title: [Benefits of continuous subcutaneous insulin infusion in children with type 1 diabetes mellitus].
abstract: BACKGROUND
  The Diabetes Control and Complications Trial clearly demonstrated the benefits of blood glucose control, especially in children and adolescents, in the prevention of long-term complications of type 1 diabetes (T1D). This can be achieved with intensive insulin treatment with either multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII), also known as insulin pump. The aim of this study was to compare glycemic control of T1D children treated with either CSII or MDI.
  
  
  METHODS
  Thirty-eight T1D children treated with CSII were compared to 38 children treated with MDI, matched for age, gender, and duration of diabetes. Collected data, including daily doses of insulin in IU/kg/d, HbA1c levels, body mass index expressed in standard deviation/age, number of severe hypoglycemia episodes and of admissions related to T1D expressed in events/patient/year, were retrospectively collected every 3 months.
  
  
  RESULTS
  There was no difference between the 2 groups at baseline. During the 3 years of follow-up, patients treated with CSII had lower daily doses of insulin (0.78 ± 0.19 vs. 0.87 ± 0.22 IU/kg/d, p<0.05), significantly lower levels of HbA1c (7.5 ± 0.6 vs. 8.0 ± 1.3 %, p<0.05), and a decreased number of admissions related to T1D (0.07 ± 0.14 vs. 0.17 ± 0.22 events/patient/year, p<0.05) than children treated with MDI. In contrast, body mass index and number of severe hypoglycemic episodes did not differ between the two groups. No diabetic ketoacidosis episode was recorded in either group.
  
  
  CONCLUSIONS
  The results from this study suggest that treatment with CSII provided better metabolic control than treatment with MDI, in spite of lower daily doses of insulin and without increasing acute complications, in children with T1D.
authors.affiliation: Service de médecine pédiatrique, université François-Rabelais, CHRU de Tours, Tours, France.
authors.forename: C
authors.initials: C
authors.lastname: Hasselmann
authors.forename: E
authors.initials: E
authors.lastname: Bonnemaison
authors.forename: N
authors.initials: N
authors.lastname: Faure
authors.forename: I
authors.initials: I
authors.lastname: Mercat
authors.forename: M
authors.initials: M
authors.lastname: Bouillo Pépin-Donat
authors.forename: N
authors.initials: N
authors.lastname: Magontier
authors.forename: A
authors.initials: A
authors.lastname: Chantepie
authors.forename: F
authors.initials: F
authors.lastname: Labarthe
mesh_terms: D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D055104:Infusions, Subcutaneous; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin