Comparison of Continuous Subcutaneous Insulin Infusion and Multiple Daily Injections in Pediatric Type 1 Diabetes: A Meta-Analysis and Prospective Cohort Study

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Main idea: Continuous subcutaneous insulin infusion might be associated with better glycemic control and better effect for children’s growth development. No higher risks of long-term complications and delayed pubertal development were observed in continuous subcutaneous insulin infusion. The findings provided evidence for a better therapy regimen for T1D in children, nevertheless, they need to be validated by a larger sample size study.

Abstract

The incidence of pediatric type 1 diabetes (T1D) is increasing worldwide, and the appropriate choice of therapy regimens is important for children, especially in developing countries with inadequate resources.

Results: Compared to continuous subcutaneous insulin infusion in TID, hemoglobin levels in MDI (WMD = 0.21, 95% CI: 0.20 to 0.23) were increased significantly in meta-analysis. Among 188 clinical cases, the mean age of recruitment was 7.55 years. The duration of TID was 4.23 years. 50.53% (n = 95) of the subjects were boys. The 4-year follow-up showed that children’s Hemoglobin A1c(HbA1c)e A1c(HbA1c) was 0.67 % lower in children with CSII compared to children with MDI in multivariable regression models with adjustment for potential confounders (children’s age at follow-up, duration of TID, gender, birth weight, parity, and delivery method). Continuous subcutaneous insulin infusion was associated with 2.31 kg higher in children’s weight in the adjusted model. No difference was found in peripheral nerve and fundus consequences as well as the status of obesity and thin and pubertal development between continuous subcutaneous insulin infusion and MIT.

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