Effect of use of insulin pump with low glucose suspend feature on metabolic control in children with type 1 diabetes

Vesna Miljković

doi:10.7251/bii1801037b

Abstract

&lt;p&gt;Introduction. The automatic suspension of the insulin pump and discontinuation of insulin delivery in case of hypoglycemia is one of the features of Veo insulin pump when it is connected with the sensor used for continuous monitoring of glycemia (CGM). This type of therapy is currently considered to be the best one for achieving a good metabolic control in children with type 1 diabetes mellitus. The objective of the study was to check whether the use of an option for automatic suspension in case of hypoglycemia and combined bolus affects the metabolic control in children with type 1 diabetes mellitus using the insulin pump for a three-month period. Methods. The study included 25 participants (13 girls and 12 boys), aged 7 to 15 years with average age 11.88 &amp;plusmn; 3.15 years and average diabetes duration of 6.12 &amp;plusmn; 2.5 years. On average, the participants have already been using the insulin pump Paradigm Veo TM MMT-754 for 3.08 &amp;plusmn; 1.73 years. The measurements of HbA1c were done at the beginning of the study, then after three and six months. Results. The percentage of glucose serum levels above 7.8 mmol/L insignificantly increased, while the percentage of glucose serum levels below 3.9 mmol/L decreased during the three-month period of CGM wearing. The initial HbA1c was 7.53 &amp;plusmn; 0.87%. After three months of wearing, CGM HbA1c showed a slight decrease to 7.48 &amp;plusmn; 0.73%, while at the follow-up after another three months without CGM HbA1c increased to 7.57 &amp;plusmn; 0.98%. Conclusion. This study shows that the use of an insulin pump with the option of automatic suspension in case of hypoglycemia and combined bolus is only associated with a certain improvement in the metabolic control after three months of continuous wearing without increasing the risk of hypoglycemia.&lt;/p&gt;

Highlights

IntroductionInsulin pump therapy is considered to be an optimal type of insulin therapy in children with type 1 diabetes mellitus, since it resembles the physiological need for insulin during 24 hours
This study shows that the use of an insulin pump with the option of automatic suspension in case of hypoglycemia and combined bolus is only associated with a certain improvement in the metabolic control after three months of continuous wearing without increasing the risk of hypoglycemia
Insulin pump therapy is considered to be an optimal type of insulin therapy in children with type 1 diabetes mellitus, since it resembles the physiological need for insulin during 24 hours

Summary

Introduction

Insulin pump therapy is considered to be an optimal type of insulin therapy in children with type 1 diabetes mellitus, since it resembles the physiological need for insulin during 24 hours. The insulin pump Veo in the combination with a continuous glucose monitoring (CGM) is a effective way to apply insulin therapy because it automatically suspends supply of basal insulin in case of hypoglycemia. This option significantly reduces the severity and duration of hypoglycemic events simultaneously enabling the metabolic control of children with diabetes [1]. The first long-term study of efficacy and safety of insulin pump therapy with both SAP and LGS, which lasted for 47 months, showed a significant and sustained decrease in HbA1c and a reduction in hypoglycemic events [7]. Several studies showed that safety and efficacy as well as satisfaction and tolerance of CGM were maintained at long-term follow up [11, 12]

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Conclusion