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Vol 4, No 3 (2003): Practical Diabetology
Original articles (translated)
Published online: 2003-05-22
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Safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes

Leslie P. Plotnick, Loretta M. Clark, Frederick L. Brancati, Thomas Erlinger
Diabetologia Praktyczna 2003;4(3):245-252.

open access

Vol 4, No 3 (2003): Practical Diabetology
Original articles (translated)
Published online: 2003-05-22

Abstract

INTRODUCTION. To evaluate the safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes.
MATERIAL AND METHODS.
All 95 patients who began insulin pump therapy at Johns Hopkins Hospital between January 1990 and December 2000 were included in the study. The mean age was 12.0 years (range 4–18), and 29% of the patients were < 10 years old. Data were obtained by chart review beginning 6–12 months before pump start. The median duration of follow-up was 28 months.
RESULTS. There was a small but significant decrease in HbA1c at 3–6 months after pump start (7.7% vs. 7.5%; P = 0.03). HbA1c levels then gradually increased and remained elevated after 1 year of followup; however, this association was confounded by age and diabetes duration, both of which were associated with higher HbA1c levels. After adjusting for duration and age, mean HbA1c after pump start was significantly lower than before pump start (7.7% vs. 8.1%; P < 0.001). The number of medical complications (diabetic ketoacidosis, emergency department visits) was similar before and after pump start. There were fewer hypoglycemic events after pump start (12 vs. 17, rate ratio 0.46, 95% CI 0.21–1.01).
CONCLUSIONS. This study suggests that pump therapy is safe and effective in selected children and adolescents with type 1 diabetes.

Abstract

INTRODUCTION. To evaluate the safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes.
MATERIAL AND METHODS.
All 95 patients who began insulin pump therapy at Johns Hopkins Hospital between January 1990 and December 2000 were included in the study. The mean age was 12.0 years (range 4–18), and 29% of the patients were < 10 years old. Data were obtained by chart review beginning 6–12 months before pump start. The median duration of follow-up was 28 months.
RESULTS. There was a small but significant decrease in HbA1c at 3–6 months after pump start (7.7% vs. 7.5%; P = 0.03). HbA1c levels then gradually increased and remained elevated after 1 year of followup; however, this association was confounded by age and diabetes duration, both of which were associated with higher HbA1c levels. After adjusting for duration and age, mean HbA1c after pump start was significantly lower than before pump start (7.7% vs. 8.1%; P < 0.001). The number of medical complications (diabetic ketoacidosis, emergency department visits) was similar before and after pump start. There were fewer hypoglycemic events after pump start (12 vs. 17, rate ratio 0.46, 95% CI 0.21–1.01).
CONCLUSIONS. This study suggests that pump therapy is safe and effective in selected children and adolescents with type 1 diabetes.
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Keywords

insulin pump therapy; type 1 diabetes mellitus

About this article
Title

Safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes

Journal

Clinical Diabetology

Issue

Vol 4, No 3 (2003): Practical Diabetology

Pages

245-252

Published online

2003-05-22

Bibliographic record

Diabetologia Praktyczna 2003;4(3):245-252.

Keywords

insulin pump therapy
type 1 diabetes mellitus

Authors

Leslie P. Plotnick
Loretta M. Clark
Frederick L. Brancati
Thomas Erlinger

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