Insulin pump treatment for children with diabetes is better than insulin injection
More and more children suffer from type 1 diabetes. The majority of those affected are treated with an insulin pump. Compared to insulin injections, this brings with it significantly more advantages for young diabetics, as a study has now shown.
More and more children with type 1 diabetes
The number of people who develop diabetes is increasing. More and more children are also affected. According to experts, type 1 diabetes is the most common metabolic disorder in children and adolescents. In Germany, an estimated 31,000 young patients are affected. The majority are treated with an insulin pump; in children under the age of six, it is even over 85 percent. This treatment has significant advantages over syringe therapy in children and adolescents who suffer from type 1 diabetes. This is confirmed by a large study at 350 diabetes centers in Germany, Austria and Luxembourg.
Insulin pump versus injection therapy
According to the German Diabetes Society (DDG), the study compared a total of 9,814 patients with an insulin pump compared to 9,814 patients with injection therapy. The period ranged from January 2011 to December 2015.
The researchers mathematically compensated for differences in age, gender, duration of diabetes and migration background. The average age of the patients was 14.6 years, the upper limit was 20 years.
All study participants had had type 1 diabetes for at least one year.
The results have now been published in the renowned journal "Journal of the American Medical Association".
With pump, insulin intake can be better distributed in young children
"With a programmable insulin pump, the body can be continuously supplied with insulin via a small catheter in the subcutaneous fat," explains study author and DDG expert Professor Dr. med. Beate Karges from the RWTH (Rheinisch-Westfälische Technische Hochschule) Aachen.
"Insulin delivery can be better distributed and controlled with the insulin pump, especially in young children, than with injections that are repeated several times a day."
However, there were fears among experts that pump therapy could increasingly trigger ketoacidosis - serious metabolic disorders that result from insulin deficiency.
There was also no confirmed knowledge of how often severe hypoglycaemia and whether the patients gained weight undesirably.
"The current JAMA publication now provides reliable answers to these questions for the first time," says study author and DDG expert Professor Dr. Reinhard Holl from the University of Ulm.
Less insulin needed
Study results: In the insulin pump group, the incidence of severe hypoglycaemia was lower (9.55 versus 13.97 per 100 patients and year), as was the incidence of hypoglycaemia with loss of consciousness (2.30 versus 2.96 per 100 patients and year).
The number of ketoacidotic derailments was also significantly lower in the pump therapy group (3.64 versus 4.26 per 100 patients per year). The mean HbA1c value was 8.04 percent better in the pump group than in the group with insulin injections (8.22 percent).
Pump patients also required less insulin per kilogram of body weight and day (0.84 versus 0.98 units), while the body mass index did not differ between the two groups.
Pump patients do not gain weight
"Pump patients do not gain weight," emphasizes Dr. Joachim Rosenbauer from the German Diabetes Center (DDZ), who also participated in the study.
"Pump patients also checked their blood sugar with 6.6 measurements per day more often than the syringe patients, who took an average of 5.9 measurements."
In the study, both treatment groups, patients with pump and syringe therapy, used selective blood glucose measurement: Patients take a tiny drop of blood from their fingers several times a day and measure blood glucose using a test strip.
In the meantime, after the completion of the study, more and more patients today use a continuous glucose measurement via a sensor.
Overall, according to the authors, the results of the study are representative of the health care situation in Germany.
"The examination provides parents and children with important information to help them decide on the appropriate form of therapy," says Karges.
Improved metabolic control and increased flexibility
Although the insulin pump for adolescents during puberty is often a challenge when the first boyfriend or girlfriend comes into life, over 95 percent adhere to it.
"The insulin pump is a safe form of treatment that provides the majority of patients with improved metabolic control, increased flexibility and thus quality of life," reports Holl.
The costs for pump therapy for children and adolescents are usually borne by the health insurers upon request.
So explained Professor Dr. Andreas Neu, head of the diabetes ambulance at the University Children's Hospital in Tübingen, years ago in the pharmacy magazine "Diabetes Ratgeber": "I have never seen children reject a pump - no matter how intensively they checked it beforehand." (ad)