Long-term use of continuous subcutaneous insulin infusion compared with multiple daily injections of glargine in pediatric patients.
BACKGROUND
Studies comparing continuous subcutaneous insulin infusion (CSII) and glargine in pediatric patients are scarce and cover only 1 year follow up. Although short-term results are favorable for CSII, there is no clear evidence whether this therapy leads to a sustained improvement of glycemic control.


OBJECTIVE
To evaluate long-term effects and safety of CSII versus multiple daily injections (MDI) of glargine over 2 years of treatment in children and adolescents.


METHODS
32 patients (aged 12.5 +/- 2.4 years; 19 females) with intensively treated type 1 diabetes mellitus were eligible. They were divided into two groups, virtually identical at study entry: eight on CSII and 24 on MDI of glargine. Variables at 0, 6, 12, 18 and 24 months were compared between groups by two-sided Mann-Whitney and Fisher tests.


RESULTS
No significant differences were found between groups (CSII vs MDI) throughout the study period. At 24 months hemoglobin A1c was 7.70 +/- 0.64% vs 7.54 +/- 0.74% (p = 0.8); body mass index SDS was 0.33 +/- 0.74 vs 0.40 +/- 1.01 (p = 0.9); total daily insulin requirements were 0.95 +/- 0.10 vs 1.05 +/- 0.18 U/kg (p = 0.4), incidence of severe hypoglycemia was 0.00 +/- 0.00 vs 0.04 +/- 0.14 episodes/patient/year (p = 0.8); and incidence of ketoacidosis was 0.20 +/- 0.27 vs 0.04 +/- 0.14 episodes/patient/year (p = 0.2).


CONCLUSIONS
CSII and MDI with glargine are equally effective and safe in pediatric patients at 2-year follow-up.
García-García
Emilio
E
Department of Pediatrics, "Torrecárdenas" Hospital, Almería, Spain. ggej@hotmail.com
Galera
Rafael
R
Aguilera
Purificación
P
Cara
Gabriel
G
Bonillo
Antonio
A
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069036:Insulin Glargine; D007332:Insulin Infusion Systems; D049528:Insulin, Long-Acting; D008297:Male
D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine