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1.
Eur J Pediatr ; 171(1): 59-65, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21594576

RESUMO

UNLABELLED: We aimed to retrospectively evaluate the efficacy of continuous subcutaneous insulin infusion (CSII) therapy in relation to social deprivation in an urban paediatric type 1 diabetic population. Data were compared between 51 children on CSII therapy (mean age 11.2 years and duration of follow-up 1.9 years) and matched controls on multiple daily injection (MDI) therapy. Social deprivation was measured using the UK Office of National Statistics 2007 Index of Multiple Deprivation. Using linear mixed modelling analysis, lower HbA1c levels at 24 months were associated with CSII not MDI therapy (P = 0.02), after adjustment for known variables. Children with the least educated parents showed a rise in HbA1c levels from baseline on MDI therapy (least versus most educated tertile; HbA1c change +0.5% [95% confidence interval -0.1 to 1.1] versus 0% [-0.8 to 0.8]), whereas this was not observed in CSII therapy (least versus most educated tertile; HbA1c change -0.3% [-0.7 to +0.1] versus -0.2% [-0.7 to +0.3], P value for ANCOVA = 0.02, after adjusting for income and employment). CONCLUSION: Parental educational deprivation was associated with a failure of MDI but not CSII therapy. These outcomes need confirmation by larger studies.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Sistemas de Infusão de Insulina , Insulina/administração & dosagem , Fatores Socioeconômicos , Estudos de Casos e Controles , Criança , Diabetes Mellitus Tipo 1/sangue , Esquema de Medicação , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Modelos Lineares , Estudos Longitudinais , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Reino Unido , Saúde da População Urbana
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