Insulin pump therapy in toddlers and preschool children with type 1 diabetes mellitus.

Published

Journal Article

OBJECTIVE: To test whether glycemic control in young children could be achieved more effectively and safely by using continuous insulin infusions administered by insulin pumps. STUDY DESIGN: We analyzed the effects of pump therapy in nine toddlers in whom type 1 diabetes developed between the ages of 10 and 40 months. After a mean of 13.7 months of therapy with multiple daily injections, patients were treated with insulin pumps for periods ranging from 7 to 19 months (mean, 12.7 months). RESULTS: Before initiation of pump therapy, HbA1c levels averaged 9.5% +/- 0.4%, and patients had a mean of 0.52 episodes per month of severe hypoglycemia (uncontrolled shaking, inconsolable crying, disorientation, or seizures). After initiation of pump therapy, HbA1c levels declined to 7.9% +/- 0.3% (P <.001 vs prepump levels), and the incidence of severe hypoglycemia decreased to 0.09 episodes per month (P <.05). Normal linear growth and weight gain were maintained during pump therapy. There were no changes in the frequency of physician or emergency room visits for acute hyperglycemia or ketoacidosis. However, the frequency of parental contacts with health personnel declined by >80%, reflecting increasing parental confidence and independence in diabetic care. Subjective assessments revealed significant improvements in quality of life and high levels of satisfaction with pump therapy. CONCLUSIONS: Insulin pump therapy may provide an effective alternative for selected preschool children with type 1 diabetes.

Full Text

Duke Authors

Cited Authors

  • Litton, J; Rice, A; Friedman, N; Oden, J; Lee, MM; Freemark, M

Published Date

  • October 2002

Published In

Volume / Issue

  • 141 / 4

Start / End Page

  • 490 - 495

PubMed ID

  • 12378187

Pubmed Central ID

  • 12378187

International Standard Serial Number (ISSN)

  • 0022-3476

Digital Object Identifier (DOI)

  • 10.1067/mpd.2002.127500

Language

  • eng

Conference Location

  • United States