Long-term insulin pump treatment in girls with type 1 diabetes and eating disorders--is it feasible?
OBJECTIVE
This study evaluated the feasibility of insulin pump treatment in adolescent girls with type 1 diabetes mellitus (T1DM) and eating disorders (ED).


METHODS
Sixty-three girls >10 years old were included in the study. Forty-eight were treated with pump (no-ED-pump group); 15 had ED, of whom eight were treated with pump (ED-pump group), and seven were treated with multiple daily injections (MDI) (ED-MDI group).


RESULTS
Girls in the ED-pump group had higher hemoglobin A1c (HbA1c) compared to those in the no-ED-pump group both before and after pump initiation (P = 0.007). In the ED-pump group, levels 0-6 months after pump initiation were slightly but not significantly lower compared to baseline reference values (8.48% vs. 8.84%, respectively; P = 0.42). In the no-ED-pump group there was a significant decrease in HbA1c level 0-6 months after pump initiation (8.03% vs. 7.67%, respectively; P = 0.004). Thereafter HbA1c levels were not different from baseline reference on both groups. The rate of hypoglycemic episodes was similar in the ED pump and no-ED-pump groups (0.9 vs. 1.0 episodes per 100 patient-years, respectively). Prior to diagnosis of ED, mean HbA1c levels in the ED-pump group and the ED-MDI group were similar: 9.24 ± 1.25% versus 8.47 ± 1.30% (P = 0.51). In the time intervals after the diagnosis of ED, mean HbA1c level of all measurements in the eight girls in the ED-pump group was significantly lower compared with the seven patients in the ED-MDI group: 9.07 ± 1.33% versus 10.40 ± 2.01% (P = 0.04).


CONCLUSIONS
Treatment with an insulin pump was feasible in girls with T1DM and ED and resulted in significantly lower HbA1c levels compared to the ED-MDI group.
Pinhas-Hamiel
Orit
O
Maccabi Juvenile Diabetes Center, 4 Bar-Ilan Street, Raanana, Israel. orithami@sheba.health.gov.il
Graph-Barel
Chana
C
Boyko
Valentina
V
Tzadok
Michal
M
Lerner-Geva
Liat
L
Reichman
Brian
B
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005240:Feasibility Studies; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000009:adverse effects; D055815:Young Adult
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin