title: Important determinants of diabetes control in insulin pump therapy in patients with type 1 diabetes mellitus.
abstract: BACKGROUND
  Insulin pumps are equipped with advanced functions. Intensive training and adherence are required for optimum use of the technology. We aimed to assess the association of various key elements in insulin pump functions on blood glucose control.
  
  
  METHODS
  Patients on insulin pump therapy were enrolled. Insulin pumps were downloaded (CareLink(®) Pro 3 software; Medtronic Minimed, Northridge, CA), and data were collected over an 8-12-week period. Glycemic control of patients was classified as controlled (hemoglobin A1c [HbA1c] level of 7.5% or less in adults and 8% or less in children) and uncontrolled based on HbA1c level at enrollment. Variables studied were use of sensors and duration, frequency of blood glucose monitoring, Bolus Wizard (Medtronic Minimed) use, frequency of correction boluses, and frequency of cannula changing.
  
  
  RESULTS
  Seventy-two patients were enrolled (50 children). Median age was 12 years for children and 27.5 years for adults. Respective median numbers of blood glucose checks were 4.4 and 3.2 for controlled and uncontrolled children (P<0.021) and 3.1 and 2.8 for controlled and uncontrolled adults, respectively. Respective frequency of Bolus Wizard use per day showed a median of 6 and 4.15 for controlled and uncontrolled children (P<0.001) and 3.8 and 3.5 for controlled and uncontrolled adults. Controlled children wore sensors for longer (5 vs. 2.9 days/week) and did more corrections (3.9 vs. 2.5). There was no difference in the frequency of changing the infusion cannula in children's or adults' groups.
  
  
  CONCLUSIONS
  We conclude that the frequency of blood glucose monitoring and Bolus Wizard use have a favorable association with glycemic control. These observations were more significant in the children's groups. Our data shows that patients with better control tend to bolus more for correction and wear sensors longer.
authors.affiliation: 1 Paediatric Endocrinology Department, Mafraq Hospital , AbuDhabi, United Arab Emirates .
authors.forename: Asma
authors.initials: A
authors.lastname: Deeb
authors.forename: Samar
authors.initials: S
authors.lastname: Abu-Awad
authors.forename: Salima
authors.initials: S
authors.lastname: Abood
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Abiary
authors.forename: Jamal
authors.initials: J
authors.lastname: Al-Jubeh
authors.forename: Hana
authors.initials: H
authors.lastname: Yousef
authors.forename: Laila
authors.initials: L
authors.lastname: AbdelRahman
authors.forename: Ahlam
authors.initials: A
authors.lastname: Al Hajeri
authors.forename: Huda
authors.initials: H
authors.lastname: Mustafa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring / Q000379:methods / Q000706:statistics & numerical data; D057785:Catheters / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin