title: Sustained metabolic control and low rates of severe hypoglycaemic episodes in preschool diabetic children treated with continuous subcutaneous insulin infusion.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of continuous subcutaneous insulin infusion (CSII) in children under 7 years of age.
  
  
  METHODS
  One hundred and ten children, aged 0.9-7 years, who had received CSII therapy for at least 6 months, were studied for 237 patient-years by a retrospective chart review. Charts were reviewed for glycosylated hemoglobin (HbA1c), severe hypoglycaemia (SH), ketoacidosis (DKA), height, weight and insulin requirement. In 69 cases (children aged 1.6-7 years) CSII was administered after at least 3 months of insulin therapy with pens. In this group, data from the year from before CSII administration were compared with values recorded during 1 year of CSII treatment.
  
  
  RESULTS
  Mean HbA1c decreased from 7.8 +/- 0.9 before CSII to 7.5 +/- 1.0 after 6 and 12 months of pump therapy (p = 0.04). In the whole group, the mean HbA1c after 6 months of CSII was 7.5 +/- 1.0 and remained unchanged for up to 4 years of follow-up. Some episodes of SH--4.2 per 100 patient-years, and DKA--5.7 per 100 patient-years were recorded. No increase in BMI z-score occurred.
  
  
  CONCLUSIONS
  In the youngest children, CSII therapy lowers HbA1c values and provides sustained metabolic control without increases in hypoglycaemia or ketoacidosis episodes.
authors.affiliation: Department of Diabetology and Birth Defects, the Medical University of Warsaw, Poland. epankowska@interia.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Pańkowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szypowska
authors.forename: Maria
authors.initials: M
authors.lastname: Lipka
authors.forename: Agata
authors.initials: A
authors.lastname: Skórka
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007223:Infant; D007260:Infusion Pumps; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin