Sustained benefits of continuous subcutaneous insulin infusion.

ABSTRACT

AIM: To evaluate the efficacy and safety of continuous subcutaneous insulin infusion (CSII), and its impact on glycaemic control, insulin doses and auxological parameters in children with diabetes over a 4-year period. METHOD: A retrospective analysis of all patients treated with CSII. Data on HbA1c, height, weight, insulin doses, hypoglycaemia and diabetic ketoacidosis (DKA) were analysed. RESULTS: 67 patients, aged 1-16 years showed a mean (±SD) HbA1c pre-CSII of 8.2%, decreasing to 7.3% (±0.8%) at 6 months (p<0.01), 7.7% (±0.99) at 2 years (p<0.05), 7.4% (±0.94) at 3 years (n=9, p=0.15) and 7.6% (±0.97) at 4 years (n=4, p=1.0). Insulin doses reduced significantly with a trend towards reduced BMI SDS. Nine preschool children showed HbA1c reduction from 8.4% (±0.94) to 7.4% (±0.32, p<0.01) over 20 months with no episodes of severe hypoglycaemia or DKA. CONCLUSION: The authors demonstrate that CSII is associated with significantly improved sustained glycaemic control, especially in preschool children with diabetes in motivated families.