Insulin pump use did not alter HbA1c levels in children with type 1 diabetes

American Association of Diabetes Educators 36th Annual Meeting

Despite improvements in insulin delivery via insulin pump, researchers reported no significant changes in HbA1c levels among a group of children with type 1 diabetes who attended a week-long diabetes camp over the course of 12 years.

"This lack of improvement is disappointing in view of the fact that treatment paradigms have improved with products such as fast-acting insulin analogs and long-acting insulin analogs that have come into the market and the fact that insulin pumps were much more common in 2008," Dennis J.Pillion, PhD, professor in the department of pharmacology and toxicology at the University of Alabama at Birmingham, told Endocrine Today.

Researchers recorded data on children aged 8 to 16 years who attended a residential diabetes camp for one week in 1996, 2002 and 2008. Blood glucose was measured four to six times daily; the same day camp was used for all three years.

The researchers hypothesized that improved diabetes management, education, insulin and technology would result in fewer hyperglycemic and hypoglycemic episodes in 2008 and HbA1c values closer to target levels than in earlier years.

When compared with children attending the camp during 1996, children were more likely to be wearing an insulin pump at camp during 2008 — more than half of the children used one 2008.

However, overall HbA1c levels did not significantly improve in 2008 compared with 1996. Similarly, the number of moderate to severe hyperglycemic events did not significantly improve when compared with previous years.

"The number of children with hemoglobin A1c values below 7% remains low," Pillion said. "When the number of moderate or severe low blood sugar events per camper per week in 2002 were compared with comparable data from 2008, the numbers were indistinguishable. The same was true when the number of moderate or severe hyperglycemic events per camper per week were compared. Hence, glycemic control in the two to three months prior to camp attendance was not significantly improved in 2008, nor was glycemic control during camp attendance."

Still, “camp remains an invaluable site for patient education under real-world conditions, with additional benefits in the areas of building self-esteem and independence and providing a network of supportive friends and health-care providers outside the normal sphere of the camper's local environment,” he added. - by Jennifer Southall

For more information:

Pillion DJ. #T11a. Presented at: The American Academy of Diabetes Educators 36th Annual Meeting; August 5-8, 2009; Atlanta.