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Arch Pediatr. 1996 Oct;3(10):969-76.

[Remission of severe hypoglycemic incidents in young diabetic children treated with subcutaneous infusion].

[Article in French]

Author information

1
Service d'endocrinologie et de diabétologie pédiatriques, hôpital Robert-Debré, Paris, France.

Abstract

BACKGROUND:

Conventional insulin therapy for diabetes mellitus can be inadequate for controlling glycemia in young patients in whom the risk of hypoglycemia is particularly high.

PATIENTS:

A retrospective study comparing all the children under 6 years of age treated in our department by continuous subcutaneous insulin infusion (group P, n = 10, mean age: 3.7 years) to 17 children with conventional insulin therapy (group C, mean age: 5.1 years) was conducted during a mean period of 2 years.

RESULTS:

Mean insulin doses, HbAlc, pre-prandial and daily glycemic levels, measured at 0, 3, 6, 12, 18 and 24 months, did not differ significantly between both groups. Mean HbAlc levels remained < or = 8% in the two groups. There was no episode of severe hypoglycemia in group P vs ten episodes in group C (P < 0.05); this benefit was confirmed in those six children belonging to group P who had previously followed a conventional therapy: 11 episodes during the conventional period vs 0 episode during the pump period (P < 0.05). Nine out of ten families were very satisfied with the treatment by pump mainly because of a more comfortable life style and a reduction of parents' anxiety due to disappearance of severe hypoglycemias. The insulin pump therapy had some limits: cutaneous complications and technical ones were responsible for two keto-acidosis episodes (0.1 episode per year-patient) and a higher frequency of hospitalizations. In group C, hospitalizations were caused by severe hypoglycemias and unbalanced glycemic control.

CONCLUSIONS:

Insulin pump therapy could be indicated in young diabetic children at high risk of severe hypoglycemia under conditions of a specialized medical and educational supervision and knowledge of the limits of such a treatment.

PMID:
8952790
DOI:
10.1016/0929-693x(96)81717-9
[Indexed for MEDLINE]

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