title: Sensor augmented pump therapy from onset of type 1 diabetes: late follow-up results of the Pediatric Onset Study.
abstract: OBJECTIVE
  To evaluate the metabolic control and β-cell function 1 yr after the end of the European multicentre randomized Pediatric Onset Study.
  
  
  METHODS
  Of 154 study patients, 131 were re-examined 24 months after type 1 diabetes onset (49.6% boys, age at onset 8.9 ± 4.3 yrs). Of which, 62 patients belonged to the primary group of the main study applying a sensor-augmented pump system during the first yr and 69 patients to the control group performing conventional insulin pump therapy with self-monitoring blood glucose. HbA1c, fasting blood glucose, and C-peptide were centrally measured (Clinical Trail Registration Number: ISRCTN05450731).
  
  
  RESULTS
  At 24 months, i.e., 1 yr after the end of the interventional study, 52.4% of the patients used the sensor-augmented pump system, 46.0% conventional pump, and 1.6% multiple daily injections. HbA1c was 7.6 ± 1.3% in the primary and 7.7 ± 1.2% in the control group (p = 0.493). Frequent sensor use during the first yr was associated with statistically insignificant lowering of the HbA1c at 24 months (p = 0.236) as compared with irregular or no sensor use (7.4 ± 1.0% vs. 7.7 ± 1.3%). Although fasting C-peptide was not clearly different between the primary and control group (0.13 ± 0.17 vs. 0.09 ± 0.10 nmol/L, p = 0.121), patients with frequent sensor use had significantly less C-peptide loss within 24 months (C-peptide reduction 0.02 ± 0.18 vs. 0.07 ± 0.11 nmol/L, p = 0.046). There was no difference between the groups regarding daily insulin requirements.
  
  
  CONCLUSIONS
  Sensor-augmented pump therapy from onset of diabetes may lead to better long-term glycemic control and help to preserve endogenous β-cell function, if patients comply with frequent use of continuous glucose monitoring.
authors.affiliation: Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus, Auf der Bult, Hannover, Germany. kordonouri@hka.de
authors.forename: Olga
authors.initials: O
authors.lastname: Kordonouri
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hartmann
authors.forename: Ewa
authors.initials: E
authors.lastname: Pankowska
authors.forename: Birgit
authors.initials: B
authors.lastname: Rami
authors.forename: Thomas
authors.initials: T
authors.lastname: Kapellen
authors.forename: Régis
authors.initials: R
authors.lastname: Coutant
authors.forename: Karin
authors.initials: K
authors.lastname: Lange
authors.forename: Thomas
authors.initials: T
authors.lastname: Danne
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007223:Infant; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008297:Male
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human