Insulin Pumps Reduces Glycemic Excursions in Pre-schoolers

Study concluded that CSII was feasible and safe in preschool children and pump therapy reduced glycemic excursions.

A group of investigators led by Dr George Jeha of Baylor College of Medicine in Houston, USA, compared the effects of continuous subcutaneous insulin infusion (CSII) with twice-daily insulin injection in preschool children with type 1 diabetes on glycemic control, daily variations in glycemic control, and parental anxiety. Ten patients aged younger than 6 years who were receiving insulin injections underwent continuous glucose monitoring for two 72-hour periods before starting CSII, and were then re-monitored after 3 and 6 months. The investigators compared pre- and post-CSII results for blood glucose concentrations, variation in blood glucose concentrations, and HbA1c. The number, distribution, and duration of hypoglycemic episodes were recorded. Parental anxiety was assessed using the Parental Stress Index (PSI) scale.

The investigators found that, after initiating CSII, blood glucose variability decreased by 22% (93±19mg/dL vs 72±5mg/dL; p=0.02) and HbA1c decreased by 13% (8.6% vs 7.5%; p=0.01). The number and duration of hypoglycemic episodes over 24 hours decreased (1.16 episodes vs 0 episodes [p=0.01] and 1.19h vs 0.05h [p=0.01], respectively). The change in PSI scores was not statistically significant.

The investigators concluded that CSII was feasible and safe in preschool children and pump therapy reduced glycemic excursions as well as the duration and frequency of hypoglycemic episodes.

Diabetes Technology and Therapeutics 2005;7:876-84

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