Endocrine Abstracts

Aim: To investigate the glycaemic control of patients with T1DM before and after the introduction of CSII therapy.

Methods: All patients with T1DM receiving CSII therapy for more than 6 months attending the Children’s University Hospital from 2005–2011 were included. Glycosylated haemoglobin (HbA1c) was recorded 12 and 6 months prior to starting therapy, at the time of CSII initiation and annually thereafter. Adverse events and BMI were also recorded at these intervals.

Results: Data was collected on 104 children (52 males). The mean age at diagnosis of T1DM was 6.4 years (range 0.7–15.4 years). CSII therapy was commenced at a mean age of 10.3 years (range 0.9–17.3 years) with a mean duration of therapy of 2.5 years (range 0.5–5.9 years). Mean (S.D.) HbA1c pre CSII therapy was 8.6% (1.0) with values of 8.1% (0.87) 1 year after commencing therapy (P<0.05). The HbA1c value at 2–5 years after commencing pump therapy were 8.2% (0.79), 8.1% (0.78), 8.1% (0.68) and 7.9% (0.37) respectively (P<0.05). There were three adverse events (diabetic ketoacidosis, severe hypoglycaemia) per year prior to CSII therapy and 1.2 events per year after its initiation. No change was seen in BMI Z score pre and post CSII therapy. No site infections were seen.

Conclusion: Tight metabolic control reduces the incidence of micro vascular complications in T1DM (DCCT Research Group J Pediatr 1994). In this study, HbA1c improved significantly following introduction of CSII therapy and this improvement was maintained over the study period. CSII therapy is a safe and effective method to optimize and maintain glycaemic control in children with T1DM.