Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life

Aims To determine the impact of insulin pump therapy (continuous subcutaneous insulin infusion) on key parameters of diabetes management including quality of life in children and adolescents with Type 1 diabetes mellitus (T1DM). Methods All patients started on insulin pump therapy were prospective...

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Published in:	Diabetic medicine Vol. 22; no. 1; pp. 92 - 96
Main Authors:	McMahon, S. K., Airey, F. L., Marangou, D. A., McElwee, K. J., Carne, C. L., Clarey, A. J., Davis, E. A., Jones, T. W.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Ltd 01-01-2005 Blackwell
Subjects:	Adolescent adolescents Adult Biological and medical sciences Child Child, Preschool children Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - drug therapy Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Glycated Hemoglobin A - metabolism Humans hypoglycaemia Hypoglycemia - drug therapy Hypoglycemic Agents - administration & dosage Infant Insulin - administration & dosage Insulin Infusion Systems insulin pump therapy Medical sciences Quality of Life Treatment Outcome Endocrinopathy Human adolescents hypoglycaemia Diabetes mellitus insulin pump therapy Metabolic diseases Hypoglycemia Quality of life Clinical management Treatment Insulin pump children Adolescent Child
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Summary:	Aims To determine the impact of insulin pump therapy (continuous subcutaneous insulin infusion) on key parameters of diabetes management including quality of life in children and adolescents with Type 1 diabetes mellitus (T1DM). Methods All patients started on insulin pump therapy were prospectively followed before and after institution of insulin pump therapy. Data collected included age, duration of diabetes, glycated haemoglobin levels (HbA1c), anthropometric data and episodes of severe hypoglycaemia defined as hypoglycaemia resulting in coma or convulsion. A subset of patients also completed the Diabetes Quality of Life Instrument (DQOL) and Self‐Efficacy for Diabetes Scale (SED) questionnaires to assess quality of life. Results At the time of analysis, 100 patients had been managed with insulin pump therapy. The mean age when starting pump therapy was 12.5 (3.9–19.6) years. Duration of therapy ranged from 0.2 to 4.0 years (mean 1.4 years, median 1.5 years). HbA1c decreased from 8.3 ± 0.1% prior to pump therapy to 7.8 ± 0.1% (P < 0.0001). Episodes of severe hypoglycaemia decreased from 32.9 to 11.4 per 100 patient years. Components of quality of life measures showed improvement on pump treatment. BMI standard deviation scores (z scores) did not increase. Conclusions Pump therapy is proving an effective means of insulin therapy in the young patient that shows promise to improve glycaemic control with a reduction in hypoglycaemia frequency. Quality of Life measures suggest that psychosocial outcomes may be improved.
Bibliography:	ArticleID:DME1359 ark:/67375/WNG-2GG7F0G6-K istex:7D8EECFDEBA5BEE6774A28808CBF0CEBF35B1840 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0742-3071 1464-5491
DOI:	10.1111/j.1464-5491.2004.01359.x