Evaluating clinical outcomes, quality of life (QOL) in children young people with T1 Diabetes managed on CSII. Comparing those who started CSII at diagnosis with those who started 1 year or more.
Commencement of CSII within 30 days of diagnosis (G1) compared to those who commenced > 12 months after diagnosis (G 2). Data was collected retrospectively including anthropometric data, HBA1c, episodes of diabetes ketoacidosis (DKA), severe hypoglycaemic, total daily insulin doses.
Differences between the groups were compared by t test.
G1, n=49 patients (female n= 18) G 2 n=37 patients (female n= 18) Mean age at diagnosis for G1 was 9.02 y(+ 4.81) (mean + SD ) G 2 4.9 y(+2.9)The age at pump start for G1 was 9.04 y (+ 4.81) G2 9.12 y(+ 3.2). The mean basal insulin dose for G1 0.70 + 0.234 compared G2 0.78 + 0.179 .
No significant difference between the two groups other than their duration of diabetes at pump start G1; 5.59 (+7.19) days and G2; 4.72 (+3.2) y.
Glycemic control between the two groups was statistically different at each time point over the 48 months with HbA1c in G1< G2. Mean HbA1c G1 6.68% compared to 6.93% G2.
21 patients in G125 patients in G2 >13 years. Each time point over 48 months the HbA1c in G1 was statistically lower than G2.
No episodes of DKA occurred in G1 or G2 once CSII started. Severe hypoglycaemic episodes were decreased in G2 by 75%.
QOL data showed that no significant differences between the two groups with both parents and children. Parents mean 80.0 SD+2, children mean 81.5 SD+1.5.
Starting insulin pump therapy within 1 month of diagnosis resulted in improvement in HbA1c, reduction of hypoglycaemia, no episodes of DKA no detrimental effect on QOL. In subjects aged > 13y who started CSII at diagnosis there were better outcomes than those who started after or equal to 12 months.