Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2132-2137 (doi:10.1542/10.1542/peds.2005-2363)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (9)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Berhe, T.
Right arrow Articles by Stone, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Berhe, T.
Right arrow Articles by Stone, R.
Related Collections
Right arrow Endocrinology
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Feasibility and Safety of Insulin Pump Therapy in Children Aged 2 to 7 Years With Type 1 Diabetes: A Retrospective Study

Tseghai Berhe, MD, MS, FAAPa,b, Daniel Postellon, MDb, Bruce Wilson, MDb and Roberta Stone, RD, CDEb

a Section of Pediatric Endocrinology and Metabolism, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois
b DeVos Children's Hospital Diabetes Center (Spectrum Health), Grand Rapids, Michigan

BACKGROUND AND OBJECTIVES. Although insulin pump therapy has been successful in adults, adolescents and school children, its use has been limited in young children. The purpose of this study was to evaluate the glycemic control, safety and efficacy of continuous subcutaneous insulin infusion via pump in young children (2–7 years old) with type 1 diabetes who were transitioned from twice-a-day insulin injection (neutral protamine Hagedorn/Lente + Humalog/Novalog) to insulin pump therapy. Hemoglobin A1c, BMI, average fasting blood glucose, episodes of severe hypoglycemia, episodes of diabetic ketoacidosis, episodes of lipohypertrophy, blood glucose variability, and number of sick day calls were compared before and after insulin pump therapy.

METHODS. Data were collected retrospectively by chart review over a 2-year period during quarterly diabetes clinic visits from 33 patients who were managed on neutral protamine Hagedorn/Lente + Humalog/Novolog twice-a-day injections for at least 1 year prior to transitioning to insulin pump therapy.

RESULTS. There was a significant improvement in the average hemoglobin A1c after continuous subcutaneous insulin infusion therapy. The average fasting blood sugar was lower in the continuous subcutaneous insulin infusion group. Severe episodes of hypoglycemia and episodes of lipohypertrophy were significantly higher before insulin pump therapy initiation. There were significantly fewer sick day calls after continuous subcutaneous insulin infusion. Blood sugar variability improved significantly after insulin pump therapy. There was no significant difference in BMI or amount of carbohydrate consumed. None of the patients experienced diabetic ketoacidosis requiring emergency treatment before or after insulin pump therapy.

CONCLUSIONS. Continous subcutaneous insulin infusion therapy in young children with type 1 diabetes is a safe, effective and superior alternative to a twice-a-day insulin regimen.

Key Words: children • type 1 diabetes • insulin pump • hypoglycemia • hemoglobin A1c

Abbreviations: HbA1c—hemoglobin A1c • DCCT—Diabetes Control and Complications Trail • CSII—continuous subcutaneous insulin infusion • MDI—multiple daily injection • NPH—neutral protamine Hagedorn • TDD—total daily dose • DKA—diabetic ketoacidosis

Accepted Dec 14, 2005.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Eur J EndocrinolHome page
S. Wiegand, K. Raile, T. Reinehr, S. Hofer, A. Nake, W. Rabl, R. W Holl, and on behalf of the DPV-Wiss Study Group
Daily insulin requirement of children and adolescents with type 1 diabetes: effect of age, gender, body mass index and mode of therapy.
Eur. J. Endocrinol., April 1, 2008; 158(4): 543 - 549.
[Abstract] [Full Text] [PDF]

Home page
 AAP NewsHome page
C. Kemp
Diabetic preschoolers do well with insulin pump
AAP News, September 1, 2006; 27(9): 2 - 2.
[Full Text]