title: A cross-sectional international survey of continuous subcutaneous insulin infusion in 377 children and adolescents with type 1 diabetes mellitus from 10 countries.
abstract: OBJECTIVE
  To document current practices using continuous subcutaneous insulin infusion (CSII) by downloading electronically the 90-d pump data held within the pump memory and relating that to clinical data from children and adolescents in different pediatric diabetes centers from Europe and Israel.
  
  
  METHODS
  Data of patients (1-18 yr) treated with CSII in 23 centers from nine European countries and Israel were recorded with the encapture software (PEC International, Frankfurt, Germany). The number of patients who participated was 377 (48% female; mean diabetes duration +/- SD: 6.8 +/- 3.7 yr; age: 12.9 +/- 3.8 yr, preschool n = 33; prepubertal n = 95; adolescent n = 249; CSII duration: 1.6 +/- 1.2 yr; local HbA1c: 8.1 +/- 1.2%).
  
  
  RESULTS
  The total insulin dose was lower than previously reported for injection therapy (0.79 +/- 0.20 U/kg/d). Covariance coefficient of daily total insulin was high in all age groups (adolescents 19 +/- 9%, prepubertal 18 +/- 8 and preschool 17 +/- 8). The distribution of basal insulin infusion rates over 24 hr (48 +/- 12% of total dose) varied significantly between centers and age groups. The number of boluses per day (7 +/- 3) was not significantly different between the age groups (average daily bolus amount: 0.42 +/- 0.16 U/kg). The rate of severe hypoglycemia (coma/convulsions) was 12.4 episodes per 100 patient-years and the number of diabetes-related hospital days was 124 per 100 patient-years.
  
  
  CONCLUSIONS
  Pediatric CSII patients show a high variability in their insulin therapy. This relates both to age-dependent differences in the distribution of basal insulin as to the age-independent day-to-day variation in prandial insulin.
authors.affiliation: Kinderkrankenhaus auf der Bult, Hannover, Germany. danne@hka.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Danne
authors.forename: Tadej
authors.initials: T
authors.lastname: Battelino
authors.forename: Olga
authors.initials: O
authors.lastname: Kordonouri
authors.forename: Ragnar
authors.initials: R
authors.lastname: Hanas
authors.forename: Christof
authors.initials: C
authors.lastname: Klinkert
authors.forename: Johnny
authors.initials: J
authors.lastname: Ludvigsson
authors.forename: Raquel
authors.initials: R
authors.lastname: Barrio
authors.forename: Christine
authors.initials: C
authors.lastname: Aebi
authors.forename: Sylvia
authors.initials: S
authors.lastname: Gschwend
authors.forename: Primus-E
authors.initials: PE
authors.lastname: Mullis
authors.forename: Urs
authors.initials: U
authors.lastname: Schumacher
authors.forename: Urs
authors.initials: U
authors.lastname: Zumsteg
authors.forename: Anita
authors.initials: A
authors.lastname: Morandi
authors.forename: Ivana
authors.initials: I
authors.lastname: Rabbone
authors.forename: Valentino
authors.initials: V
authors.lastname: Cherubini
authors.forename: Sonia
authors.initials: S
authors.lastname: Toni
authors.forename: Carine
authors.initials: C
authors.lastname: de Beaufort
authors.forename: Peter
authors.initials: P
authors.lastname: Hindmarsh
authors.forename: Alex
authors.initials: A
authors.lastname: Sumner
authors.forename: Willie M
authors.initials: WM
authors.lastname: van Waarde
authors.forename: Norbert
authors.initials: N
authors.lastname: van den Berg
authors.forename: Moshe
authors.initials: M
authors.lastname: Phillip
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016248:Computer Storage Devices; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000031:analogs & derivatives; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data*; D038622:Internationality; D008297:Male
chemical_list: D007328:Insulin