A randomized, controlled study of insulin pump therapy in diabetic preschoolers

Linda DiMeglio, Tina M. Pottorff, Sheryl R. Boyd, Lisa France, Naomi Fineberg, Erica Eugster

Research output: Contribution to journalArticle

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Abstract

To compare glycemic control, safety, and parental satisfaction in preschool-aged diabetic children randomized to treatment either with continuous subcutaneous insulin infusion (CSII) or intensive insulin injection therapy.This clinical trial enrolled 42 patients <5 years of age who had been diagnosed with diabetes for at least 12 months. Children were randomly assigned to CSII (n = 21) or intensive insulin injection therapy (n = 21). Hemoglobin A1c (HbA1c) level was measured at baseline, 3, and 6 months. Secondary outcomes included severe hypoglycemic events, meter-detected hypoglycemia, blood sugar variability, body mass index (BMI), and satisfaction with therapy.Thirty-seven patients completed 6 months of therapy. There was a significant decrease in HbA1c during the study period for both groups (from 8.9% ± 0.6% to 8.6% ± 0.6% at 3- and 6-month visits). At 3 months, children using pumps had a significantly lower HbA1c than the injection group (8.4% vs 8.8%); however, by 6 months the two groups were similar (8.5% vs 8.7%). No differences in pre-meal blood sugar variabilities were seen between groups. Children on pumps had increases in the number of meter-detected episodes of hypoglycemia. Pump therapy was safe and well tolerated. No episodes of ketoacidosis occurred in either group, whereas one hypoglycemic seizure occurred in each group. Parents reported satisfaction with CSII, with 95% of families continuing on CSII beyond the 6-month study period.Pump therapy in preschool-aged children was not associated with clinically significant differences in glycemic control as compared with intensive injection therapy. The rationale for initiating CSII in this age group should be based on patient selection and lifestyle preference.

Original languageEnglish
Pages (from-to)380-384
Number of pages5
JournalJournal of Pediatrics
Volume145
Issue number3
DOIs
StatePublished - Sep 2004

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Subcutaneous Infusions
Insulin
Hemoglobins
Injections
Therapeutics
Hypoglycemia
Hypoglycemic Agents
Blood Glucose
Ketosis
Preschool Children
Patient Selection
Meals
Life Style
Seizures
Body Mass Index
Age Groups
Parents
Clinical Trials
Safety

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

A randomized, controlled study of insulin pump therapy in diabetic preschoolers. / DiMeglio, Linda; Pottorff, Tina M.; Boyd, Sheryl R.; France, Lisa; Fineberg, Naomi; Eugster, Erica.

In: Journal of Pediatrics, Vol. 145, No. 3, 09.2004, p. 380-384.

Research output: Contribution to journalArticle

DiMeglio, Linda ; Pottorff, Tina M. ; Boyd, Sheryl R. ; France, Lisa ; Fineberg, Naomi ; Eugster, Erica. / A randomized, controlled study of insulin pump therapy in diabetic preschoolers. In: Journal of Pediatrics. 2004 ; Vol. 145, No. 3. pp. 380-384.
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