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Background: Studies comparing continuous subcutaneous insulin infusion (CSII) and glargine in pediatric patients are scarce and cover only 1 year follow up. Although short-term results are favorable for CSII, there is no clear evidence whether this therapy leads to a sustained improvement of glycemic control. Objective: To evaluate long-term effects and safety of CSII versus multiple daily injections (MDI) of glargine over 2 years of treatment in children and adolescents.Patients and Methods: 32 patients (aged 12.5 ± 2.4 years; 19 females) with intensively treated type 1 diabetes mellitus were eligible. They were divided into two groups, virtually identical at study entry: eight on CSII and 24 on MDI of glargine. Variables at 0, 6, 12, 18 and 24 months were compared between groups by two-sided Mann-Whitney and Fisher tests. Results: No significant differences were found between groups (CSII vs MDI) throughout the study period. At 24 months hemoglobin Ai c was 7.70 ± 0.64% vs 7.54 ± 0.74% (p = 0.8); body mass index SDS was 0.33 ± 0.74 vs 0.40 ± 1.01 (p = 0.9); total daily insulin requirements were 0.95 ± 0.10 vs 1.05 ± 0.18 U/kg (p = 0.4), incidence of severe hypoglycemia was 0.00 ± 0.00 vs 0.04 ±0.14 episodes/patient/year (p = 0.8); and incidence of ketoacidosis was 0.20 ± 0.27 vs 0.04 ± 0.14 episodes/patient/year (p = 0.2).

Objective: To compare transfusion requirements and erythropoietic response in preterms between schedules of rEPO administration once or three times per week, using the same weekly dose.Study Design: Prospective, randomized trial including infants weighing <1500 g at birth and/or were p32 weeks' gestation: Group 1 (60 infants) received subcutaneous rEPO at 250 units kg À1 per dose, three times weekly for 6 weeks; Group 2 (59 infants), at 750 units kg À1 per dose, once weekly for 6 weeks. Efficacy was evaluated based on the transfusion requirement, hemoglobin changes, reticulocyte counts, serum transferrin receptor (sTfR) and serum ferritin. The frequency of adverse effects was registered in both groups.Result: A total of 13 infants were transfused in each group (relative risk: 0.98; 95% confidence interval: 0.4 to 2.3). Phlebotomy loss and red blood cell transfusion volumes received were similar in both groups. Hemoglobin levels were lower at end of study in Group 2 (10.6±1.5 g dl À1 versus 11.5±1.4 g dl À1 ; P<0.003). At end of study, reticulocyte counts and sTfR values increased and serum ferritin values decreased, without significant differences between the two groups. Incidence of complications was similar in both groups. Conclusion:The once-weekly rEPO schedule for very low birth weight infants proved as effective as the three-times-weekly schedule, in relation to erythropoietic stimulus and transfusion requirement.

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