Insulin Pump Alarm Does Not Sustain Glucose Control in Children

While meal bolus alarms in diabetic children receiving continuous subcutaneous infusion therapy lead to fewer missed meal boluses and improved glycemic control, the benefits are modest and transient.

Dr. H. Peter Chase and colleagues from the University of Colorado Health Sciences Center, Denver, evaluated if using insulin pumps with meal bolus alarms lead to fewer missed meal boluses per week in 48 type 1 diabetics between the ages of 8 and 20 years. The children were using an insulin pump for at least 6 months and had HbA1c (A1C) values of 8% or lower.

The children were randomized to a Deltec Cozmo insulin pump that had a meal bolus alarm or continued use of their current insulin pumps without a meal bolus alarm (control group). The patients were instructed to return for clinic visits at 3 and 6 months.

Patients in the experimental group had a significantly lower number of missed meal boluses per week at 3 months (from 4.9 to 2.5, p = 0.0005), but no significant reductions were noted in the control group (from 4.3 to 4.2).

A significant decline in the mean A1C value was observed in the experimental group after 3 months (from 9.32 to 8.86, p = 0.0430), but there were no changes in the control group (from 8.93 to 8.67).

However, at 6 months, there were no significant differences in A1C values between the two groups.

Although bolus alarms may have the potential to improve glycemic control in children and adolescents with insulin pumps, the study findings suggest that these alarms only have a “transient, modest effect in doing so,” the researcher conclude.

Diabetes Care 2006;29:1012-1015.