BACKGROUND: This study evaluated the predictors of effectiveness and durability of insulin pump therapy in children and adolescents who have initiated continuous subcutaneous insulin infusion (CSII) within 2 years after the diagnosis of type 1 diabetes mellitus (T1DM). SUBJECTS AND METHODS: The charts of individuals with T1DM using insulin pumps who were treated at our center were reviewed, including subjects with age at onset of <22 years, interval between onset and insulin pump commencement (interval onset-commencement) of <2 years, use of pumps of >1 year, and use of glucose sensors for <4 weeks/year. The primary end point was the mean glycosylated hemoglobin (HbA1c) value (MHbA1c) throughout the follow-up. RESULTS: From 684 patients treated with insulin pumps, 119 met the inclusion criteria, and 113 were selected for statistical analysis (60 females; age at diabetes onset, 8.9±5.6 years [mean±SD]; follow-up, 4.0±1.8 years; range, 1-8 years; baseline HbA1c, 9.3±1.8%). Only the interval onset-commencement was a linear predictor of the MHbA1c (P=0.01; R(2)=0.089). A significant reduction of the mean yearly HbA1c from baseline throughout all the follow-up was observed (P<0.001). Categorizing the sample into four quartiles on the basis of an increasing interval onset-commencement resulted in levels of MHbA1c significantly lower in the first and second quartiles in comparison with the fourth quartile (7.6±0.8% and 7.8±1.0%, respectively, versus 8.5±0.8%; P<0.001 and P=0.004, respectively). CONCLUSIONS: The present study suggests that early pump commencement in children and adolescents with T1DM provides lower and more durable HbA1c values than a late commencement. It is possible that an early pump commencement could prolong the honeymoon phase, but we cannot confirm or exclude this hypothesis because the lack of data about C-peptide levels during the follow-up.
BACKGROUND: This study evaluated the predictors of effectiveness and durability of insulin pump therapy in children and adolescents who have initiated continuous subcutaneous insulin infusion (CSII) within 2 years after the diagnosis of type 1 diabetes mellitus (T1DM). SUBJECTS AND METHODS: The charts of individuals with T1DM using insulin pumps who were treated at our center were reviewed, including subjects with age at onset of <22 years, interval between onset and insulin pump commencement (interval onset-commencement) of <2 years, use of pumps of >1 year, and use of glucose sensors for <4 weeks/year. The primary end point was the mean glycosylated hemoglobin (HbA1c) value (MHbA1c) throughout the follow-up. RESULTS: From 684 patients treated with insulin pumps, 119 met the inclusion criteria, and 113 were selected for statistical analysis (60 females; age at diabetes onset, 8.9±5.6 years [mean±SD]; follow-up, 4.0±1.8 years; range, 1-8 years; baseline HbA1c, 9.3±1.8%). Only the interval onset-commencement was a linear predictor of the MHbA1c (P=0.01; R(2)=0.089). A significant reduction of the mean yearly HbA1c from baseline throughout all the follow-up was observed (P<0.001). Categorizing the sample into four quartiles on the basis of an increasing interval onset-commencement resulted in levels of MHbA1c significantly lower in the first and second quartiles in comparison with the fourth quartile (7.6±0.8% and 7.8±1.0%, respectively, versus 8.5±0.8%; P<0.001 and P=0.004, respectively). CONCLUSIONS: The present study suggests that early pump commencement in children and adolescents with T1DM provides lower and more durable HbA1c values than a late commencement. It is possible that an early pump commencement could prolong the honeymoon phase, but we cannot confirm or exclude this hypothesis because the lack of data about C-peptide levels during the follow-up.
Authors: Hsin-Chieh Yeh; Todd T Brown; Nisa Maruthur; Padmini Ranasinghe; Zackary Berger; Yong D Suh; Lisa M Wilson; Elisabeth B Haberl; Jessica Brick; Eric B Bass; Sherita Hill Golden Journal: Ann Intern Med Date: 2012-09-04 Impact factor: 25.391
Authors: Maria H Lin; Crystal G Connor; Katrina J Ruedy; Roy W Beck; Craig Kollman; Bruce Buckingham; Maria J Redondo; Desmond Schatz; Heidi Haro; Joyce M Lee; William V Tamborlane; Jamie R Wood Journal: Diabetes Technol Ther Date: 2013-07-19 Impact factor: 6.118
Authors: David M Nathan; Margaret Bayless; Patricia Cleary; Saul Genuth; Rose Gubitosi-Klug; John M Lachin; Gayle Lorenzi; Bernard Zinman Journal: Diabetes Date: 2013-12 Impact factor: 9.461
Authors: Omaima M Sabek; Maria J Redondo; Duc T Nguyen; Christine A Beamish; Daniel W Fraga; Christiane S Hampe; Surya N Mulukutla; Edward A Graviss; A Osama Gaber Journal: Endocrinol Diabetes Metab Date: 2019-11-29
Authors: Yun Jeong Lee; Young Ah Lee; Jae Hyun Kim; Hye Rim Chung; Min Jeong Gu; Ji Young Kim; Choong Ho Shin Journal: Ann Pediatr Endocrinol Metab Date: 2020-12-31