Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013:2013:791283.
doi: 10.1155/2013/791283. Epub 2013 Nov 14.

Insulin therapy with personal insulin pumps and early angiopathy in children with type 1 diabetes mellitus

Joanna Tołwińska  1 , Barbara Głowińska-Olszewska  1 , Artur Bossowski  1
Affiliations

Insulin therapy with personal insulin pumps and early angiopathy in children with type 1 diabetes mellitus

Joanna Tołwińska et al. Mediators Inflamm. 2013.

Abstract

Objective: Assessment of the effect of a treatment method change from multiple daily insulin injection (MDI) to continuous subcutaneous insulin infusion (CSII) on the development of early angiopathy in children with T1DM with or without retinopathy.

Methods: The study pump group involved 32 diabetic children aged 14.8, with the initial HbA1c level of 8.3%, previously treated by MDI. The patients were examined before pump insertion and after 3 and 6 months of CSII. We assessed HbA1c level, carotid artery intima-media thickness (c-IMT), and flow-mediated dilatation (FMD) of the brachial artery. The pump group was compared to a group of eight teenagers with diagnosed nonproliferative retinopathy, treated with MDI.

Results: HbA1c in the entire group was found to improve in the second and in the third examination. During 6 months of CSII, FMD increased and IMT decreased. Retinopathic adolescents had significantly thicker IMT and lower FMD compared to baseline results of the pump group. Treatment intensification in the retinopathy-free children enhanced these differences.

Conclusions: CSII is associated with lower IMT and higher FMD. Whether on the long-run CSII is superior to MDI to delay the occurrence of diabetes late complications remains to be explained.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Change in HbA1c in the insulin pump group during 6 months of using new treatment method (1—before CSII, 2—after 3 months of CSII, and 3—after 6 months of CSII).
Figure 2
Figure 2
IMT values in the study groups: retinopathy group compared to the pump group before implementation of CSII (insulin pump group 1) and after 6 months (insulin pump group 3).
Figure 3
Figure 3
FMD values in the study groups: retinopathy group compared to the pump group before implementation of CSII (insulin pump group 1), after 3 months (insulin pump group 2) and after 6 months (insulin pump group 3).
Figure 4
Figure 4
A change in HbA1c in the groups depending on the initial value <7.5% and >7.5% (1—before CSII, 2—after 3 months of CSII, and 3—after 6 months of CSII).
Figure 5
Figure 5
A change in IMT in the groups depending on the initial value of HbA1c < 7.5% and >7.5% (1—before CSII and 3—after 6 months of CSII).
Figure 6
Figure 6
A change in FMD in the groups depending on the initial value of HbA1c < 7.5% and >7.5% (1—before CSII, 2—after 3 months of CSII, and 3—after 6 months of CSII).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bruttomesso D, Costa S, Baritussio A. Continuous subcutaneous insulin infusion (CSII) 30 years later: still the best option for insulin therapy. Diabetes/Metabolism Research and Reviews. 2009;25(2):99–111. - PubMed
    1. Danne T, Battelino T, Jarosz-Chobot P, et al. Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the PedPump Study in 17 countries. Diabetologia. 2008;51(9):1594–1601. - PubMed
    1. Phillip M, Battelino T, Rodriguez H, Danne T, Kaufman F. Use of insulin pump therapy in the pediatric age-group: consensus statement from the European Society for Paediatric Endocrinology, the Lawson Wilkins Pediatric Endocrine Society, and the International Society for Pediatric and Adolescent Diabetes, endorsed by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2007;30(6):1653–1662. - PubMed
    1. Jeitler K, Horvath K, Berghold A, et al. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia. 2008;51(6):941–951. - PubMed
    1. Hammond P. Continuous subcutaneous insulin infusion: short-term benefits apparent, long-term benefits speculative. The British Journal of Diabetes and Vascular Disease. 2004;4(2):104–108.

LinkOut - more resources