TY - JOUR T1 - Continuous subcutaneous insulin infusion in children less than 6 years-old: Long-term progress JO - Anales de Pediatría (English Edition) T2 - AU - Colino,Esmeralda AU - Martín Frías,María AU - Roldán,Belén AU - Álvarez,María Ángeles AU - Yelmo,Rosa AU - Barrio,Raquel SN - 23412879 M3 - 10.1016/j.anpede.2016.12.007 DO - 10.1016/j.anpede.2016.12.007 UR - https://www.analesdepediatria.org/en-continuous-subcutaneous-insulin-infusion-in-articulo-S2341287917301643 AB - ObjectiveThe aims of the study are to evaluate the efficacy and safety of continuous subcutaneous insulin infusion (CSII) treatment in pre-school children with type I diabetes, and to assess whether the criteria of good metabolic control are achieved. MethodA review was performed on the medical charts of patient's <6 years of age who started CSII treatment between 2003 and 2014. The cohort consisted of 27 patients (mean age 4 (2.9–4.7) years, 56% males). An analysis was made including the age at onset, type I diabetes duration, HbA1c (HPLC, Menarini, normal value 5.1±0.31%), insulin dose (IU/kg/day), number of capillary blood glucose measurements, number of baseline processes per day, % baseline/total insulin (B/TI), insulin ratios (I/HC) at different meals, severe hypoglycaemia (HS episodes/100 patients years), DKA events, percentages of normal blood glucose (70–180mg/dL), hyperglycaemia (>180mg/dL), and hypoglycaemia (<70mg/dL), mean blood glucose, standard deviation and coefficient of variation ((SD/mean glucose)×100). Statistical analysis was performed using SPSS. ResultsHbA1c decreased from 6.9% (6.7–7.5) to 6.8% (6.4–7.1) after one year of CSII. Afterwards, it remained under 6.8% during the follow-up (median 5 years [3–6]). Prior to CSII, 74% of children had HbA1c levels <7.5%. It increased to 96% after one year of CSII. Median blood glucose measurements/day was 10 (9–11). Total insulin dose did not change significantly. During the follow-up, there was one episode of DKA and one episode of HS. I/HC at breakfast were higher than at other meals (0.92 vs. 0.55, 0.6 and 0.5, respectively). ConclusionsCSII is effective and safe in pre-school children. It allows good metabolic control (based on Society for Paediatric and Adolescent Diabetes/American Diabetes Association criteria) to be achieved and maintained for long periods of time without an increase in adverse events. ER -