Insulin pump for children with diabetes more suitable than the syringes

Treatment with insulin pump for children with diabetes better than insulin injection

More and more children are suffering from type 1 diabetes. Most of those affected are treated with an insulin pump. This brings in comparison to the insulin syringe significantly more benefits for young diabetics, as a study showed now.

More and more children with type 1 diabetes

The number of people suffering from diabetes is increasing. Also more and more children are affected. According to experts, type 1 diabetes is the most common metabolic disease in children and adolescents. In Germany, an estimated 31,000 young patients are affected. The majority is treated with an insulin pump, in children under six, it is even over 85 percent. This treatment offers clear advantages over syringe therapy in children and adolescents with type 1 diabetes. This is proven by a major study of 350 diabetes centers in Germany, Austria and Luxembourg.

Treatment with an insulin pump has clear advantages over syringe therapy in children and adolescents with type 1 diabetes. This proves a large study at 350 diabetes centers. (Image: Robert Kneschke / fotolia.com)

Insulin pump versus injection therapy

According to the German Diabetes Association (DDG), the study compared a total of 9,814 patients with insulin pump versus 9,814 patients with injection therapy. The period lasted from January 2011 to December 2015.

Differences in age, sex, duration of diabetes and migration background, the scientists computationally balanced out. On average, the age of the patients was 14.6 years, the upper limit was 20 years.

All study participants had been suffering from 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 delivery 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 fatty tissue," explains study author and DDG expert Professor Dr. med. med. Beate Karges from the RWTH (Rheinisch-Westfälische Technische Hochschule) Aachen.

"The insulin delivery can be better distributed and controlled with the insulin pump, especially in young children than with multiple daily injections."

However, there were fears in the professional world that a pump therapy could cause increased ketoacidosis - serious metabolic imbalances caused by insulin deficiency.

There was also no reliable information on how often severe hypoglycaemia (hypoglycaemia) occurs and whether the patients gain unwanted weight.

"The current JAMA publication now provides reliable answers to these questions for the first time," says study author and DDG expert Professor Dr. med. med. Reinhard Holl from the University of Ulm.

Less insulin needed

Study results: In the insulin pump group, the frequency of severe hypoglycaemia was lower (9.55 versus 13.97 per 100 patients per year), as was the incidence of hypoglycaemia with unconsciousness (2.30 versus 2.96 per 100 patients per year).

The number of ketoacidotic derailment was also significantly lower in the group with pump therapy (3.64 versus 4.26 per 100 patients per year). Mean HbA1c was 8.04 percent better in the pump group than in insulin injections (8.22 percent).

Pump patients also required less insulin per kilogram of body weight per day (0.84 versus 0.98 units), while the body mass index did not differ between the two groups.

Pump patients do not increase their weight

"Pump patients do not increase their weight," emphasizes Dr. med. med. Joachim Rosenbauer from the German Diabetes Center (DDZ), who also participated in the study.

"Pump patients also checked their blood sugar more frequently at 6.6 readings a day than the syringe patients, who took an average of 5.9 measurements."

Within the study, both treatment groups, patients with pump and syringe therapy, used point-by-point blood glucose monitoring: Patients extract a tiny drop of blood from the finger several times a day and measure blood sugar via a test strip.

Now, after completing the study, more and more patients are using continuous glucose measurement via a sensor.

Overall, according to the authors, the results of the study are representative of the supply situation in Germany.

"The study provides parents and children with important information to decide on the appropriate form of therapy," says Karges.

Improved metabolic control and increased flexibility

Although the adolescent adolescent pump often poses a challenge when the first boyfriend or girlfriend first comes to life, more than 95 percent of them 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," says Holl.

The costs for pump therapy in children and adolescents are usually taken over by the health insurance funds on application.

So explained Professor Andreas Neu, Head of the Diabetes Outpatient Department of the University Children's Hospital Tübingen, years ago in the pharmacy magazine "Diabetes Guide": "I have never seen in children that the health insurance has rejected a pump - no matter how intense it has previously tested." (ad)