Continuous subcutaneous insulin infusion in young girls: a two-year follow-up study

Abstract

Aims: To investigate why young girls decided to start continuous subcutaneous insulin infusion (CSII) therapy, and to examine their opinions and concerns with regard to using an insulin pump. In addition, the girls were evaluated for HbA_1c values, insulin requirements and body mass index standard deviation score (BMI SDS) over a period of two years after starting CSII compared with a group of girls using multiple daily injections (MDI).

Methods: Twelve girls (mean age 10.8 years) starting CSII were followed over a period of two years. Why the girls started CSII and whether they preferred CSII or MDI were investigated. Their statements about CSII were analysed and categorised by two paediatric diabetes nurses. On four occasions HbA_1c values, insulin requirement and BMI SDS were collected and compared with those of a control group of 12 girls using MDI for the same period of time.

Results: The girls started CSII due to a desire to test pump therapy, and their experiences of unstable blood glucose. They preferred CSII to MDI. The main positive statements were categorised as ‘quality-of-life benefits’. The main negative category was ‘the pump gets in the way’. In the CSII group, HbA_1c decreased from 8.5 (7.4–9.5) to 7.5 (6.9–8.1) (p<0.05) over two years, and the insulin requirement decreased by 30%. In the control group these values were unchanged. There were no changes in the BMI SDS mean values for either group.

Conclusion: CSII was well accepted by the young girls, facilitated a decrease in HbA_1c values, and did not result in weight gain.

Keywords:

• CSII
• children
• adolescents
• females
• type 1 diabetes