Glycaemic control improves after continuous subcutaneous insulin infusion therapy: results from an Irish regional centre for paediatric type 1 diabetes mellitus

Objectives: The use of continuous subcutaneous insulin infusion (CSII) in the management of paediatric patients with type 1 diabetes mellitus (T1DM) has increased substantially in the last decade. The aim of this study was to evaluate and compare glycaemic control in a population of paediatric patients with T1DM before commencing CSII compared with 2 years after commencing CSII. Methods: This is a retrospective study with data collection from diabetes clinic records. Complete data were obtained on 34/45 eligible patients. Glycosylated haemoglobin (HbA1c) and body mass index (BMI) were compared 6 months pre- and 2 years post CSII commencement. Data were stratified in 6-month blocks. Results: Mean HbA1c improved over 2 years post CSII with the lowest value in the first 6 months post-commencement. When gender, age, time since diagnosis and time on pump were added as covariates, results became non-significant, with only age exhibiting a statistically significant influence on glycaemic control (p = 0.03). This improved glycaemic control is associated with some increment in BMI which showed no statistical significance in the first year post-CSII. Conclusion: CSII commencement is associated with significantly improved glycaemic control most notably in the first 6 months after CSII commencement. There is association between CSII commencement and increased BMI noted to be statistically significant in the second year.