Dina Omar
Dasman Diabetes Institute, Kuwait
Title: Continuous subcutaneous insulin infusion (csii) is safe and effective in the management of children and adolescents with type 1 diabetes: report from a specialized center, in kuwait
Biography
Biography: Dina Omar
Abstract
Aim: This study aims to assess the effectiveness and safety of CSII as an alternative to MDI in the management of children and adolescents with T1D in Dasman Diabetes Institute.
Design: Retrospective prospective cohort study.
Participants: Children and adolescents (<20 years old) with T1D who switched from MDI to CSII during 2011-2013. Data were collected from electronic health records. Effectiveness were measured by improvement in HbA1c and TDD, and safety by reduction in incidence of major complication (severe hypoglycemia (SH) and diabetic ketoacidosis (DKA)). Data were collected for 24 months prior to CSII use, and 30 months after.
Results: The mean age of study cohort (n= 64) was 10.9 ± 4.8 years (mean ± SD). HbA1c dropped from 8.7±1.4% at baseline to 8.1±1.0% (0.6% absolute reduction) at 3 months (p<0.05). Sustainability of improvement was demonstrated only in those with high baseline HbA1c (>9.0%) with an absolute reduction of 2.4% from 10.6±1.3% to 8.8±2.2% at 30 months. There was no significant reduction in insulin requirement. Reduction in the incidence of SH was statistically significant while it was not significant for DKA.
Conclusions: The use of CSII is effective in improving glycemic control of children and adolescents with T1D in the short term (3 months). Those who were in poor control (HbA1c >9.0%) at baseline, showed significant improvement of glycemic control, after 30 months. CSII use in our study cohort was safe as reduction in the incidence of acute major diabetic complications was demonstrated.