title: [Quality of treatment in children with type 1 diabetes based on the Polish Prospective Pump Programme].
abstract: BACKGROUND
  In pediatric patients with type 1 diabetes mellitus, the value of HbA1c is a predictor of the risk of late systemic complications in adulthood. In the last years significant changes in the method of treatment in pre-pubertal children with T1DM have taken place. However, there is lack of precise data concerning the results of metabolic control of this group of patients.
  
  
  OBJECTIVE
  was to assess the impact of the Polish Prospective Insulin Pump Programme (OPPLP) on the quality of metabolic control in prepubertal children with T1DM. The OPPLP included also education for diabetological staff (HPC) from the Polish Diabetic Centres as well as standardization of continuous subcutaneous insulin infusion (CSII) implementation procedures.
  
  
  METHODS
  Population studies were conducted in the years: 2005-2008. 920 patients were enrolled at age from 1.2 to 14.6 years (median 8.5 years). 71.75 % of patients were in pre-pubertal age. 734 patients received CSII therapy. The cross sectional, prospective study, conducted according to the protocol of the OPPLP with clinical data collection from 2005 to 2008. We analyzed the data obtained during 1657 visits and assessed 1657 blood samples for HbA1c value in the Central Laboratory. The clinical data were recorded in the electronic net-database.
  
  
  RESULTS
  In whole group the median of HbA1c was 7.46 % (min. 5% - max. 12.1%); 60.1% patients has HbA1c below 7.5%. The quality of treatment was comparable among the centres: med. HbA1c ranged from min. 6.5% to max. 8.0%. During the period from 2005 to 2008 effective results were obtained in glycemic control: med. HbA1c: 2005 - 7.6%, 2006 - 7.2%, 2007 - 7.0% and 2008 - 7.5%. Slightly higher HbA1c was observed in children with longer duration of diabetes (r=0.17, p<0.005).
  
  
  CONCLUSIONS
  The OPPLP, including HCP education, enabled optimalization of metabolic control in the prepubertal children switched pump therapy. Moreover, the programme brought about an even level of treatment between the Polish Diabetic Centres irrespective of their size. It is important to continue the programme and to develop a country level register of children with T1DM.
authors.affiliation: Poradnia Diabetologiczna, Instytut Matki i Dziecka, Warszawa. ewa.pankowska@imid.med.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Pańkowska
authors.forename: Marlena
authors.initials: M
authors.lastname: Błazik
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Czerniawska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szadkowska
authors.forename: Bożena
authors.initials: B
authors.lastname: Florys
authors.forename: Przemysława
authors.initials: P
authors.lastname: Jarosz-Chobot
authors.forename: Lucyna
authors.initials: L
authors.lastname: Lisowicz
authors.forename: Joanna
authors.initials: J
authors.lastname: Nazim
authors.forename: Anna
authors.initials: A
authors.lastname: Noczyńska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Młynarski
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Myśliwiec
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Szalecki
authors.forename: Krystyna
authors.initials: K
authors.lastname: Wójcik
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007223:Infant; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D010353:Patient Education as Topic / Q000458:organization & administration; D011044:Poland; D015397:Program Evaluation; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human