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Insulin pumps an option for children with type 1 diabetes

If you or your child has type 1 diabetes, a new study suggests that treatment using insulin pumps may be more effective at controlling blood sugar and less likely to cause complications than insulin injections.

BMJ Group News

What do we know already?

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Type 1 diabetes usually starts in childhood and happens because the body stops making a hormone called insulin, or makes too little of it. Your body needs insulin to control how much sugar (glucose) there is in your blood. Without enough insulin, instead of the glucose being gradually used up as fuel by your cells, it builds up in your bloodstream and can make you ill.

Most people with type 1 diabetes have to replace the insulin their body doesn’t produce. They do this by an injection several times a day. But people who aren’t able to inject insulin may be able to use an insulin pump, which gives a steady supply of insulin into the bloodstream.

There haven’t been many good-quality studies that have focused on using insulin pumps to treat children and teenagers.

This study included 345 children with an average age of 11 who used insulin pumps. Researchers compared the results of treatment in these children with results in 345 children of a similar age who used insulin injections. The study lasted about three and a half years, after which the researchers looked to see in which group diabetes was best controlled. They measured this in three ways:

  • Which group had lower average blood sugar
  • Which group had fewer ‘hypos’ - times when their blood sugar fell too low (severe hypoglycaemia) because of their insulin level
  • Which group were less likely to go to hospital because their blood sugar rose too high, which can cause a condition called diabetic ketoacidosis.

 

What does the new study say?

Average blood sugar was lower and at a healthier level in children using insulin pumps than in children who used insulin injections.

Fewer children who used insulin pumps had episodes of very low blood sugar (severe hypoglycaemia or ‘hypos’). Children who used pumps had about half the number of ‘hypos’ per year at the end of the study as they were having before they started using an insulin pump. In children who used insulin injections, the number of ‘hypos’ per year increased by about one third by the end of the study.

Fewer children who used insulin pumps had to go to hospital for treatment for diabetic ketoacidosis. Each year about 1 in every 100 children who used insulin pumps went to hospital with diabetic ketoacidosis, compared with about 5 in 100 who used injections.

How reliable is the research?

This study only looked at a relatively small number of children who were all treated at one hospital in Australia. We would need larger and longer studies to find out more about how well insulin pumps work and how often they cause side effects.

What does this mean for me?

This study suggests that using an insulin pump may be a good option to help manage type 1 diabetes in children. Both insulin injections and insulin pumps can help the symptoms of diabetes but some people find one type of treatment easier to use than the other, and so it’s worth discussing with your GP or nurse which of the insulin devices is best suited to you.

It’s worth remembering, though, that insulin pumps are not automatically available on the NHS to everyone with type 1 diabetes. For people not considered eligible through the NHS, the cost is several thousand pounds per year.

Published on August 20, 2013

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