The longest and largest study of the effectiveness of insulin pumps to treat type 1 diabetes in children has shown that the pumps are more effective at controlling blood sugar than insulin injections and cause fewer complications. The research is published in Diabetologia, the journal of the European Association for the Study of Diabetes, and is by Associate Professor Elizabeth Davis, Princess Margaret Hospital for Children, Perth, WA, Australia and colleagues.
The increasing use of insulin pump therapy over the last 15 years, particularly in children, has been driven by improvements in pump technology, the availability of insulin analogues, plus factors such as the results of the Diabetes Control and Complications Trial which established the benefits offered by improved blood sugar control. Despite this increased use, the outcomes of pump therapy continue to be debated. However there has been inadequate research into the long term effects of pump therapy in children, with many studies too short in duration or not recruiting enough patients.
In this study, a total of 345 patients on pump therapy were matched to controls on injections, with a mean age 11 years (range 2-19 years), with a mean duration of diabetes at the start of pump therapy of 4.1 years (range 6 months to 15.5 years) and a follow up of 3.5 years (range 0-10.5 years). The mean HbA1c reduction (a standard method for measuring blood glucose control) in the pump cohort was 0.6% (6.6 mmol/mol). This improved HbA1c remained significant until seven years of follow up (at which point the numbers in the study were too small to analyse the results with statistical confidence). Both groups started with the same HbA1c and max difference was 1% difference at 6 yrs: 7.6 % in the pump group and 8.6 % in the non-pump group.
Pump therapy reduced episodes of severe hypoglycaemia (dangerously low blood glucose) from 14.7 to 7.2 events per 100 patients per year. In contrast, sever
|Contact: Elizabeth Davis|