Aysun BİDECİ, Peyami CİNAZ, Fatma DEMİREL, Mahmut Orhun ÇAMURDAN

The follow-up results of insulin pump use in Turkish children with type I diabetes mellitus

Amaç: Çocuklarda kullanımı giderek yaygınlaşmasına rağmen, diyabetli Türk çocuklarında insülin pompası uygulanımma dair yayınlanmış veri yoktur. Bu çalışmanın amacı diyabetli Türk çocuklarında insülin pompası uygulanmanın sonuçlarım araştırmaktır. Gereç ve Yöntemler: Yaş ortalaması 14.7±2.6 yıl, pompa kullanım süresi 3-24 ay olan on diyabetik çocuğun verileri incelenmiş, ve pompa kullanımı öncesi bir senelik sürede elde edilen verilerle karşılaştırılmıştır. Bulgular: İstatistiksel olarak anlamlı olmamakla birlikte, HbAlc düzeyi pompa öncesi döneme kıyasla azalma eğiliminde idi. Vücut kitle indeksi Z skorları benzerdi (Pompa öncesi ve sonrası sırasıyla; 0.45±0.76 ve 0.54±0.53 kg/m2, p>0.05). Ortalama insülin dozu azalmıştı (Pompa öncesi ve sonrası sırasıyla; l.l±0.2 ve 0.9±0.1 U/kg/gün, p

Diyabetli Türk çocuklarında insülin pompası kullanımı izlem sonuçları

Purpose: Although its use is increasing in children, there are no data about pump use in Turkish children with diabetes. The aim of this study was to investigate the outcome measures of insulin pump use in diabetic Turkish children. Materials and Methods: Ten children (age; 14.7±2.6 years, pump therapy duration; 3-24 months) were prospectively studied. Main outcome measures were compared with those of the 12 months prior to pump therapy. Results: Although statistically insignificant, HbAlc tended to be lower compared to the pre-pump period. Body mass index Z scores remained similar (0.45±0.76 vs. 0.54±0.53 kg/m2, p>0.05). Insulin doses decreased (l.l±0.2 vs. 0.9±0.1 U/kg/day, p

PDF

___

1. The DCCT Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial. J Pediatr 1994; 125: 177-188.
2. Tamborlane WV, Sherwin RS, Genel M, Felig P. Reduction to normal of plasma glucose in juvenile diabetes by subcutaneous administration of insulin with a portable infusion pump. N Engl J Med. 1979; 300(11): 573-578.
3. Wilson DM, Buckingham BA, Kunselman EL, Sullivan MM, Paguntalan HU, Gitelman SE. A two-center randomized controlled feasibility trial of insulin pump therapy in young children with diabetes. Diabetes Care 2005; 28:15-19.
4. Cinaz P., Çamurdan M.O., Bideci A., Demirel R, Bakar C. Body mass index values in children with ages 6-16 years. 48th National Pediatrics Congress, Samsun (abstract book) 2004; 421-422.
5. Deiss D, Hartmann R, Hoeffe J, Kordonouri O. Assessment of glycemic control by continuous glucose monitoring system in 50 children with type 1 diabetes starting on insulin pump therapy. Pediatr Diabe- . tes2004;5: 117-121.
6. DiMeglio LA, Pottorff TM, Boyd SR, France L, Fineberg N, Eugster EA. A randomized, controlled study of insulin pump therapy in diabetic preschoolers. J Pediatr 2004; 145: 380-384.
7. Alemzadeh R, Ellis JN, Holzum MK, Parton EA, Wyatt DT. Beneficial effects of continuous subcutaneous insulin infusion and flexible multiple daily insulin regimen using insulin glargine in type 1 diabetes. Pediatrics. 2004; 114: e91-95.
8. Sulli N, Shashaj B. Continuous subcutaneous insulin infusion in children and adolescents with diabetes mellitus: decreased HbAlc with low risk of hypoglycemia. J Pediatr Endocrinol Metab 2003; 16: 393-399.
9. Mack-Fogg JE, Orlowski CC, Jospe N. Continuous subcutaneous insulin infusion in toddlers and children with type 1 diabetes mellitus is safe and effective. Pediatr Diabetes 2005; 6: 17-21.
10. Heptulla RA, Allen HF, Gross TM, Reiter EO. Continuous glucose monitoring in children with type 1 diabetes: before and after insulin pump therapy: Pediatr Diabetes 2004; 5: 10-15.
11. Saha ME, Huuppone T, Mikael K, Juuti M, Komulainen J. Continuous subcutaneous insulin infusion in the treatment of children and adolescents with type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2002; 15: 1005-1010.
12. Weintrob N, Schechter A, Benzaquen H, Shalitin S, Lilos P, Galatzer A, Phillip M. Glycemic patterns detected by continuous subcutaneous glucose sensing in children and adolescents with type 1 diabetes mellitus treated by multiple daily injections vs continuous subcutaneous insulin infusion. Arch Pediatr Adolesc Med 2004; 158: 677- 684.
13. Weintrob N, Benzaquen H, Galatzer A, Shalitin S, Lazar L, Fayman G, Lilos P, Dickerman Z, Phillip M. Comparison of continuous subcutaneous insulin infusion and multiple daily injection regimens in children with type 1 diabetes: a randomized open crossover trial. Pediatrics 2003; 112:59-64.
14. Bober E, Buyukgebiz A. Hypoglycemia and its effects on the brain in children with type 1 diabetes mellitus. Pediatr Endocrinol Rev 2005; 2: 378-382.
15. McMahon SK, Airey FL, Marangou DA, McElwee KJ, Came CL, Clarey AJ, Davis EA, Jones TW. Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life. Diabet Med 2005; 22: 92-96.
16. Plotnick LP, Clark LM, Brancati FL, Erlinger T. Safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes. Diabetes Care 2003; 26: 1142-1146.
17. Ahern JA, Boland EA, Doane R, Ahern JJ, Rose P, Vincent M, Tamborlane WV. Insulin pump therapy in pediatrics: a therapeutic alternative to safely lower HbAlc levels across all age groups. Pediatr Diabetes 2002; 3: 10-15.
18. Boland EA, Grey M, Oesterle A, Fredrickson L, Tamborlane WV. Continuous subcutaneous insulin infusion. A new way to lower risk of severe hypoglycemia, improve metabolic control, and enhance coping in adolescents with type 1 diabetes. Diabetes Care 1999; 22: 1779-1784.
19. Maniatis AK, Klingensmith GJ, Slover RH, Mowry CJ, Chase HP. Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care. Pediatrics. 2001; 107:351-356.
20. Weinzimer SA, Ahern JH, Doyle EA, Vincent MR, Dziura J, Steffen AT, Tamborlane WV. Persistence of benefits of continuous subcutaneous insulin infusion in very young children with type 1 diabetes: a follow-up report. Pediatrics 2004; 114: 1601-1605.
21. Schiaffini R, Ciampalini P, Spera S, Cappa M, Crino A. An observational study comparing continuous subcutaneous insulin infusion (CSII) and insulin glargine in children with type 1 diabetes. Diabetes Metab Res Rev 2005; 21: 347-352.
22. Litton J, Rice A, Friedman N, Oden J, Lee MM, Freemark M. Insulin pump therapy in toddlers and preschool children with type 1 diabetes mellitus. J Pediatr 2002; 141: 490-495.
23. Weissberg-Benchell J, Antisdel-Lomaglio J, Seshadri R. Insulin pump therapy: a meta-analysis. Diabetes Care 2003; 26: 1079-1087.
24. Tamborlane WV, Ahern J. Implications and results of the Diabetes Control and Complications Trial. Pediatr Clin North Am 1997; 44: 285-300.