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Factors Correlating With Improved A1C in Children Using Continuous Subcutaneous Insulin Infusion

¹ Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
² Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Address correspondence and reprint requests to Jennifer J.F. McVean, MD, Department of Pediatrics, University of Wisconsin Children's Hospital, 600 Highland Ave., H4-436, Madison, WI 53792. E-mail: jj.mcvean@hosp.wisc.edu

Abbreviations: CSII, continuous subcutaneous insulin infusion

The first 20% of the full text of this article appears below.

	INTRODUCTION

 
The Diabetes Control and Complications Trial demonstrated that tight metabolic control in patients with type 1 diabetes reduces the risk of microvascular complications (1). Subsequently, the use of continuous subcutaneous insulin infusion (CSII) to achieve strict metabolic control increased exponentially. The advantages of CSII over multiple daily injections include increased lifestyle flexibility, variable basal infusion rates with boluses given before meals, and only one injection for insulin administration every few days (2). CSII in children lowers A1C and decreases hypoglycemia (3,4). The American Diabetes Association recommended A1C treatment goals for pediatric patients of 7.5–8.5% for those aged <6 years, 8% for those aged 6–12 years, <7.5% for those aged 13–19 years, and <7% for those aged 19–22 years (5), but few children and adolescents reach these goals. The reason for this remains unclear. We conducted this study to determine the percentage of children using CSII who reached their A1C goal and to identify differences between children who met their goal and those who did not.

	RESEARCH DESIGN AND METHODS—

 
Medical records of all patients (aged 2–22 years, n = 236) with type 1 diabetes for 1 year using CSII for 6 months who were followed at the University of Wisconsin pediatric diabetes clinic were reviewed. Data from the time of initiation of CSII . . . [Full Text of this Article]

	RESULTS—

 

	CONCLUSIONS—

 

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				F. Campbell Review: The pros and cons of continuous subcutaneous insulin infusion (CSII) therapy in the paediatric population and practical considerations when choosing and initiating CSII in children The British Journal of Diabetes & Vascular Disease, September 1, 2008; 8(1_suppl): S6 - S10. [Abstract] [PDF]