Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry

Agnieszka Szypowska; Anke Schwandt; Jannet Svensson; Shlomit Shalitin; Roque Cardona-Hernandez; Gun Forsander; Frida Sundberg; Carine de Beaufort; David M Maahs; Claudio Maffeis; Stephen M P O'Riordan; Iveta Dzivite Krisane; Mauro Scharf; Sofia Castro; Maia Konstantinova; Barbora Obermannova; Kristina Casteels; Damla Gökşen; Júlia Galhardo; Christina Kanaka-Gantenbein; Birgit Rami-Merhar; Laszlo Madacsy; SWEET Study Group

doi:10.1111/pedi.12416

Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry

Agnieszka Szypowska, Anke Schwandt, Jannet Svensson, Shlomit Shalitin, Roque Cardona-Hernandez, Gun Forsander, Frida Sundberg, Carine de Beaufort, David M Maahs, Claudio Maffeis, Stephen M P O'Riordan, Iveta Dzivite Krisane, Mauro Scharf, Sofia Castro, Maia Konstantinova, Barbora Obermannova, Kristina Casteels, Damla Gökşen, Júlia Galhardo, Christina Kanaka-GantenbeinBirgit Rami-Merhar, Laszlo Madacsy, SWEET Study Group

Department of Clinical Medicine

59 Citations (Scopus)

Abstract

Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

Original language	English
Journal	Pediatric Diabetes
Volume	17
Issue number	S23
Pages (from-to)	38-45
Number of pages	8
ISSN	1399-543X
DOIs	https://doi.org/10.1111/pedi.12416
Publication status	Published - 1 Oct 2016

Keywords

Adolescent
Blood Glucose
Child
Child, Preschool
Diabetes Mellitus, Type 1
Female
Humans
Infant
Injections
Insulin Infusion Systems
Male
Registries
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/pedi.12416

http://repositorio.chlc.min-saude.pt/bitstream/10400.17/2796/1/Ped%20Diabetes%202016_17_38.pdf

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Szypowska, A., Schwandt, A., Svensson, J., Shalitin, S., Cardona-Hernandez, R., Forsander, G., Sundberg, F., de Beaufort, C., Maahs, D. M., Maffeis, C., O'Riordan, S. M. P., Krisane, I. D., Scharf, M., Castro, S., Konstantinova, M., Obermannova, B., Casteels, K., Gökşen, D., Galhardo, J., ... SWEET Study Group (2016). Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry. Pediatric Diabetes, 17(S23), 38-45. https://doi.org/10.1111/pedi.12416

Szypowska, A, Schwandt, A, Svensson, J, Shalitin, S, Cardona-Hernandez, R, Forsander, G, Sundberg, F, de Beaufort, C, Maahs, DM, Maffeis, C, O'Riordan, SMP, Krisane, ID, Scharf, M, Castro, S, Konstantinova, M, Obermannova, B, Casteels, K, Gökşen, D, Galhardo, J, Kanaka-Gantenbein, C, Rami-Merhar, B, Madacsy, L & SWEET Study Group 2016, 'Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry', Pediatric Diabetes, vol. 17, no. S23, pp. 38-45. https://doi.org/10.1111/pedi.12416

@article{71211d90f2174a45ba3df8251ca1d900,

title = "Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry",

abstract = "Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.",

keywords = "Adolescent, Blood Glucose, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Humans, Infant, Injections, Insulin Infusion Systems, Male, Registries, Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't",

author = "Agnieszka Szypowska and Anke Schwandt and Jannet Svensson and Shlomit Shalitin and Roque Cardona-Hernandez and Gun Forsander and Frida Sundberg and {de Beaufort}, Carine and Maahs, {David M} and Claudio Maffeis and O'Riordan, {Stephen M P} and Krisane, {Iveta Dzivite} and Mauro Scharf and Sofia Castro and Maia Konstantinova and Barbora Obermannova and Kristina Casteels and Damla G{\"o}k{\c s}en and J{\'u}lia Galhardo and Christina Kanaka-Gantenbein and Birgit Rami-Merhar and Laszlo Madacsy and {SWEET Study Group}",

note = "{\textcopyright} 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2016",

month = oct,

day = "1",

doi = "10.1111/pedi.12416",

language = "English",

volume = "17",

pages = "38--45",

journal = "Pediatric Diabetes",

issn = "1399-543X",

publisher = "Wiley-Blackwell",

number = "S23",

}

TY - JOUR

T1 - Insulin pump therapy in children with type 1 diabetes

T2 - analysis of data from the SWEET registry

AU - Szypowska, Agnieszka

AU - Schwandt, Anke

AU - Svensson, Jannet

AU - Shalitin, Shlomit

AU - Cardona-Hernandez, Roque

AU - Forsander, Gun

AU - Sundberg, Frida

AU - de Beaufort, Carine

AU - Maahs, David M

AU - Maffeis, Claudio

AU - O'Riordan, Stephen M P

AU - Krisane, Iveta Dzivite

AU - Scharf, Mauro

AU - Castro, Sofia

AU - Konstantinova, Maia

AU - Obermannova, Barbora

AU - Casteels, Kristina

AU - Gökşen, Damla

AU - Galhardo, Júlia

AU - Kanaka-Gantenbein, Christina

AU - Rami-Merhar, Birgit

AU - Madacsy, Laszlo

AU - SWEET Study Group

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

AB - Background: Intensified insulin delivery using multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) is recommended in children with type 1 diabetes (T1D) to achieve good metabolic control. Objective: To examine the frequency of pump usage in T1D children treated in SWEET (Better control in Paediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers and to compare metabolic control between patients treated with CSII vs MDI. Methods: This study included 16 570 T1D children participating in the SWEET prospective, multicenter, standardized diabetes patient registry. Datasets were aggregated over the most recent year of treatment for each patient. Data were collected until March 2016. To assess the organization of pump therapy a survey was carried out. Results: Overall, 44.4% of T1D children were treated with CSII. The proportion of patients with pump usage varied between centers and decreased with increasing age compared with children treated with MDI. In a logistic regression analysis adjusting for age, gender and diabetes duration, the use of pump was associated with both: center size [odd ratio 1.51 (1.47-1.55), P <.0001) and the diabetes-related expenditure per capita [odd ratio 1.55 (1.49-1.61), P <.0001]. Linear regression analysis, adjusted for age, gender, and diabetes duration showed that both HbA1c and daily insulin dose (U/kg/d) remained decreased in children treated with CSII compared to MDI (P <.0001). Conclusions: Insulin pump therapy is offered by most Sweet centers. The differences between centers affect the frequency of use of modern technology. Despite the heterogeneity of centers, T1D children achieve relatively good metabolic control, especially those treated with insulin pumps and those of younger age.

KW - Adolescent

KW - Blood Glucose

KW - Child

KW - Child, Preschool

KW - Diabetes Mellitus, Type 1

KW - Female

KW - Humans

KW - Infant

KW - Injections

KW - Insulin Infusion Systems

KW - Male

KW - Registries

KW - Comparative Study

KW - Journal Article

KW - Multicenter Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1111/pedi.12416

DO - 10.1111/pedi.12416

M3 - Journal article

C2 - 27417128

SN - 1399-543X

VL - 17

SP - 38

EP - 45

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - S23

ER -

Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry

Abstract

Keywords

UN SDGs

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