Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life

Diabetic Medicine - Tập 22 Số 1 - Trang 92-96 - 2005
Sandra McMahon1,2, F. L. Airey2, D. A. Marangou2, Karen McElwee2, Christine L. Carne2, A. J. Clarey2, Elizabeth A. Davis1,2, Timothy W. Jones1,2
1Centre for Child Health Research, The University of Western Australia, Telethon Institute for Child Health Research, Perth, Australia
2Department Endocrinology and Diabetes, Princess Margaret Hospital for Children

Tóm tắt

AbstractAims  To determine the impact of insulin pump therapy (continuous subcutaneous insulin infusion) on key parameters of diabetes management including quality of life in children and adolescents with Type 1 diabetes mellitus (T1DM).Methods  All patients started on insulin pump therapy were prospectively followed before and after institution of insulin pump therapy. Data collected included age, duration of diabetes, glycated haemoglobin levels (HbA1c), anthropometric data and episodes of severe hypoglycaemia defined as hypoglycaemia resulting in coma or convulsion. A subset of patients also completed the Diabetes Quality of Life Instrument (DQOL) and Self‐Efficacy for Diabetes Scale (SED) questionnaires to assess quality of life.Results  At the time of analysis, 100 patients had been managed with insulin pump therapy. The mean age when starting pump therapy was 12.5 (3.9–19.6) years. Duration of therapy ranged from 0.2 to 4.0 years (mean 1.4 years, median 1.5 years). HbA1c decreased from 8.3 ± 0.1% prior to pump therapy to 7.8 ± 0.1% (P < 0.0001). Episodes of severe hypoglycaemia decreased from 32.9 to 11.4 per 100 patient years. Components of quality of life measures showed improvement on pump treatment. BMI standard deviation scores (z scores) did not increase.Conclusions  Pump therapy is proving an effective means of insulin therapy in the young patient that shows promise to improve glycaemic control with a reduction in hypoglycaemia frequency. Quality of Life measures suggest that psychosocial outcomes may be improved.

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Tài liệu tham khảo

Rosenbloom AL, 2000, Therapeutic controversy: prevention and treatment of diabetes in children, J Clin Endocrinol Metabolism, 85, 494

10.2337/diacare.22.3.495

10.1046/j.1464-5491.1999.00024.x

10.1515/JPEM.1999.12.2.185

10.1016/S0889-8529(05)70106-7

10.2337/diacare.26.4.1224

10.1056/NEJM199309303291401

10.1046/j.1463-1326.1999.0010s2007.x

Anonymous., 1994, Effect of intensive diabetes treatment on the development and progression of long‐term complications in adolescents with insulin‐dependent diabetes mellitus: Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group, J Pediatrics, 125, 177, 10.1016/S0022-3476(94)70190-3

Amiel SA, 1999, Hypoglycaemia in Clinical Diabetes, 147

10.2337/diacare.20.1.22

10.2337/diacare.25.3.593

10.1046/j.1464-5491.2002.00713.x

10.3810/pgm.2002.05.1200

10.1034/j.1399-5448.2002.30103.x

10.2337/diacare.26.4.1142

10.1067/mpd.2002.127500

10.1067/S0022-3476(03)00579-1

10.1542/peds.107.2.351

10.2337/diacare.22.11.1779

10.2337/diacare.23.5.579

10.1002/(SICI)1520-7560(199909/10)15:5<338::AID-DMRR57>3.0.CO;2-Y

10.1515/JPEM.2002.15.5.607

10.1542/peds.112.3.559

10.1515/JPEM.2002.15.7.1005

10.1515/JPEM.2003.16.3.393

10.1515/JPEM.1998.11.S1.177

10.1177/014572179101700219

10.2337/diacare.10.3.324

10.2337/diacare.26.4.1079

10.1037/0278-6133.19.5.452

10.1177/000992280003900501

10.2337/diacare.25.3.439