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A 7-year follow-up retrospective, international, multicenter study of insulin pump therapy in children and adolescents with type 1 diabetes

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Abstract

We evaluated the long-term glycemic control in children with type 1 diabetes, using continuous subcutaneous insulin infusion (CSII) for at least 5 years in three diabetes centers from three different countries: Canada, Italy and Spain. This was an observational retrospective multicenter cohort study. Subjects were included if they were followed at one of the participating centers, had type 1 diabetes, age 5–20 years at time of data collection and used CSII for more than 5 years. Data collected included gender, age, disease duration, age at CSII initiation, body mass index (BMI), hemoglobin A1c (HbA1c), insulin requirement and serious adverse events (SAE) at baseline and every 12 months during follow-up. One hundred fifteen patients were included in the study (55 % males), aged 5–20 years (mean: 13.5 ± 3.8 years), with mean diabetes duration of 6.3 ± 3.4 years, using CSII for mean of 6.9 ± 1.2 years (range 5–12 years.). HbA1c significantly improved after 1 year of CSII treatment and during follow-up (p = 0.02). When HbA1c was compared between countries, a difference was observed, with slightly lower values in Italy than in Canada and Spain (p = 0.04). When evaluated by gender, HbA1c was similar at baseline, but significantly improved only in males during all follow-up (p = 0.004). No significant differences were observed for BMI, insulin requirement or SAE. Insulin pump therapy is safe and effective in the pediatric population, although in this study, the major benefit in HbA1c was seen in males. The use of advanced pump features was associated with greater improvement in HbA1c.

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Conflict of interest

A.E.S receives research support, and participates in advisory boards for Medtronic, no conflict of interest disclosed for this study; C.M., J.H., R.C.-H., L.S.-O., and G.V.Z. have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Pediatrics, Azienda Ospedaliera, University of Milano, “Ospedale Luigi Sacco,” Via G.B. Grassi 74, 20154, Milan, Italy

    Chiara Mameli, Andrea E. Scaramuzza & Gian Vincenzo Zuccotti

  2. Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada

    Josephine Ho

  3. Division of Endocrinology and Diabetes, Hospital Sant Joan de Déu, Barcelona, Spain

    Roque Cardona-Hernandez & Larisa Suarez-Ortega

Authors
  1. Chiara Mameli
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  2. Andrea E. Scaramuzza
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  3. Josephine Ho
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  4. Roque Cardona-Hernandez
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  5. Larisa Suarez-Ortega
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  6. Gian Vincenzo Zuccotti
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Corresponding author

Correspondence to Andrea E. Scaramuzza.

Additional information

Communicated by Guido Pozza.

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Mameli, C., Scaramuzza, A.E., Ho, J. et al. A 7-year follow-up retrospective, international, multicenter study of insulin pump therapy in children and adolescents with type 1 diabetes. Acta Diabetol 51, 205–210 (2014). https://doi.org/10.1007/s00592-013-0481-y

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  • DOI: https://doi.org/10.1007/s00592-013-0481-y

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