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Comparing continuous subcutaneous insulin infusion and multiple daily injections in children with Type 1 diabetes in Sweden from 2011 to 2016: A longitudinal study from the Swedish National Quality Register (SWEDIABKIDS)
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik. Östersund Hospital.ORCID-id: 0000-0002-3390-778X
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Östersund Hospital.ORCID-id: 0000-0002-5203-9877
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.ORCID-id: 0000-0001-6328-1098
Department of Pediatrics, Örebro University, Hospital and School of Medical Sciences, Örebro University, Örebro, Sweden.
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2021 (Engelska)Ingår i: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 22, nr 5, s. 766-775Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: This study aimed to compare metabolic control measured as hemoglobin A1c (HbA1c), the risk of severe hypoglycemia, and body composition measured as body mass index standard deviation scores (BMI-SDS) in a nationwide sample of children and adolescents with Type 1 diabetes with continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI), respectively.

Research Design and Methods: Longitudinal data from 2011 to 2016 were extracted from the Swedish National Quality Register (SWEDIABKIDS) with both cross-sectional (6 years) and longitudinal (4 years) comparisons. Main end points were changes in HbA1c, BMI-SDS, and incidence of severe hypoglycemia.

Results: Data were available from 35,624 patient-years (54% boys). In general, HbA1c decreased approximately 0.5% (2–5 mmol/mol) from 2011 to 2016 (ptrend < 0.001) and the use of CSII increased in both sexes and all age groups. Mean HbA1c was 0.1% (0.7–1.5 mmol/mol) lower in the CSII treated group. Teenagers, especially girls, using CSII tended to have higher BMI-SDS. There was no difference in the number of hypoglycemias between CSII and MDI over the years 2011–2016.

Conclusions: There was a small decrease in HbA1c with CSII treatment but of little clinical relevance. Overall, mean HbA1c decreased in both sexes and all age groups without increasing the episodes of severe hypoglycemia, indicating that other factors than insulin method contributed to a better metabolic control.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2021. Vol. 22, nr 5, s. 766-775
Nyckelord [en]
continuous subcutaneous insulin infusion, HbA1c, hypoglycemia, metabolic control, multiple daily injection
Nationell ämneskategori
Pediatrik Endokrinologi och diabetes
Identifikatorer
URN: urn:nbn:se:umu:diva-183402DOI: 10.1111/pedi.13217ISI: 000651444600001PubMedID: 33929074Scopus ID: 2-s2.0-85105872175OAI: oai:DiVA.org:umu-183402DiVA, id: diva2:1557942
Forskningsfinansiär
Stiftelsen SamaritenRegion Jämtland HärjedalenTillgänglig från: 2021-05-27 Skapad: 2021-05-27 Senast uppdaterad: 2023-03-24Bibliografiskt granskad

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Fureman, Anna-LenaLilja, MikaelLind, Torbjörn

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