Marie-Anne Burckhardt1,2,3, Grant J Smith1, Matthew N Cooper1, Timothy W Jones1,2,3, Elizabeth A Davis1,2,3. 1. Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia. 2. Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Australia. 3. Division of Paediatrics, Medical School, The University of Western Australia, Perth, Australia.
Abstract
BACKGROUND: Long-term glycemic outcomes in people with type 1 diabetes (T1D) on insulin pump therapy (continuous subcutaneous insulin infusion [CSII]) with appropriate control data are limited. Randomized controlled studies of technology in diabetes care are generally limited in duration and likely to have a selection bias. Hence, evaluation of population-based data provides a robust alternative evaluation of the benefits of insulin pump therapy. AIM: To investigate the outcomes of insulin pump therapy, as compared to injection therapy, in children with T1D attending a state-wide diabetes service in Western Australia. METHODS: Patients using insulin pump therapy between January 1999 and July 2016 were matched to patients on injection therapy on the basis of age, date of diagnosis, and hemoglobin A1C (HbA1c) at the start of pump therapy. RESULTS: A total of 513 pump-injection matches were identified. The pump cohort had a significantly lower mean HbA1c for the first 6 years of follow-up. The difference in HbA1c between the cohorts was observed by 6 months (3 mmol/mol [0.3%], standard error of the mean (SEM) 0.05, N = 463 matched pairs, P < 0.001) and was sustained with the greatest difference in HbA1c at 6 years (4 mmol/mol [0.4%], SEM 0.21, N = 112 matched pairs, P = 0.04). Beyond 6 years of follow-up, the HbA1c was not significantly lower in the pump cohort (N < 70 matched pairs). CONCLUSIONS: Patients using insulin pump therapy had a better long-term glycemic control relative to the matched injection therapy cohort. Large population-based cohort studies using real-world data provide a valuable perspective on evaluation of new technologies in children with T1D.
BACKGROUND: Long-term glycemic outcomes in people with type 1 diabetes (T1D) on insulin pump therapy (continuous subcutaneous insulin infusion [CSII]) with appropriate control data are limited. Randomized controlled studies of technology in diabetes care are generally limited in duration and likely to have a selection bias. Hence, evaluation of population-based data provides a robust alternative evaluation of the benefits of insulin pump therapy. AIM: To investigate the outcomes of insulin pump therapy, as compared to injection therapy, in children with T1D attending a state-wide diabetes service in Western Australia. METHODS:Patients using insulin pump therapy between January 1999 and July 2016 were matched to patients on injection therapy on the basis of age, date of diagnosis, and hemoglobin A1C (HbA1c) at the start of pump therapy. RESULTS: A total of 513 pump-injection matches were identified. The pump cohort had a significantly lower mean HbA1c for the first 6 years of follow-up. The difference in HbA1c between the cohorts was observed by 6 months (3 mmol/mol [0.3%], standard error of the mean (SEM) 0.05, N = 463 matched pairs, P < 0.001) and was sustained with the greatest difference in HbA1c at 6 years (4 mmol/mol [0.4%], SEM 0.21, N = 112 matched pairs, P = 0.04). Beyond 6 years of follow-up, the HbA1c was not significantly lower in the pump cohort (N < 70 matched pairs). CONCLUSIONS:Patients using insulin pump therapy had a better long-term glycemic control relative to the matched injection therapy cohort. Large population-based cohort studies using real-world data provide a valuable perspective on evaluation of new technologies in children with T1D.
Authors: Claudia Boettcher; Sascha R Tittel; Thomas Meissner; Bettina Gohlke; Rainer Stachow; Axel Dost; Sybille Wunderlich; Iris Lowak; Stefanie Lanzinger Journal: BMJ Open Diabetes Res Care Date: 2021-12
Authors: Ileana Mardare; Stephen M Campbell; Johanna C Meyer; Israel Abebrese Sefah; Amos Massele; Brian Godman Journal: Front Pharmacol Date: 2022-01-14 Impact factor: 5.810
Authors: Elizabeth Ann Pyatak; Raymond Hernandez; Loree T Pham; Khatira Mehdiyeva; Stefan Schneider; Anne Peters; Valerie Ruelas; Jill Crandall; Pey-Jiuan Lee; Haomiao Jin; Claire J Hoogendoorn; Gladys Crespo-Ramos; Heidy Mendez-Rodriguez; Mark Harmel; Martha Walker; Sara Serafin-Dokhan; Jeffrey S Gonzalez; Donna Spruijt-Metz Journal: JMIR Res Protoc Date: 2021-10-22