Effectiveness of Multiple Daily Injections or Continuous Subcutaneous Insulin Infusion for Children with Type 1 Diabetes Mellitus in Clinical Practice

Abstract EN

Aims.

To determine whether multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) contributes to better glucose control in children with different type 1 diabetes duration.

Methods.

Subjects were grouped according to early ( ≤ 1 year after disease onset; 1A) or late (1–3 years after onset; 2A) MDIs/CSII treatment initiation.

Corresponding control groups (1B, 2B) received insulin injections twice daily.

Results.

HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; all P < 0.05 ), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%; P = 0.04 ).

Levels were lower in group 1A than in group 2A when disease duration was matched (7.61% versus 8.49%; P < 0.05 ).

Logistic regression revealed no correlation between HbA1c level and MDIs/CSII therapy.

HbA1c levels were only negatively related to insulin dosage.

Conclusions.

Blood glucose control was better in patients receiving MDIs/CSII than in those receiving conventional treatment.

Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation.

MDIs/CSII therapy should be combined with comprehensive management.