HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Plotnick, L. P. Articles by Erlinger, T. Search for Related Content PubMed PubMed Citation Articles by Plotnick, L. P. Articles by Erlinger, T. Social Bookmarking                What's this?

Safety and Effectiveness of Insulin Pump Therapy in Children and Adolescents With Type 1 Diabetes

¹ Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland
² Department of Medicine, Johns Hopkins University, Baltimore, Maryland
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
⁴ Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland

OBJECTIVE—To evaluate the safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes.

RESEARCH DESIGN AND METHODS—All 95 patients who began insulin pump therapy at Johns Hopkins Hospital between January 1990 and December 2000 were included in the study. The mean age was 12.0 years (range 4–18), and 29% of the patients were <10 years old. Data were obtained by chart review beginning 6–12 months before pump start. The median duration of follow-up was 28 months.

RESULTS—There was a small but significant decrease in HbA_1c at 3–6 months after pump start (7.7 vs. 7.5%; P = 0.03). HbA_1c levels then gradually increased and remained elevated after 1 year of follow-up; however, this association was confounded by age and diabetes duration, both of which were associated with higher HbA_1c levels. After adjusting for duration and age, mean HbA_1c after pump start was significantly lower than before pump start (7.7 vs. 8.1%; P < 0.001). The number of medical complications (diabetic ketoacidosis, emergency department visits) was similar before and after pump start. There were fewer hypoglycemic events after pump start (12 vs. 17, rate ratio 0.46, 95% CI 0.21–1.01).

CONCLUSIONS—This study suggests that pump therapy is safe and effective in selected children and adolescents with type 1 diabetes.

Abbreviations: DKA, diabetic ketoacidosis • ED, emergency department • RR, rate ratio

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				R. G. Feltbower, H. J. Bodansky, C. C. Patterson, R. C. Parslow, C. R. Stephenson, C. Reynolds, and P. A. McKinney Acute Complications and Drug Misuse Are Important Causes of Death for Children and Young Adults With Type 1 Diabetes: Results from the Yorkshire Register of Diabetes in Children and Young Adults Diabetes Care, May 1, 2008; 31(5): 922 - 926. [Abstract] [Full Text] [PDF]

				J. U. Cope, A. E. Morrison, and J. Samuels-Reid Adolescent Use of Insulin and Patient-Controlled Analgesia Pump Technology: A 10-Year Food and Drug Administration Retrospective Study of Adverse Events Pediatrics, May 1, 2008; 121(5): e1133 - e1138. [Abstract] [Full Text] [PDF]

				S. A. Weinzimer, C. Ternand, C. Howard, C.-T. Chang, D. J. Becker, L. M.B. Laffel, and for the Insulin Aspart Pediatric Pump Study Group A Randomized Trial Comparing Continuous Subcutaneous Insulin Infusion of Insulin Aspart Versus Insulin Lispro in Children and Adolescents With Type 1 Diabetes Diabetes Care, February 1, 2008; 31(2): 210 - 215. [Abstract] [Full Text] [PDF]

				M. Phillip, T. Battelino, H. Rodriguez, T. Danne, F. Kaufman, and for the Consensus forum participants 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, June 1, 2007; 30(6): 1653 - 1662. [Full Text] [PDF]

				J. R. Wood, E. C. Moreland, L. K. Volkening, B. M. Svoren, D. A. Butler, and L. M.B. Laffel Durability of insulin pump use in pediatric patients with type 1 diabetes. Diabetes Care, November 1, 2006; 29(11): 2355 - 2360. [Abstract] [Full Text] [PDF]

				R. J. Iannotti, T. R. Nansel, S. Schneider, D. L. Haynie, B. Simons-Morton, D. O. Sobel, L. Zeitzoff, L. P. Plotnick, and L. Clark Assessing Regimen Adherence of Adolescents With Type 1 Diabetes Diabetes Care, October 1, 2006; 29(10): 2263 - 2267. [Abstract] [Full Text] [PDF]

				E. A. Eugster, G. Francis, and and the Lawson-Wilkins Drug and Therapeutics Commi Position Statement: Continuous Subcutaneous Insulin Infusion in Very Young Children With Type 1 Diabetes Pediatrics, October 1, 2006; 118(4): e1244 - e1249. [Abstract] [Full Text] [PDF]

				A. T. Soliman, M. Omar, M. M. Rizk, A. El Awwa, and F. M. AlGhobashy Glycaemic Control with Modified Intensive Insulin Injections (MII) Using Insulin Pens and Premixed Insulin in Children with Type-1 Diabetes: A Randomized Controlled Trial J Trop Pediatr, August 1, 2006; 52(4): 276 - 281. [Abstract] [Full Text] [PDF]

				R. Nimri, N. Weintrob, H. Benzaquen, R. Ofan, G. Fayman, and M. Phillip Insulin pump therapy in youth with type 1 diabetes: a retrospective paired study. Pediatrics, June 1, 2006; 117(6): 2126 - 2131. [Abstract] [Full Text] [PDF]

				G. Lepore, A. R. Dodesini, I. Nosari, and R. Trevisan Age and A1C Are Important Clinical Predictors of Continuous Subcutaneous Insulin Infusion Efficacy in Type 1 Diabetic Patients Diabetes Care, July 1, 2005; 28(7): 1834 - 1835. [Full Text] [PDF]

				J. Silverstein, G. Klingensmith, K. Copeland, L. Plotnick, F. Kaufman, L. Laffel, L. Deeb, M. Grey, B. Anderson, L. A. Holzmeister, et al. Care of Children and Adolescents With Type 1 Diabetes: A statement of the American Diabetes Association Diabetes Care, January 1, 2005; 28(1): 186 - 212. [Full Text] [PDF]

				L. Siegel-Czarkowski, K. C. Herold, and R. S. Goland Continuous Subcutaneous Insulin Infusion in Older Patients With Type 1 Diabetes Diabetes Care, December 1, 2004; 27(12): 3022 - 3023. [Full Text]

				S. A. Weinzimer, J. H. Ahern, E. A. Doyle, M. R. Vincent, J. Dziura, A. T. Steffen, and W. V. Tamborlane Persistence of Benefits of Continuous Subcutaneous Insulin Infusion in Very Young Children With Type 1 Diabetes: A Follow-up Report Pediatrics, December 1, 2004; 114(6): 1601 - 1605. [Abstract] [Full Text] [PDF]

				E. A. Doyle, S. A. Weinzimer, A. T. Steffen, J. A. H. Ahern, M. Vincent, and W. V. Tamborlane A Randomized, Prospective Trial Comparing the Efficacy of Continuous Subcutaneous Insulin Infusion With Multiple Daily Injections Using Insulin Glargine Diabetes Care, July 1, 2004; 27(7): 1554 - 1558. [Abstract] [Full Text] [PDF]