title: Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry.
abstract: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control.
  
  
  
  To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI.
  
  
  
  This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out.
  
  
  
  Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P < .0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P < .0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P < .0001).
  
  
  
  Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.
authors.affiliation: Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland. agnieszka.szypowska@gmail.com.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szypowska
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.|German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Schwandt
authors.affiliation: Pediatric Department, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Jannet
authors.initials: J
authors.lastname: Svensson
authors.affiliation: The Jesse Z and Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Shalitin
authors.affiliation: Division of Endocrinology and Diabetes, Hospital Sant Joan de Déu, Barcelona, Spain.
authors.forename: Roque
authors.initials: R
authors.lastname: Cardona-Hernandez
authors.affiliation: Institute for Clinical Sciences, Sahlgrenska Achademy, University of Gothenburg, Gothenburg, Sweden.|The Queen Silvia Childrens Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Gun
authors.initials: G
authors.lastname: Forsander
authors.affiliation: The Queen Silvia Childrens Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Frida
authors.initials: F
authors.lastname: Sundberg
authors.affiliation: DCCP-Clinique pédiatrique de Luxembourg, Luxembourg, Luxembourg.|Department of Pediatric Endocrinology, UZBrussels, Brussels, Belgium.
authors.forename: Carine
authors.initials: C
authors.lastname: De Beaufort
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver Aurora, Colorado, USA.
authors.forename: David
authors.initials: D
authors.lastname: Maahs
authors.affiliation: Pediatric Diabetes and Metabolic Disorders Unit & Regional Center for Pediatric Diabetes, University Hospital, University of Verona, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Maffeis
authors.affiliation: Paediatrics Diabetes & Endocrine Unit, Department of Paediatrics & Child Health, Cork University Hospital, University College Cork, Cork, Ireland.
authors.forename: Stephen M P
authors.initials: SM
authors.lastname: O'Riordan
authors.affiliation: Children's University Hospital Children's Endocrinology Centre, Riga Stradins University, Riga, Latvia.
authors.forename: Iveta Dzivite
authors.initials: ID
authors.lastname: Krisane
authors.affiliation: Pediatric Endocrinology, Hospital Nossa Senhora Das Graças, Brazil.
authors.forename: Mauro
authors.initials: M
authors.lastname: Scharf
authors.affiliation: Child and Young Department, APDP-Diabetes, Lisbon, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Castro
authors.affiliation: Medical University-Clinic of Endocrinology, Diabetes and Genetics, Sofia University Pediatric Hospital, Sofia, Bulgaria.
authors.forename: Maia
authors.initials: M
authors.lastname: Konstantinova
authors.affiliation: Department of Pediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Barbora
authors.initials: B
authors.lastname: Obermannova
authors.affiliation: Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.|Department of Development and Regeneration, KU Leuven, Belgium.
authors.forename: Kristina
authors.initials: K
authors.lastname: Casteels
authors.affiliation: Faculty of Medicine Pediatric Endocrinology and Diabetes, Ege University, İzmir, Turkey.
authors.forename: Damla
authors.initials: D
authors.lastname: Gökşen
authors.affiliation: Unit of Pediatric Endocrinology and Diabetes, Hospital Dona Estefânia, Lisbon, Portugal.
authors.forename: Júlia
authors.initials: J
authors.lastname: Galhardo
authors.affiliation: Diabetes Center, Division of Endocrinology, Diabetes and Metabolism First Department of Pediatrics, Medical School National and Kapodistrian University of Athens-Greece "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Kanaka-Gantenbein
authors.affiliation: Department of Pediatrics and Adolescent Medicine of Medical University of Vienna, Vienna, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Rami-Merhar
authors.affiliation: First Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Madacsy
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections / Q000706:statistics & numerical data*; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data*; D008297:Male; D012042:Registries
chemical_list: D001786:Blood Glucose
keywords: 
  CSII
  ; 
  MDI
  ; childhood diabetes; continuous subcutaneous insulin infusion; multiple daily injections