 2011Accepted: 14 September 2011

Abstract

Treatment with continuous subcutaneous insulin infusion CSII allows a large degree of treatment individualization and intensification in children with diabetes. The study’s aim was to evaluate the impact of treatment with CSII on glycated haemoglobin level HbA1c in children with diabetes and investigate whether introduction of CSII is associated with an increased risk of acute complications of diabetes. Patients treated throughout the recruitment period exclusively with multiple daily injections MDI were matched for duration of diabetes and HbA1c level at baseline with patients treated exclusively with CSII in a 1:1 group ratio n = 223 and 231 for MDI and CSII, respectively. The CSII group showed lower HbA1c after the observation period 7.98 ± 1.38 vs. 7.56 ± 0.97; P = 0.002. HbA1c variability measured as standard deviations of average values was also lower in the CSII group 0.73 ± 0.45 vs. 0.84 ± 0.54; P = 0.049. The rate of hospitalization due to acute events was similar in both groups 14.7-100 vs. 14.0-100 person-years in the MDI and CSII group, P = 0.72. Duration of hospital stay per year was on average 1.25 days shorter in the CSII group P = 0.0004, but the risk of acute complications resulting in hospitalization did not differ between the groups hazard ratio HR 1.16; 95% confidence interval 95% CI 0.68–1.63. The most significant risk factor for hospitalization due to acute complications was baseline HbA1c concentration HR 1.25; 95% CI 1.14–1.37. In conclusion, CSII treatment may improve glycemic control and reduce its variability. Change of MDI to CSII does not alter the risk of hospitalization and may reduce the annual duration of hospitalization in children with diabetes.

KeywordsInsulin delivery systems Complications of diabetes Paediatric diabetes Healthcare organization Electronic supplementary materialThe online version of this article doi:10.1007-s00592-011-0332-7 contains supplementary material, which is available to authorized users.

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Author: Wojciech Fendler - Anna Iza Baranowska - Beata Mianowska - Agnieszka Szadkowska - Wojciech Mlynarski

Source: https://link.springer.com/







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