Agnieszka Szypowska1, Anke Schwandt2,3, Jannet Svensson4, Shlomit Shalitin5,6, Roque Cardona-Hernandez7, Gun Forsander8,9, Frida Sundberg9, Carine De Beaufort10,11, David Maahs12, Claudio Maffeis13, Stephen M P O'Riordan14, Iveta Dzivite Krisane15, Mauro Scharf16, Sofia Castro17, Maia Konstantinova18, Barbora Obermannova19, Kristina Casteels20,21, Damla Gökşen22, Júlia Galhardo23, Christina Kanaka-Gantenbein24, Birgit Rami-Merhar25, Laszlo Madacsy26. 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.
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 diabetespatient 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.
Authors: Susana R Patton; Amy E Noser; Erin M Youngkin; Shideh Majidi; Mark A Clements Journal: Diabetes Technol Ther Date: 2019-06-05 Impact factor: 6.118
Authors: Beate Karges; Anke Schwandt; Bettina Heidtmann; Olga Kordonouri; Elisabeth Binder; Ulrike Schierloh; Claudia Boettcher; Thomas Kapellen; Joachim Rosenbauer; Reinhard W Holl Journal: JAMA Date: 2017-10-10 Impact factor: 56.272
Authors: Faisal S Malik; Katherine A Sauder; Scott Isom; Beth A Reboussin; Dana Dabelea; Jean M Lawrence; Alissa Roberts; Elizabeth J Mayer-Davis; Santica Marcovina; Lawrence Dolan; Daria Igudesman; Catherine Pihoker; Jean M Lawrence; Peggy Hung; Corinna Koebnick; Xia Li; Eva Lustigova; Kristi Reynolds; David J Pettitt; Elizabeth J Mayer-Davis; Amy Mottl; Joan Thomas; Malaka Jackson; Lisa Knight; Angela D Liese; Christine Turley; Deborah Bowlby; James Amrhein; Elaine Apperson; Bryce Nelson; Dana Dabelea; Anna Bellatorre; Tessa Crume; Richard F Hamman; Katherine A Sauder; Allison Shapiro; Lisa Testaverde; Georgeanna J Klingensmith; David Maahs; Marian J Rewers; Paul Wadwa; Stephen Daniels; Michael G Kahn; Greta Wilkening; Clifford A Bloch; Jeffrey Powell; Kathy Love-Osborne; Diana C Hu; Lawrence M Dolan; Amy S Shah; Debra A Standiford; Elaine M Urbina; Catherine Pihoker; Irl Hirsch; Grace Kim; Faisal A Malik; Lina Merjaneh; Alissa Roberts; Craig Taplin; Joyce Yi-Frazier; Natalie Beauregard; Cordelia Franklin; Carlo Gangan; Sue Kearns; Mary Klingsheim; Beth Loots; Michael Pascual; Carla Greenbaum; Giuseppina Imperatore; Sharon H Saydah; Barbara Linder; Santica M Marcovina; Alan Chait; Noemie Clouet-Foraison; Jessica Harting; Greg Strylewicz; Ralph D'Agostino; Elizabeth T Jensen; Lynne E Wagenknecht; Ronny A Bell; Ramon Casanova; Jasmin Divers; Maureen T Goldstein; Leora Henkin; Scott Isom; Kristin Lenoir; June Pierce; Beth Reboussin; Joseph Rigdon; Andrew Michael South; Jeanette Stafford; Cynthia Suerken; Brian Wells; Carrie Williams Journal: Diabetes Care Date: 2022-02-01 Impact factor: 19.112