Skip to main content
×
Home

BENEFITS OF CONTINUOUS SUBCUTANEOUS INSULIN INFUSION ON QUALITY OF LIFE

  • Andrea Lukács (a1), Emőke Kiss-Tóth (a1), Beatrix Varga (a2), Andrea Soós (a3), Peter Takác (a1) and László Barkai (a4)...
Abstract

Purpose: The aim of this study was to compare the general health-related quality of life (HRQoL), the metabolic control (HbA1c), the anthropometric measurement, and the cardiorespiratory fitness (expressed by VO2max) in youths with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) to those receiving multiple daily injections (MDI). We looked for factors influencing the HRQoL and metabolic control.

Methods: A total of 239 patients treated with CSII (51 girls and 53 boys) or MDI (64 girls and 71 boys) between ages 8 and 18 years were assessed with the Pediatric Quality of Life Inventory, Generic Core Scales, and Diabetes Module. VO2max was evaluated using the 20-meter shuttle run test.

Results: CSII group had significantly better HRQoL according to both child self-report and parent proxy-report. Youths with CSII reported better physical, emotional, and school-related functioning, and had less diabetes-related fear and symptoms than the MDI group. There were no significant differences in body mass index z-scores, insulin doses, HbA1c, and VO2max between the groups. HRQoL was predicted by the CSII therapy (β = −0.220; p = .000) and the VO2max (β = 0.386; p = .000), other clinical and anthropometric parameters had no effect; the HbA1c was predicted only by VO2max (β = −0.353; p = .000).

Conclusions: Diabetic youths treated with CSII therapy have better HRQoL than those treated with MDI. There are no differences between the investigated groups in anthropometric data, glycated hemoglobin, and physical fitness. Moreover, good physical fitness has an important role in achieving better metabolic control and HRQoL, which underlines the importance of regular aerobic exercise in the treatment and care of type 1 diabetes in childhood.

Copyright
References
Hide All
1.Soltesz G, Patterson CC, Dahlquist G; (EURODIAB Study Group). Worldwide childhood type 1 diabetes incidence – what can we learn from epidemiology? Pediatr Diabetes. 2007;8 (Suppl 6):614.
2.Bangstad H-J, Danne T, Deeb LC, et al.Insulin treatment in children and adolescents with diabetes (ISPAD Clinical Practice Consensus Guidelines 2009 Compendium). Pediatr Diabetes. 2009;10 (Suppl 12):8299.
3.Tamborlane WV, Sherwin RS, Genel M, Felig P. Reduction to normal of plasma glucose in juvenile diabetes by subcutaneous administration of insulin with a portable infusion pump. N Engl J Med. 1979;300:573–8.
4.Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus. J Pediatr. 1994;125:177–88.
5.Phillip M, Battelino T, Rodriguez H, Danne T, Kaufman F. Use of insulin pump therapy in the pediatric age-group: consensus statement from the European Society for Paediatric Endocrinology, Lawson Wilkins Pediatric Endocrine Society, International Society for Pediatric and Adolescent Diabetes, endorsed by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2007;30:1653–62.
6.Wilson DM, Buckingham BA, Kunselman EL, et al.A two-center randomized controlled feasibility trial of insulin pump therapy in young children with diabetes. Diabetes Care. 2005;28:15–9.
7.Monami M, Lamanna C, Marchionni N, Mannucci E. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis. Acta Diabetol. 2010;47 (Suppl 1):7781.
8.Misso ML, Egberts KJ, Page M, O'Connor D, Shaw J. Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus. Cochrane Database Syst Rev. 2010;1:CD005103.
9.Cummins E, Royle P, Snaith A, et al.Clinical effectiveness and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes: systematic review and economic evaluation. Health Technol Assess. 2010;14:iiiiv, xi–xvi, 1–181.
10.Golden SH, Brown T, Yeh HCet al., Methods for insulin delivery and glucose monitoring: comparative effectiveness. Comparative Effectiveness Review No. 57. (Prepared by Johns Hopkins University Evidence-based Practice Center under Contract No 290-2007-10061-I.) AHRQ Publication No. 12-EHC036-EF, Rockville, MD: Agency for Healthcare Research and Quality. [cited 2012 July]. Available from: www.effetivehealthcare.ahrq.gov/reports/final.cfm.
11.American Diabetes Association. Physical activity/exercise and diabetes mellitus. Diabetes Care. 2004;27 (Suppl 1):S5862.
12.Peirce NS. Diabetes and exercise. Br J Sports Med. 1999;33:161–73.
13.Rigla M, Sánchez-Quesada JL, Ordóñez-Llanos J, et al.Effect of physical exercise on lipoprotein(a) and low-density lipoprotein modifications in type 1 and type 2 diabetic patients. Metabolism. 2000;49:640–7.
14.Komatsu WR, Gabbay MA, Castro ML, et al.Aerobic exercise capacity in normal adolescents and those with type 1 diabetes mellitus. Pediatr Diabetes. 2005;6:145–9.
15.Williams BK, Guelfi KJ, Jones TW, Davis EA. Lower cardiorespiratory fitness in children with type 1 diabetes. Diabet Med. 2011;28:1005–7.
16.Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001;39:800–12.
17.Varni JW, Burwinkle MA, Jacobs JR, et al.The PedsQL™ in type 1 and type 2 diabetes: reliability and validity of the Pediatric Quality of Life Inventory™ Generic Core Scales and type 1 Diabetes Module. Diabetes Care. 2003;26:631637.
18.Léger LA, Mercier D, Gadoury C, Lambert J. The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci. 1988;6:93101.
19.Liu NY, Plowman SA, Looney MA. The reliability and validity of the 20-meter shuttle test in American students 12 to 15 years old. Res Q Exerc Sport. 1992;63:360–5.
20.Kenney L, Wilmore JH, Costill DL. Physiology of Sport and Exercise. 5th ed.Champaign, IL: Human Kinetics; 2005:269.
21.Hungarian National Institute of Child Health. [cited 2012 April 18]. Available from: http://www.ogyei.hu/upload/files/gyermekkoriTaplaltsag.pdf.
22.Naughton MJ, Ruggiero MS, Lawrence JM, et al.(SEARCH for Diabetes in Youth Study). Health-related quality of life of children and adolescents with type 1 or type 2 diabetes mellitus. Arch Pediatr Adolesc Med. 2008;162:649–57.
23.Bode BW, Tamborlane WV, Davidson PC. Insulin pump therapy in the 21st century. Strategies for successful use in adults, adolescents, and children with diabetes. Postgrad Med. 2002;111:6977.
24.Pańkowska E, Błazik M, Dziechciarz P, Szypowska A, Szajewska H. Continuous subcutaneous insulin infusion vs. multiple daily injections in children with type 1 diabetes: a systematic review and meta-analysis of randomized control trials. Pediatr Diabetes. 2009;10:52–8.
25.Barnard K, Thomas S, Royle P, Noyes K, Waugh N. Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. BMC Pediatr. 2010;10:50.
26.McGarthy M. The everything parent's guide to children with juvenile diabetes: reassuring advice for managing symptoms and raising a healthy, happy child. New York: Adams Media and F+W Publications Company; 2007:33.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 16
Total number of PDF views: 20 *
Loading metrics...

Abstract views

Total abstract views: 461 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th November 2017. This data will be updated every 24 hours.