BSPED2010 Oral Communications Oral Communications 4 (Brief Communications) (4 abstracts)
Medium term impact of continuous subcutaneous insulin infusion (CSII) on HbA1c levels: A regional meta-analysis of 185 patients
A Sinha 1 , A Butt 2 , N Hopper 2 , T Mukundan 3 , E Posner 3 , J Jani 6 , F Jamil 4 , J Ahmed 6 , A Norrington 7 , M Burns 7 , G Birrell 7 , B Lamb 5 & T Cheetham 1
1Great North Children’s Hospital, Newcastle upon Tyne, UK; 2Sunderland Royal Hospital, Sunderland, UK; 3University Hospital of North Durham, Durham, UK; 4Darlington Memorial Hospital, Darlington, UK; 5Bishop Auckland Hospital, Bishop Auckland, UK; 6University Hospital of Hartlepool, Hartlepool, UK; 7James Cook University Hospital, Middlesbrough, UK.
Background: The use of CSII in children with T1DM is increasing. Several meta-analyses have concluded that there is an improvement in glycaemic control with CSII but most of these investigations have included adults and have been of short duration (<6 months). Our aim was to assess the medium term impact of CSII on HbA1c levels in patients managed with CSII in one region of The UK.
Methods: Data was collected retrospectively from 7 centres within North-East England. These centres manage the majority of young people on CSII (>95%) in the locality. Only patients under the age of 18 who had been on insulin injections for 1 year prior and at least 1 year of CSII therapy were included. HbA1c data pre and post CSII initiation was collected and then analysed using meta-analysis software (Review Manager 5.0) and Minitab v15.0. Results are expressed as mean differences, calculated from end of treatment values, with 95% confidence intervals (CI) for continuous outcomes. Pooled results were meta-analysed using the generic inverse variance method with a fixed-effects model. Statistical significance was set at a P value ≤0.05.
Results: Data from 185 patients was included in the meta-analysis. There was a significant improvement in HbA1c favouring CSII therapy at 4 months post CSII initiation (P=0.05, weighted mean difference −0.23; 95% confidence intervals −0.47, 0.00) but this trend was not sustained at 1 year (P=0.88, weighted mean difference −0.02; 95% confidence intervals −0.30, 0.26) or 2 years (P=0.27, weighted mean difference 0.19; 95% confidence intervals −0.14, 0.51).
Conclusions: The impact of CSII in isolation is remarkably similar to many other initiatives involving new insulin regimens in T1DM with a short term improvement in HbA1c that wanes in the longer term.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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