Safety and Effectiveness of Insulin Pump Therapy in Children and Adolescents With Type 1 Diabetes.

Autor: Plotnick, Leslie P., Clark, Loretta M., Brancati, Frederick L., Erlinger, Thomas
Předmět:
Zdroj: Diabetes Care; Apr2003, Vol. 26 Issue 4, p1142-1146, 5p, 2 Charts, 2 Graphs
Abstrakt: OBJECTIVE — To evaluate the safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS — All 95 patients who began insulin pump therapy at Johns Hopkins Hospital between January 1990 and December 2000 were included in the study. The mean age was 12.0 years (range 4-18), and 29% of the patients were < 10 years old. Data were obtained by chart review beginning 6-12 months before pump start. The median duration of follow-up was 28 months. RESULTS — There was a small but significant decrease in HbA[sub 1c] at 3-6 months after pump start (7.7 vs. 7.5%; P = 0.03). HbA[sub 1c] levels then gradually increased and remained elevated after 1 year of follow-up; however, this association was confounded by age and diabetes duration, both of which were associated with higher HbA[sub 1c] levels. After adjusting for duration and age, mean HbA[sub 1c] after pump start was significantly lower than before pump start (7.7 vs. 8.1%; P < 0.001). The number of medical complications (diabetic ketoacidosis, emergency department visits) was similar before and after pump start. There were fewer hypoglycemic events after pump start (12 vs. 17, rate ratio 0.46, 95% CI 0.21-1.01). CONCLUSIONS — This study suggests that pump therapy is safe and effective in selected children and adolescents with type 1 diabetes. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index