title: The effect of socioeconomic deprivation on efficacy of continuous subcutaneous insulin infusion: a retrospective paediatric case-controlled survey.
abstract: We aimed to retrospectively evaluate the efficacy of continuous subcutaneous insulin infusion (CSII) therapy in relation to social deprivation in an urban paediatric type 1 diabetic population. Data were compared between 51 children on CSII therapy (mean age 11.2 years and duration of follow-up 1.9 years) and matched controls on multiple daily injection (MDI) therapy. Social deprivation was measured using the UK Office of National Statistics 2007 Index of Multiple Deprivation. Using linear mixed modelling analysis, lower HbA1c levels at 24 months were associated with CSII not MDI therapy (P = 0.02), after adjustment for known variables. Children with the least educated parents showed a rise in HbA1c levels from baseline on MDI therapy (least versus most educated tertile; HbA1c change +0.5% [95% confidence interval -0.1 to 1.1] versus 0% [-0.8 to 0.8]), whereas this was not observed in CSII therapy (least versus most educated tertile; HbA1c change -0.3% [-0.7 to +0.1] versus -0.2% [-0.7 to +0.3], P value for ANCOVA = 0.02, after adjusting for income and employment).
  
  
  CONCLUSIONS
  Parental educational deprivation was associated with a failure of MDI but not CSII therapy. These outcomes need confirmation by larger studies.
authors: Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK.
authors: Senthil
authors: S
authors: Senniappan
authors: Paul
authors: P
authors: Hine
authors: Wing
authors: W
authors: Tang
authors: Judith
authors: J
authors: Campbell
authors: Mark
authors: M
authors: Bone
authors: Vengudi
authors: V
authors: Sankar
authors: Mark
authors: M
authors: Robinson
authors: Claire
authors: C
authors: Smith
authors: Chris
authors: C
authors: Cooper
authors: Rakesh
authors: R
authors: Amin
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