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
Meta-Analysis
. 2019 Jun 25;14(6):e0217655.
doi: 10.1371/journal.pone.0217655. eCollection 2019.

Health-related quality of life in paediatric patients with Type 1 diabetes mellitus using insulin infusion systems. A systematic review and meta-analysis

Bastian Rosner  1 , Andres Roman-Urrestarazu  1   2
Affiliations
Meta-Analysis

Health-related quality of life in paediatric patients with Type 1 diabetes mellitus using insulin infusion systems. A systematic review and meta-analysis

Bastian Rosner et al. PLoS One. .

Abstract

Background: In 2017, more than 1.1 million children were living with type 1 diabetes mellitus (T1DM) globally. The goal in paediatric diabetes therapy is reaching optimal glycaemic control as early as possible in order to avoid complications and early mortality without compromising the quality of life (QoL) of children. Several different insulin regimens are available for T1DM patients to reach this goal.

Aims: This review set out to analyse whether continuous subcutaneous insulin infusion (CSII) regimens are superior to multiple daily injection (MDI) therapy in T1DM youth regarding QoL. Additionally, it assessed glycaemic control and adverse events as secondary outcomes and discussed potential future public health implications and justifications for using CSII as a first-line therapy in diabetic youth.

Methods: A systematic review and random effects meta-analysis was performed on studies investigating the association between QoL and diabetes treatment regimen. Differences in adverse event rates between groups were analysed using a Mann-Whitney U test. Lastly, differences in glycaemic control were assessed using a random effects meta-analysis.

Results: QoL and glycaemic control was significantly better in CSII subjects at baseline and follow-up. No significant differences in adverse events were found between study groups. No significant changes over time could be shown for either QoL or glycaemic control.

Conclusion: CSII proved to provide similar or slightly better outcomes in all analysed fields. This is consistent with previous research. However, to make credible recommendations, better-designed studies are needed to investigate the impact of CSII in children.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Literature search strategy.
Fig 2
Fig 2. Pooled quality of life results (SMD) at baseline.
Fig 3
Fig 3. Pooled quality of life results (SMD) at follow-up.
Fig 4
Fig 4. Pooled HbA1c results (MD) at baseline.
Fig 5
Fig 5. Pooled HbA1c results (MD) at follow-up.
See this image and copyright information in PMC

References

    1. World Health Organization. Global report on diabetes. WHO, 2016; https://www.who.int/diabetes/global-report/en/. Accessed 16.01.19. 10.2337/db15-0956 - DOI
    1. World Health Organization. The top 10 causes of death. WHO, 2018; https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed 17.01.19.
    1. World Health Organization. Noncommunicable diseases. WHO, 2018; https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. Accessed 24.02.2019.
    1. AMBOSS. Diabetes mellitus. 2019; https://www.amboss.com/us/knowledge/Diabetes_mellitus. Accessed 21.01.19.
    1. American Diabetes Association. 2. Classification and Diagnosis of Diabetes. Diabetes Care. 2015;38:S8–S16. - PubMed

Publication types

Substances