G229(P) Longitudinal audit of diabetes control with insulin pump therapy over seven years of treatment – interim results. (12th March 2018)

• Record Type: Journal Article
• Authors: Hawes, D; Kanumakala, S
• Is Part Of: Archives of disease in childhood. Volume 103(2018)Supplement 1
• Page Start: A95
• Page End: A95
• Publication Date: 2018-03-12
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2018-rcpch.224
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aim: Insulin pump therapy i.e. Continuous Subcutaneous Insulin Infusion therapy (CSII) is a well-recognised treatment modality in Type 1 Diabetes Mellitus (T1DM). NICE recommends a target%HbA1c level ≤6.5% to minimise long-term complication risk 1 . CSII can be considered in patients<12 years and in those whose%HbA1c have remained high (≥8.5%) on multiple daily insulin therapy despite a high level of care. 1 The aim of this audit is to review diabetes control over time in T1DM patients managed with CSII in our Paediatric Diabetes Unit (PDU). Methods: Retrospective review of diabetes control (%HbA1c) of TIDM patients managed with CSII in our PDU (23/03/2009–10/01/2017). Inclusion criteria=All patients managed with CSII whose data is complete i.e. have a locally recorded pre-CSII%HbA1c and are managed with CSII for at least one full year following switch to CSII. Pre-CSII%HbA1c=mean of up to three%HbA1c recorded prior to switch to CSII. Annual CSII%HbA1c=mean of all%HbA1c recorded per whole year since switching to CSII. Results: In the time period reviewed there have been a total of 57 patients managed with CSII; seven patients were excluded from analysis. There was a slight male preponderance (1.08:1, 52%) with a mean age (±SD) at diagnosis/transfer into our unit of 7.6 years (±4.5 years) and at switch to CSII of 10.2 years (±4.8 years). Analysis of data showed that those patients with the better control pre-switch generally maintained better control following switch to CSII. Despite the fact that annual%HbA1c showed that diabetes control generally worsens over time, cohort annual%HbA1c have remained relatively stable over the seven-year study period. Conclusion: Our PDU has a small number of patients managed with CSII. Results obtained were reflective of other studies which demonstrated worsening diabetes control over time 2 . Despite this, cohort annual results have remained relatively stable. The difficulties of managing patients as they transition through puberty into adolescence/adulthood are well recognised. Supportive and educational opportunities must be maximised for optimal diabetes control and prevention of complications.