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Pediatr Diabetes. 2012 Nov;13(7):515-8. doi: 10.1111/j.1399-5448.2012.00863.x. Epub 2012 Apr 5.

Sensor augmented pump therapy from onset of type 1 diabetes: late follow-up results of the Pediatric Onset Study.

Author information

  • 1Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus, Auf der Bult, Hannover, Germany. kordonouri@hka.de

Abstract

AIM:

To evaluate the metabolic control and β-cell function 1 yr after the end of the European multicentre randomized Pediatric Onset Study.

METHODS:

Of 154 study patients, 131 were re-examined 24 months after type 1 diabetes onset (49.6% boys, age at onset 8.9 ± 4.3 yrs). Of which, 62 patients belonged to the primary group of the main study applying a sensor-augmented pump system during the first yr and 69 patients to the control group performing conventional insulin pump therapy with self-monitoring blood glucose. HbA1c, fasting blood glucose, and C-peptide were centrally measured (Clinical Trail Registration Number: ISRCTN05450731).

RESULTS:

At 24 months, i.e., 1 yr after the end of the interventional study, 52.4% of the patients used the sensor-augmented pump system, 46.0% conventional pump, and 1.6% multiple daily injections. HbA1c was 7.6 ± 1.3% in the primary and 7.7 ± 1.2% in the control group (p = 0.493). Frequent sensor use during the first yr was associated with statistically insignificant lowering of the HbA1c at 24 months (p = 0.236) as compared with irregular or no sensor use (7.4 ± 1.0% vs. 7.7 ± 1.3%). Although fasting C-peptide was not clearly different between the primary and control group (0.13 ± 0.17 vs. 0.09 ± 0.10 nmol/L, p = 0.121), patients with frequent sensor use had significantly less C-peptide loss within 24 months (C-peptide reduction 0.02 ± 0.18 vs. 0.07 ± 0.11 nmol/L, p = 0.046). There was no difference between the groups regarding daily insulin requirements.

CONCLUSION:

Sensor-augmented pump therapy from onset of diabetes may lead to better long-term glycemic control and help to preserve endogenous β-cell function, if patients comply with frequent use of continuous glucose monitoring.

© 2012 John Wiley & Sons A/S.

PMID:
22487079
[PubMed - indexed for MEDLINE]
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