- Insulin pump therapy may significantly benefit children and teenagers with type 1 diabetes (T1D).
Why this matters
- Improved glycemic control is associated with fewer long-term diabetes complications.
- Total study population comprised 14,119 patients with T1D (age, <20 y) using insulin pumps; 16,460 receiving ≥4 daily insulin injections; 350 European diabetes centers.
- Propensity matching paired 9814 patients from each group by age, sex, diabetes duration, migration background, BMI, HbA1c.
- Funding: German Federal Ministry of Education and Research; European Foundation for the Study of Diabetes.
- For severe hypoglycemia and hypoglycemic coma, significantly lower event rates with pump vs injections (9.55 vs 13.97/100 patient-y [incidence rate ratio, IRR, 0.68; all 95% CI 0.59-0.79] and 2.30 vs 2.96/100 patient-y [IRR, 0.78; 0.62-0.97], respectively).
- Differences remained significant after multiple comparisons adjustment (P<.001, P=.03, respectively).
- Lower overall and severe diabetic ketoacidosis rates with pump vs injections (3.64 vs 4.26/100 patient-y [IRR, 0.85; 0.73-0.995] and 2.29 vs 2.80/100 patient-y [IRR, 0.82; 0.68-0.99], respectively).
- Significantly lower overall HbA1c with pump therapy (8.04% vs 8.22%; P<.001), except for children 1.5-5 y.
- Nonrandomized, observational.
- Individual factors (eg, education, motivation, family support) not addressed.
- Pump use duration, discontinuation, use of continuous glucose monitoring not addressed.