Discontinuation of insulin pump treatment in children, adolescents, and young adults. A multicenter analysis based on the DPV database in Germany and Austria.
BACKGROUND
Insulin pump therapy is well established in the treatment of children and adolescents with type 1 diabetes. Most studies focus on outcome parameters like hemoglobin A1c (HbA1c), hypoglycemia, and quality of life, whereas few reports address patients who discontinue pump therapy.


OBJECTIVE
This survey focuses on the discontinuation rate of insulin pump treatment in the pediatric and young adult age group.


METHODS
The prospective multicenter Diabetes Patienten Verlausdokumentation (DPV) (electronic diabetes patient documentation system) database has been established since 1990 and is broadly used in Germany and Austria. All pump users among the participating centers documented since 1995 were included in this analysis.


RESULTS
In total, 11 710 patients with type 1 diabetes were recorded as treated with insulin pumps. In total, 463 patients (4%) switched from insulin pump treatment to multiple daily injections (MDI). In the group of patients who stopped with pump treatment, the mean duration of pump therapy was 1.7 yr (SE +/- 0.06 yr), 60.5% of patients were female. Subdivided into age groups, the discontinuation rate was lowest in the age group < 5 yr (0.1%), followed by the groups aged 5-10 yr (0.3%) and 15-20 yr (0.8%). The group aged 10-15 yr showed the highest rate of discontinuation (2%).


CONCLUSIONS
The discontinuation rate of insulin pump therapy is, in general, low (4%). The younger the patients at the time of initiating insulin pump treatment, the lower is the discontinuation rate. The highest rate was seen in adolescents aged 10-15 yr. Girls stopped insulin pump treatment more often than boys (60.5% vs. 39.5%).
Hofer
S E
SE
Department of Pediatrics, Medical University of Innsbruck, 6020 Innsbruck, Austria. sabine.e.hofer@i-med.ac.at
Heidtmann
B
B
Raile
K
K
Fröhlich-Reiterer
E
E
Lilienthal
E
E
Berghaeuser
M A
MA
Holl
R W
RW
D000293:Adolescent; D000367:Age Factors; D001317:Austria; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data*; D008019:Life Style; D008297:Male; D010349:Patient Compliance; D012042:Registries
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin