A cross-sectional international survey of continuous subcutaneous insulin infusion in 377 children and adolescents with type 1 diabetes mellitus from 10 countries.
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.
Danne
Thomas
T
Kinderkrankenhaus auf der Bult, Hannover, Germany. danne@hka.de
Battelino
Tadej
T
Kordonouri
Olga
O
Hanas
Ragnar
R
Klinkert
Christof
C
Ludvigsson
Johnny
J
Barrio
Raquel
R
Aebi
Christine
C
Gschwend
Sylvia
S
Mullis
Primus-E
PE
Schumacher
Urs
U
Zumsteg
Urs
U
Morandi
Anita
A
Rabbone
Ivana
I
Cherubini
Valentino
V
Toni
Sonia
S
de Beaufort
Carine
C
Hindmarsh
Peter
P
Sumner
Alex
A
van Waarde
Willie M
WM
van den Berg
Norbert
N
Phillip
Moshe
M
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
D007328:Insulin