Feasibility of strict diabetes control ininsulin-dependent diabetic adolescents

Schiffrin, Alicia; Desrosiers, Micheline; Moffatt, Michael; Belmonte, Mimi M.

doi:10.1016/s0022-3476(83)80576-9

Cited by 29 publications

(24 citation statements)

References 34 publications

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“…At the end of treatment HbA 1c /HbA 1 was significantly lower in the CSII group in each of the trials performed in adolescents [40,41]. In the trial including young children [43], glycated haemoglobin was slightly higher in CSII-treated patients but without reaching statistical significance (Table 1).…”

Section: Glycaemic Control-glycated Haemoglobinmentioning

confidence: 93%

“…In the end, 33 publications with usable information were included in our systematic review. Of these, 17 studies (27 publications ) included mainly adult type 1 diabetic patients, three trials (four publications [40][41][42][43]) only children of up to 18 years and two studies (two publications [44,45]) examined patients with type 2 diabetes mellitus only.…”

Section: Identification Of Relevant Studiesmentioning

confidence: 99%

“…Children with type 1 diabetes mellitus Of the randomised controlled trials found, one [41] used a crossover design, whereas the other two, far more recent investigations [40,43], were of parallel design. Altogether, 74 children took part in the three randomised controlled studies.…”

Section: Potentially Relevant References N=673mentioning

confidence: 99%

“…The duration of follow-up and treatment was 16 weeks in two trials and 52 weeks in the third trial. Two studies were performed in adolescents [40,41]. One study [43] included young children with a mean age of 4 years.…”

Section: Potentially Relevant References N=673mentioning

confidence: 99%

“…One study [43] included young children with a mean age of 4 years. In the older study [41], regular insulin was used; in both recent studies [40,43] insulin analogues were used as pump insulin and as bolus insulin in the respective comparison groups. Insulin glargine was used as basal insulin in the MDI groups by all patients in one trial [40] and by 60% of patients at the end of the other study [43], while the other patients in that trial used NPH and ultralente as basal insulin.…”

Section: Potentially Relevant References N=673mentioning

confidence: 99%

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Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis

et al. 2008

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Aims We compared the effects of continuous subcutaneous insulin infusion (CSII) with those of multiple daily insulin (MDI) injections on glycaemic control, risk of hypoglycaemic episodes, insulin requirements and adverse events in type 1 and type 2 diabetes mellitus. Methods The electronic databases MEDLINE, EMBASE and CENTRAL were systematically searched for randomised controlled trials up to March 2007. A systematic review and meta-analysis were performed. Results Overall, 22 studies were included (17 on type 1 diabetes mellitus, two on type 2 diabetes mellitus, three on children). With regard to adults with type 1 diabetes mellitus, our meta-analysis found a between-treatment difference of −0.4% HbA 1c (six studies) in favour of CSII therapy. Available median rates of mild or overall hypoglycaemic events were comparable between the different interventions (1.9 [0.9-3.1] [CSII] vs 1.7 [1. 1-3.3] [MDI] events per patient per week). Total daily insulin requirements were lower with CSII than with MDI therapy. In patients with type 2 diabetes mellitus, CSII and MDI treatment showed no statistically significant difference for HbA 1c . The incidence of mild hypoglycaemic events was comparable between the treatment groups. In adolescents with type 1 diabetes mellitus, glycated haemoglobin and insulin requirements were significantly lower in the CSII groups; no data were available on hypoglycaemic events. The only study performed in younger children did not provide enough data for conclusive inferences. No overall conclusions were possible for severe hypoglycaemia and adverse events for any of the different patient groups due to rareness of such events, different definitions and insufficient reporting. Conclusions/interpretation CSII therapy in adults and adolescents with type 1 diabetes mellitus resulted in a greater reduction of glycated haemoglobin, in adult patients without a higher rate of hypoglycaemia. No beneficial effect of CSII therapy could be detected for patients with type 2 diabetes mellitus. Diabetologia (2008) 51:941-951

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Section: Glycaemic Control-glycated Haemoglobinmentioning

confidence: 93%