“Our findings provide evidence for improved clinical outcomes associated with the early initiation of insulin pump therapy in children with type 1 diabetes,” write the authors of a study published in The Lancet Child & Adolescent Health. With insulin pump therapy shown in prior research to be associated with improved metabolic control when compared with multiple daily insulin injections in children with type 1 diabetes (T1D) but no clear evidence on when it is best to initiate such therapy following diagnosis, the study team aimed to compare the outcomes between early and delayed start of insulin pump therapy in young patients with T1D. They reviewed data on 8,332 patients aged 6 months-15 years at diagnosis who started insulin pump therapy either within the first 6 months (early treatment group) or in the second to third year (delayed treatment group) after diabetes diagnosis, and who were treated with insulin pump therapy for at least 1 year. When compared with the delayed treatment group, the early treatment group had signifi cantly lower estimated A1C values (7.9% and 62.6 mmol/mol vs 8.0% and 64.1 mmol/mol), as well as lower rates of hypoglycemic coma (incidence risk ratio [IRR], 0.44) and hospitalization (IRR, 0.86). Although the early treatment group had better mean systolic blood pressure (117.6 mm Hg vs 118.5 mm Hg) and HDL cholesterol (62.8 mg/dL vs 60.6 mg/ dL) levels, diastolic blood pressure levels, estimated BMI standard deviation scores, and concentrations of LDL cholesterol, non-HDL cholesterol, and triglycerides did not differ signifi cantly between the groups during follow-up.
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