Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry

the SWEET Study Group

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

Original languageEnglish
Pages (from-to)38-45
Number of pages8
JournalPediatric Diabetes
Volume17
DOIs
Publication statusPublished - Oct 1 2016

Fingerprint

Type 1 Diabetes Mellitus
Registries
Insulin
Subcutaneous Infusions
Injections
Therapeutics
Odds Ratio
Regression Analysis
Health Expenditures
Linear Models
Logistic Models
Organizations
Pediatrics
Technology

Keywords

  • childhood diabetes
  • continuous subcutaneous insulin infusion
  • CSII
  • MDI
  • multiple daily injections

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

Cite this

Insulin pump therapy in children with type 1 diabetes : analysis of data from the SWEET registry. / the SWEET Study Group.

In: Pediatric Diabetes, Vol. 17, 01.10.2016, p. 38-45.

Research output: Contribution to journalArticle

@article{5a654210b7354a39a31dca0e4a718352,
title = "Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry",
abstract = "Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4{\%} of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.",
keywords = "childhood diabetes, continuous subcutaneous insulin infusion, CSII, MDI, multiple daily injections",
author = "{the SWEET Study Group} and Agnieszka Szypowska and Anke Schwandt and Jannet Svensson and Shlomit Shalitin and Roque Cardona-Hernandez and Gun Forsander and Frida Sundberg and {De Beaufort}, Carine and David Maahs and Claudio Maffeis and O‘Riordan, {Stephen M P} and Krisane, {Iveta Dzivite} and Mauro Scharf and Sofia Castro and Maia Konstantinova and Barbora Obermannova and Kristina Casteels and Damla G{\"o}kşen and J{\'u}lia Galhardo and Christina Kanaka-Gantenbein and Birgit Rami-Merhar and L. Mad{\'a}csy",
year = "2016",
month = "10",
day = "1",
doi = "10.1111/pedi.12416",
language = "English",
volume = "17",
pages = "38--45",
journal = "Pediatric Diabetes",
issn = "1399-543X",
publisher = "Blackwell Munksgaard",

}

TY - JOUR

T1 - Insulin pump therapy in children with type 1 diabetes

T2 - analysis of data from the SWEET registry

AU - the SWEET Study Group

AU - Szypowska, Agnieszka

AU - Schwandt, Anke

AU - Svensson, Jannet

AU - Shalitin, Shlomit

AU - Cardona-Hernandez, Roque

AU - Forsander, Gun

AU - Sundberg, Frida

AU - De Beaufort, Carine

AU - Maahs, David

AU - Maffeis, Claudio

AU - O‘Riordan, Stephen M P

AU - Krisane, Iveta Dzivite

AU - Scharf, Mauro

AU - Castro, Sofia

AU - Konstantinova, Maia

AU - Obermannova, Barbora

AU - Casteels, Kristina

AU - Gökşen, Damla

AU - Galhardo, Júlia

AU - Kanaka-Gantenbein, Christina

AU - Rami-Merhar, Birgit

AU - Madácsy, L.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

AB - Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

KW - childhood diabetes

KW - continuous subcutaneous insulin infusion

KW - CSII

KW - MDI

KW - multiple daily injections

UR - http://www.scopus.com/inward/record.url?scp=84992418549&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992418549&partnerID=8YFLogxK

U2 - 10.1111/pedi.12416

DO - 10.1111/pedi.12416

M3 - Article

C2 - 27417128

AN - SCOPUS:84992418549

VL - 17

SP - 38

EP - 45

JO - Pediatric Diabetes

JF - Pediatric Diabetes

SN - 1399-543X

ER -