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Pediatr Diabetes. 2016 Oct;17 Suppl 23:38-45. doi: 10.1111/pedi.12416. Epub 2016 Jul 15.

Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry.

Author information

1
Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland. agnieszka.szypowska@gmail.com.
2
Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
3
German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
4
Pediatric Department, Copenhagen University Hospital, Herlev, Denmark.
5
The Jesse Z and Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
6
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
7
Division of Endocrinology and Diabetes, Hospital Sant Joan de Déu, Barcelona, Spain.
8
Institute for Clinical Sciences, Sahlgrenska Achademy, University of Gothenburg, Gothenburg, Sweden.
9
The Queen Silvia Childrens Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
10
DCCP-Clinique pédiatrique de Luxembourg, Luxembourg, Luxembourg.
11
Department of Pediatric Endocrinology, UZBrussels, Brussels, Belgium.
12
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver Aurora, Colorado, USA.
13
Pediatric Diabetes and Metabolic Disorders Unit & Regional Center for Pediatric Diabetes, University Hospital, University of Verona, Verona, Italy.
14
Paediatrics Diabetes & Endocrine Unit, Department of Paediatrics & Child Health, Cork University Hospital, University College Cork, Cork, Ireland.
15
Children's University Hospital Children's Endocrinology Centre, Riga Stradins University, Riga, Latvia.
16
Pediatric Endocrinology, Hospital Nossa Senhora Das Graças, Brazil.
17
Child and Young Department, APDP-Diabetes, Lisbon, Portugal.
18
Medical University-Clinic of Endocrinology, Diabetes and Genetics, Sofia University Pediatric Hospital, Sofia, Bulgaria.
19
Department of Pediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
20
Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.
21
Department of Development and Regeneration, KU Leuven, Belgium.
22
Faculty of Medicine Pediatric Endocrinology and Diabetes, Ege University, İzmir, Turkey.
23
Unit of Pediatric Endocrinology and Diabetes, Hospital Dona Estefânia, Lisbon, Portugal.
24
Diabetes Center, Division of Endocrinology, Diabetes and Metabolism First Department of Pediatrics, Medical School National and Kapodistrian University of Athens-Greece "Aghia Sophia" Children's Hospital, Athens, Greece.
25
Department of Pediatrics and Adolescent Medicine of Medical University of Vienna, Vienna, Austria.
26
First Department of Pediatrics, Semmelweis University, Budapest, Hungary.

Abstract

BACKGROUND:

Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control.

OBJECTIVE:

To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI.

METHODS:

This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out.

RESULTS:

Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P < .0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P < .0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P < .0001).

CONCLUSIONS:

Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

KEYWORDS:

CSII ; MDI ; childhood diabetes; continuous subcutaneous insulin infusion; multiple daily injections

PMID:
27417128
DOI:
10.1111/pedi.12416
[Indexed for MEDLINE]

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