title: Use of integrated real-time continuous glucose monitoring/insulin pump system in children and adolescents with type 1 diabetes: a 3-year follow-up study.
abstract: BACKGROUND
  Insulin pumps and real-time continuous glucose monitoring devices have recently been combined into the sensor-augmented pump (SAP) system. The objective of this study was the evaluation of the clinical use of SAP in a large series of children with type 1 diabetes using insulin pump therapy.
  
  
  METHODS
  A questionnaire was administered in all pediatric diabetologic centers in Italy; data were analyzed only regarding patients 18 years old or younger and using SAP for 6 months or more.
  
  
  RESULTS
  Among all patients using an insulin pump, 129 (13.5 ± 3.8 years old, with a disease duration of 6.3 ± 3.4 years) have been using SAP for 1.4 ± 0.7 years. Four hundred ninety-three patients (12.9 ± 3.4 years old, with a disease duration of 6.2 ± 3.3 years) using conventional insulin pump therapy for 1.7 ± 0.5 years have been evaluated as the control group. After 0.5-3 years of using SAP or conventional insulin pump therapy, glycosylated hemoglobin significantly improved (8.0 ± 1.5% vs. 7.4 ± 0.8% [P = 0.002] and 8.0 ± 1.6% vs. 7.7 ± 1.1% [P = 0.006], respectively); the improvement was higher with SAP (P = 0.005). Insulin requirement showed a significant decrease only in SAP patients (0.88 ± 0.25 vs. 0.7 ± 0.23 U/kg/day, P = 0.003). Body mass index did not change during the observation period. No diabetic ketoacidosis episodes were observed during the follow-up, and severe hypoglycemia significantly decreased in SAP patients (P = 0.04).
  
  
  CONCLUSIONS
  The increased availability of continuous glucose sensors is likely to have a significant impact on pediatric diabetes therapy and education in the near future. In daily settings, patients using SAP can achieve a better control than patients using conventional insulin pump.
authors.affiliation: Department of Pediatrics, Azienda Ospedaliera, University of Milano, Ospedale Luigi Sacco, Milano, Italy. scaramuzza.andrea@hsacco.it
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Scaramuzza
authors.forename: Dario
authors.initials: D
authors.lastname: Iafusco
authors.forename: Ivana
authors.initials: I
authors.lastname: Rabbone
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bonfanti
authors.forename: Fortunato
authors.initials: F
authors.lastname: Lombardo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiaffini
authors.forename: Pietro
authors.initials: P
authors.lastname: Buono
authors.forename: Sonia
authors.initials: S
authors.lastname: Toni
authors.forename: Valentino
authors.initials: V
authors.lastname: Cherubini
authors.forename: Gian Vincenzo
authors.initials: GV
authors.lastname: Zuccotti
mesh_terms: D000293:Adolescent; D000375:Aging; D015992:Body Mass Index; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000009:adverse effects; D007558:Italy; D008297:Male; D011795:Surveys and Questionnaires; D013673:Technology Assessment, Biomedical
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human