title: Frequent use of an automated bolus advisor improves glycemic control in pediatric patients treated with insulin pump therapy: results of the Bolus Advisor Benefit Evaluation (BABE) study.
abstract: The relationship between frequency and sustained bolus advisor (BA) use and glycemic improvement has not been well characterized in pediatric populations.
  
  
  
  The objective of this study is to assess the impact of frequent and persistent BA use on glycemic control among pediatric type 1 diabetes patients.
  
  
  
  In this 6-month, single-center, retrospective cohort study, 104 children [61 girls, mean age: 12.7 yr, mean HbA1c 8.0 (1.6)% [64 (17.5) mmol/mol]], treated with the Accu-Chek Aviva Combo insulin pump, were observed. Frequency of BA use, HbA1c, hypoglycemia (<70 mg/dL), therapy changes, mean blood glucose, and glycemic variability (standard deviation) was assessed at baseline and month 6. Sub-analyses of the adolescent patient use (12 months) and longitudinal use (24 months) were also conducted.
  
  
  
  Seventy-one patients reported high frequency (HF) device use (≥50%); 33 reported low frequency (LF) use (<50%) during the study. HF users achieved lower mean (SE) HbA1c levels than LF users: 7.5 (0.1)% [59 (1.1) mmol/mol] vs. 8.0 (0.2)% [64 (2.2) mmol/mol], p = 0.0252. No between-group differences in the percentage of hypoglycemia values were seen at 6 months. HF users showed less glycemic variability (84.0 vs. 94.7, p = 0.0045) than LF users. More HF patients reached HbA1c target of <7.5 at 6 months 66.2% (+16.9) vs. 27.3% (-9.1), p = 0.0056. Similar HbA1c results were seen in adolescents and BA users at 24 months.
  
  
  
  Frequent use of the Accu-Chek Aviva Combo insulin pump BA feature was associated with improved and sustained glycemic control with no increase in hypoglycemia in this pediatric population.
authors.affiliation: Diabetes Clinic for Children and Adolescents, Muenster, Germany.
authors.forename: Ralph
authors.initials: R
authors.lastname: Ziegler
authors.affiliation: Roche Diagnostics Corporation, Indianapolis, IN, USA.
authors.forename: Christen
authors.initials: C
authors.lastname: Rees
authors.affiliation: Diabetes Clinic for Children and Adolescents, Muenster, Germany.
authors.forename: Nehle
authors.initials: N
authors.lastname: Jacobs
authors.affiliation: CGParkin Communications, Inc., Boulder City, NV, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Parkin
authors.affiliation: BioStat International, Inc., Tampa, FL, USA.
authors.forename: Maureen R
authors.initials: MR
authors.lastname: Lyden
authors.affiliation: Roche Diagnostics GmbH, Mannheim, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Petersen
authors.affiliation: Roche Diagnostics Corporation, Indianapolis, IN, USA.
authors.forename: Robin S
authors.initials: RS
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D015918:Infusion Pumps, Implantable; D007328:Insulin / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: CSII; bolus advisor; bolus calculator; insulin pump; pediatric; type 1 diabetes