Access of children and adolescents with type 1 diabetes to insulin pump therapy has greatly increased in France since 2001.

AIM: Insulin pump therapy is an emerging option in the management of type 1 diabetes (T1D), but it often remains unused. For this reason, in 2007, a French national survey was carried out to update the frequency of insulin pump use in the paediatric population compared with a previous survey done in 2001. METHODS: The present survey was performed in hospital departments involved in paediatric diabetes management (n = 67) and in adult departments involved in adolescent diabetes management (n = 113). The number of T1D children (age < 18 years) treated in each department, with or without the use of an insulin pump, and the number of insulin pump therapies initiated during the previous year were collected. RESULTS: A total of 60 paediatric and 28 adult centres responded, involving 9073 T1D children and adolescents (93% in paediatric departments). Of these patients, 1461 (16%) were treated by insulin pump, 89% of which were managed in paediatric centres. However, pump use was more frequent in adult than in paediatric centres (32% versus 18%, respectively). Also, 38% of insulin pumps were initiated during the year prior to the survey. In addition, in 2001, 140 children were treated with insulin pump in 13 paediatric centres (versus 56 centres in 2007). CONCLUSION: The number of centres using insulin pump therapy for diabetic children and the number of children treated by insulin pump were increased fourfold and 10-fold, respectively, from 2001 to 2007, indicating greater access to pump therapy in the French paediatric population. The present survey is still ongoing to evaluate the decision-making criteria that influence the initiation of insulin pump therapy in T1D paediatric patients.

Penicilloyl-dextran conjugates as reagents for skin testing in penicillin allergy.

A procedure for implanting amino groups in the dextran molecule is described. The aminated polymer prepared from a dextran sample with a molecular weight of 20,000 was found to contain approximately 16 amino groups per molecule. Similarly to polylysine, the aminated dextran may be penicilloylated by incubation with penicillin at high pH. The penicilloyl-dextran (P-Dex) conjugate prepared in this way was found to contain approximately 8 penicilloyl (PO) groups per molecule. P-Dex was found practically nonimmunogenic in rabbits and showed itself antigenically active in precipitin, passive hemagglutination and passive cutaneous anaphylaxis (PCA) tests performed with a PO specific antiserum. A good correlation was found between the skin tests performed parallelly with P-Dex and penicilloyl-polylysine (PPL) in four subjects with penicillin allergy.

Spontaneous formation of immunogenic conjugates by a biotransformation product of sulfanilamide.

3-hydroxy-sulfanilamide (3-HS) has been previously shown to be formed in significant amounts in rabbits and humans treated with sulfanilamide. In the present paper we demonstrate that 3-HS reacts readily with proteins at alkaline pH and forms conjugates capable to induce hapten specific antibodies in rabbits. According to our previous observations on ortho-aminophenol (OAP), the haptenic properties of 3-HS are apparently due to the presence in its molecule of an ortho-aminophenolic structure, rendering it capable to form a highly reactive quinoneimine derivative. In spite of a similar mechanism of linking and of the presence of an ortho-aminophenolic structure in the two haptens, 3-HS and OAP immunological systems do not cross react with each other. The data presented here support the hypothesis that 3-HS may represent the hapten or one of the haptens involved in sulfonamide allergy.