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Researchers say that insulin pumps are more effective at controlling type 1 diabetes in children and cause fewer complications than insulin injections, having completed the longest and largest study of insulin pumps to date.
According to the researchers at the Princess Margaret Hospital for Children in Australia, the use of pump therapy has increased over the last 15 years, particularly in children.
Pump therapy involves having a catheter placed under the skin to deliver short-acting doses of insulin around the clock. The insulin pump delivers the dosage at two levels: at the basal rate, the normal level of blood insulin needed when a person with diabetes has not eaten or is asleep; and the bolus rate, the level of insulin needed when a diabetic eats.
The study, published in the journal of the European Association for the Study of Diabetes, analyzed 345 children with type 1 diabetes undergoing pump therapy, and the same number of children who treat their diabetes with injections.
All children were aged between 2 and 19-years-old and had a mean diabetes duration of 4.1 years at the start of pump therapy. The follow-up mean duration period for the children was 3.5 years.
Results of the analysis revealed that the use of insulin pumps reduced episodes of severe hypoglycemia - dangerously low blood glucose - from 14.7 events in every 100 patients a year, to 7.2 episodes.
Numbers of severe hypoglycemic events in children using insulin injections, meanwhile, went up over the same period, from 6.8 events in every 100 patients per year, to 10.2 episodes.
Additionally, the rate of admission for diabetic ketoacidosis was lower in children using pump therapy at 2.3 events per every 100 patients per year, compared with 4.7 events per every 100 patients per year using insulin injections.
Dr. Elizabeth Davis, an associate professor at the Princess Margaret Hospital for Children, says the results of this study are strong due to its large population-based sample over a long period of time.
"This is the largest study of insulin pump use in children. It also has the longest follow-up period of any study of insulin pump therapy in children," she says.
Dr. Davis adds:
"Our data confirm that insulin pump therapy provides an improvement in glycemic control which is sustained for at least seven years.
Although this is not a randomized trial, it is 'real life' experience in a large population-based sample over a prolonged time period and, as such, provides important information."
In other research on insulin pumps, presented at the American Diabetes Association 73rd Scientific Sessions in Chicago this year, one model of insulin pump was found to reduce nocturnal hypoglycemia without affecting glycated hemoglobin levels.
The authors of this latest research note that of the children using pump therapy, 38 stopped the treatment during the course of the study.
They explain that some children may have stopped because they became tired of the extra attention taken to manage the pump. Children may also be concerned about its physical appearance.
Written by Honor Whiteman
Copyright: Medical News Today
Not to be reproduced without the permission of Medical News Today.
Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case-control study; Stephanie Johnson, Matthew Cooper, Timothy Jones and Elizabeth Davis, Diabetologia, August 18, 2013.
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