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Insulin pumps in pe...
Insulin pumps in pediatric routine care improve long-term metabolic control without increasing the risk of hypoglycemia
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Hanås, Ragnar, 1951 (författare)
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- Adolfsson, Peter, 1963 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology
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(creator_code:org_t)
- 2006
- 2006
- Engelska.
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Ingår i: Pediatr Diabetes. - 1399-543X .- 1399-543X. ; 7:1, s. 25-31
- Relaterad länk:
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https://gup.ub.gu.se...
Abstract
Ämnesord
Stäng
- Although continuous subcutaneous insulin infusion (CSII) has been used in pediatric practice for >20 yr, the technique is not widely used in many countries. The aim of this non-randomized population-based study was to evaluate CSII in routine pediatric care. In a 1-yr cross-sectional evaluation, 27/89 patients (30.3%, age 7-21 yr) used pumps (two during the night only), the others 4-6 injections/day. In patients with >2 yr of diabetes, pump users had higher HbA1c (8.9+/-1.0 vs. 8.2+/-1.6%, p=0.04), less insulin/24 h (0.9+/-0.1 vs. 1.0+/-0.2 U/kg, p=0.002), and longer diabetes duration (p=0.02). The higher HbA1c is explained by 67% of pump patients having high HbA1c (>8.5%) as the major indication for CSII. The overall incidence of severe hypoglycemia was 31.5/100 patient years, 40.3 for injection therapy, and 11.1 for pump therapy (p=not significant). The incidence of severe hypoglycemia with unconsciousness was 12.9/100 patient years and with seizures 9.7 for injection therapy, whereas no children on pumps experienced these complications during the cross-sectional study year. We had no admissions for ketoacidosis in either group during this year. The pump patients were followed for 5 yr after pump start. Two stopped using the pump after 2 and 3 yr. For the patients with high HbA1c as indication, mean HbA1c the year before pump was 9.5%. Mean HbA1c during the first year with pump was lowered to 8.9% (p=0.019), the second year 8.6% (p=0.017), the third year 8.6 (p=0.012), the fourth year 8.7 (p=0.062), and the fifth year 8.9% (p=0.28). We found six cases of ketoacidosis corresponding to 4.7/100 patient years. In conclusion, we found a long-term lowering of HbA1c after starting CSII in a pediatric population, decreased frequency of severe hypoglycemia, and a low risk of ketoacidosis.
Nyckelord
- Adolescent
- Adult
- Child
- Cross-Sectional Studies
- Diabetes Mellitus
- Type 1/blood/*drug therapy
- Female
- Hemoglobin A
- Glycosylated/analysis
- Humans
- Hypoglycemia/epidemiology/*prevention & control
- Hypoglycemic Agents/*administration & dosage/adverse effects
- Injections
- Subcutaneous
- Insulin/*administration & dosage/adverse effects
- *Insulin Infusion Systems
- Longitudinal Studies
- Male
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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