Continuous subcutaneous insulin infusion benefits quality of life in preschool-age children with type 1 diabetes mellitus.
OBJECTIVE
To compare medical, nutritional, and psychosocial outcomes of continuous subcutaneous insulin infusion (CSII) therapy and multiple daily insulin injections (MDI) in preschoolers with type 1 diabetes mellitus (T1DM) in a randomized controlled trial.


METHODS
Sixteen children (mean age 4.4 +/- 0.7 yr, range 3.1-5.3 yr) with T1DM were randomly assigned to CSII or MDI. Hemoglobin A1c (HbA1c) was measured monthly for 6 months. Glucose variability was measured at baseline and at 6 months using continuous blood glucose sensing. Quality of life, adverse events, and nutrition information were assessed.


RESULTS
Parents of the CSII group reported a significant decrease in diabetes-related worry, while parents of the MDI group reported an increased frequency of stress associated with their child's medical care. Mean HbA1c levels from baseline (CSII 8.3 +/- 1.4%, MDI 8.0 +/- 0.8%) to 6 months (CSII 8.4 +/- 0.8%, MDI 8.2 +/- 0.4%) remained stable, and group differences were not significant. There were no significant group differences in duration of hypo- or hyperglycemic events or frequency of adverse events.


CONCLUSIONS
For young children with T1DM, CSII therapy is comparable to MDI therapy with regard to glucose control but is associated with higher treatment satisfaction and improved quality of life.
Division of Child Behavioral Health, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.
Lisa
L
Opipari-Arrigan
Emily M
EM
Fredericks
Nugget
N
Burkhart
Linda
L
Dale
Mary
M
Hodge
Carol
C
Foster
D000328:Adult; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D009752:Nutritional Status / Q000187:drug effects; D010287:Parent-Child Relations; D011788:Quality of Life; D018570:Risk Assessment; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin