Abstract:Objective To study the clinical effect of continuous subcutaneous insulin infusion (CSII) versus multiple daily injection (MDI) on blood glucose control in children with type 1 diabetes mellitus (T1DM).Methods A retrospective analysis was performed on the medical data of 91 children with T1DM who were treated with CSII for more than 1 year and 75 children with T1DM who were treated with MDI.The two groups were compared in terms of glycosylated hemoglobin (HbA1C) and the recurrence of diabetic ketoacidosis (DKA) to evaluate the difference in the efficacy during the 3-year follow-up.A survey was conducted for the children in the CSII group and their family members to investigate the degree of satisfaction with insulin pump.Results There was no significant difference in age,sex,and course of diabetes between the CSII and MDI groups at disease onset and in the first year,the second year,and the third year of follow-up (P>0.05).There was no significant difference in the HbA1C level between the two groups at disease onset (P>0.05),but in the first year of follow-up,the CSII group had a significantly lower HbA1C level than the MDI group (P=0.04).There was no significant difference in the HbA1C level between the two groups in the second year and the third year of follow-up (P>0.05).The CSII group had a higher proportion of children with HbA1C<7.5% than the MDI group in the first year,the second year,and the third year of follow-up (P>0.05).Within the 3 years of follow-up,2 children in the CSII group and 8 in the MDI group experienced the recurrence of DKA.In the third year of follow-up,there was no significant difference in blood pressure and blood lipids between the CSII and MDI groups (P>0.05).Most children and their family members (87%) were satisfied with CSII treatment.Conclusions Children with T1DM treated with CSII have a better control of blood glucose than those treated with MDI,and children and their family members are satisfied with CSII treatment.Therefore,it holds promise for clinical application.
