Original ArticlesInsulin pump therapy in toddlers and preschool children with type 1 diabetes mellitus☆
Section snippets
Patients
A total of 9 toddlers, younger than 4 years of age (5 boys,4 girls), were treated. All had classic type 1 diabetes and severe hyperglycemia and ketosis. The mean age of diagnosis of diabetes among study patients was 18.6 months (range, 10-40 months), whereas the mean age of initiation of pump therapy was 34.1 months (range, 20-58 months; Table).Empty Cell Study population Not eligible n (girls/boys) 9 (4/5) 19 (9/10) Age of onset of diabetes
Patient characteristics
Among 28 infants, toddlers, and preschool children (<5 years of age) receiving care in the Duke pediatric diabetes clinic, there were a total of 9 patients who qualified for the study under the criteria used for selection (Table). Their mean age of diagnosis of diabetes was 18.6 ± 3.1 months (mean ± SEM). The study patients were treated with multiple daily injections for a mean of 13.7 ± 3.0 months. Pump therapy was initiated at a mean age of 34.1 ± 4.5 months (range, 20-58 months) and
Discussion
The objective of our study was to test the hypothesis that continuous insulin infusion14, 15, 16, 17, 18 could improve glycemic control in toddlers and preschool children with type 1 diabetes. The power of our study derives from the fact that we examined the effects of pump therapy in a group of patients who had been treated previously with multiple daily injections. Thus, each child served as his or her own control. This design has particular advantages, given the enormous individual and
References (27)
- et al.
Hypoglycemia: a complication of diabetes therapy in children
Trends Endocrinol Metab
(2000) - et al.
Insulin pump therapy in young children with type 1 diabetes
J Pediatr
(1984) - et al.
Remission of severe hypoglycemic incidents in young diabetic children treated with subcutaneous infusion
Arch Pediatr
(1996) Variation and trends in incidence of childhood diabetes in Europe: EURODIAB ACE Study Group
Lancet
(2000)- et al.
Rising incidence of insulin dependent diabetes in children aged under 5 years in the Oxford region: time trend analysis: the Bart's-Oxford Study Group
BMJ
(1997) - et al.
The onset age of type 1 diabetes in Finnish children has become younger: the Finnish Childhood Diabetes Registry Group
Diabetes Care
(1999) - et al.
Increasing trend of type I diabetes in children and young adults in the province of Turin (Italy): analysis of age, period, and birth cohort effects from 1984 to 1996
Diabetologia
(2001) - et al.
Analysis of 20 years of prospective registration of childhood onset diabetes time trends and birth cohort effects: Swedish Childhood Diabetes Study Group
Acta Paediatr
(2000) - et al.
Epidemiology of type I diabetes mellitus in Switzerland: steep rise in incidence in under 5 year old children in the past decade
Diabetologia
(2001) - et al.
Clinical, autoimmune, and genetic characteristics of very young children with type 1 diabetes
Diabetes Care
(1999)
Hypoglycemia during intensified insulin therapy of young children
J Pediatr Endocrinol Metab
Hypoglycemia: incidence and clinical predictors in a large population-based sample of children and adolescents with IDDM
Diabetes Care
Comparison of metabolic control in a cross-sectional study of 2873 children and adolescents with IDDM from 18 countries
Diabetes Care
Cited by (152)
Continuous subcutaneous insulin infusion in children less than 6 years-old: long-term progress
2017, Anales de PediatriaInsulin therapy in neonatal diabetes mellitus: a review of the literature
2017, Diabetes Research and Clinical PracticeImpact of insulin pump therapy on long-term glycemic control in a pediatric Spanish cohort
2016, Diabetes Research and Clinical PracticeCharacterization of metabolic responders on CSII treatment amongst children and adolescents in Denmark from 2007 to 2013
2015, Diabetes Research and Clinical PracticeClinical and molecular description of two cases of neonatal diabetes secondary to mutations in PDX1
2023, Endocrinology, Diabetes and Metabolism Case Reports
- ☆
Reprint requests: Michael Freemark, MD, Division of Pediatric Endocrinology and Diabetes, Box 3080, Duke University Medical Center, Durham NC 27710.