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Insulin pumps improve blood glucose control in children with type 1 diabetes
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Children with type 1 diabetes using insulin pump therapy are more likely to have better blood glucose control than children using injection therapy, according to research in Diabetologia.
In a pooled analysis of data from three large diabetes registries, Jennifer Sherr, MD, PhD, assistant professor of pediatrics at the Yale School of Medicine, and colleagues also found that non-ethnic minorities and girls were more likely to be treated with pump therapy vs. non-whites and boys.
Sherr and colleagues analyzed data from 54,410 children with type 1 diabetes from three registries: The Prospective Diabetes Follow-up Registry in Germany/Austria (DPV; n = 26,198), the Type 1 Diabetes Exchange in the United States (T1DX; n = 13,755) and the National Pediatric Diabetes Audit in the United Kingdom (NPDA; n = 14,457). Researchers compared modality of insulin delivery based on age, sex and race, as well as the effect of pump use on HbA1c levels.
Jennifer Sherr
Mean HbA1c levels were higher in the NPDA (8.9%) vs. the DPV (8%) and T1DX (8.3%) registries, whereas pump use also was lower in the NPDA (14%) vs. the DPV (41%) or the T1DX (47%) registries. In pooled analysis, unadjusted HbA1c levels in insulin pump users were lower than levels in injection users (8% vs. 8.5%; P < .001), according to researchers.
“The threefold greater use of insulin pumps in the DPV and T1DX registries compared with the NPDA was the most striking difference,” the researchers wrote.
Across the three registries, 22.1% of ethnic minority children used pumps vs. 34.5% of non-ethnic minority children; results persisted after adjustment for age, duration of diabetes, sex and registry type. Girls also were more likely to be using pump therapy vs. boys (OR = 1.22; 95% CI, 1.17-1.27).
“Data from three trans-Atlantic registries have identified the beneficial glycemic effect of insulin pump use, with mean HbA1c being 0.5% lower than what is achieved by those on injection therapy, and application of this technology for all youth with type 1 diabetes should be a focus of care,” Sherr told Endocrine Today. “Clinicians should investigate their prescribing patterns and be aware that pump use can be applied regardless of patient age, gender or ethnic background. Patients should advocate for themselves in order to assure they are being considered for this treatment modality.” – by Regina Schaffer
Disclosure: Sherr reports that her nonprofit employer received research funding from Medtronic, with no personal compensation. Please see the full study for the other authors’ relevant financial disclosures.
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