Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry. (15th July 2016)

• Record Type: Journal Article
• Authors: Szypowska, Agnieszka; Schwandt, Anke; Svensson, Jannet; Shalitin, Shlomit; Cardona‐Hernandez, Roque; Forsander, Gun; Sundberg, Frida; De Beaufort, Carine; Maahs, David; Maffeis, Claudio; O'Riordan, Stephen M.P.; Krisane, Iveta Dzivite; Scharf, Mauro; Castro, Sofia; Konstantinova, Maia; Obermannova, Barbora; Casteels, Kristina; Gökşen, Damla; Galhardo, Júlia; Kanaka‐Gantenbein, Christina; Rami‐Merhar, Birgit; Madacsy, Laszlo
• Other Names: Pacaud Danièle guestEditor.; Szypowska Agnieszka guestEditor.; Witsch Michael guestEditor.
• Is Part Of: Pediatric diabetes. Volume 17(2016)Supplement S23
• Page Start: 38
• Page End: 45
• Publication Date: 2016-07-15
• Subjects: childhood diabetes -- continuous subcutaneous insulin infusion -- CSII -- MDI -- multiple daily injections; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12416
• Languages: English
• ISSNs: 1399-543X

Abstract

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 :W orking to crE ate CE nT ers 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.