Pumps and Patches: Technology Benefits Youth With Type 1 Dia
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Insulin delivery methods, glucose-monitoring modalities, and related outcomes were examined in a large, international, diverse cohort of children and adolescents with type 1 diabetes from the Better Control in Pediatric and Adolescent Diabetes: Working to Create Centers of Reference (SWEET) -Registry.

Participants with type 1 diabetes of more than 1 year, aged less than 18 years, and who had documented pump or sensor usage during the period were stratified into four categories: injections–no sensor (referent); injections + sensor; pump–no sensor; and pump + sensor. HbA1c and proportion of patients with diabetic ketoacidosis (DKA) or severe hypoglycemia (SH) were analyzed; linear and logistic regression models adjusted for demographics, region, and gross domestic product per capita were applied.

-- Data of 25,654 participants were analyzed. The proportions of participants (adjusted HbA1c data) by study group were as follows: injections–no sensor group, 37.44%; injections + sensor group, 14.98%; pump–no sensor group, 17.22%; and pump + sensor group, 30.35%.

-- HbA1c was lower in all categories of participants who used a pump and/or sensor compared with the injections–no sensor treatment method.

-- The proportion of DKA episodes was lower in participants in the pump + sensor and the pump–no sensor groups when compared with those in the injections–no sensor group.

-- The proportion of participants experiencing SH was lower in pump–no sensor group but higher in the injections + sensor group compared with the injections–no sensor group.

Conclusively, lower HbA1c and fewer DKA episodes were observed in participants using either a pump or continuous glucose monitoring (CGM) or both. Pump use was associated with a lower rate of SH. Across SWEET centers, use of pumps and CGM is increasing. The concomitant use of pump and CGM was associated with an additive benefit.

Source: https://care.diabetesjournals.org/content/early/2021/03/02/dc20-1674