Glycemic control in children with type 1 diabetes: Insulin pump therapy versus multiple daily injections
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Aigul Durmanova 1 , Gulnur Slyamova 2 * , Marzhan Rakhimzhanova 2 , Arnur Gusmanov 3 , Gulmira Zhakanova 4 , Gulmira Abduakhassova 5 , Assel Issabayeva 3 , Assiya Nurgaliyeva 1 , Alina Alzhaxina 1 , Aigerim Umerzakova 1 , Kristina Fedoskina 1 , Marina Kalzhanova 6 , Makhabbat Serikbayeva 7 , Altay Nabiyev 1 , Abduzhappar Gaipov 1 8
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1 Department of Internal Medicine, University Medical Center, Astana, KAZAKHSTAN2 Department of Pediatrics, University Medical Center, Astana, KAZAKHSTAN3 Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, KAZAKHSTAN4 Department of Ophthalmology, Kazakh National Medical University named after S. D. Asfendiyarov, Almaty, KAZAKHSTAN5 Department of Internal Medicine, Municipal Children’s Hospital №2, Astana, KAZAKHSTAN6 Family Medicine Clinic, West Kazakhstan Marat Ospanov Medical University, Aktobe, KAZAKHSTAN7 Regional Children’s Hospital, Shymkent, KAZAKHSTAN8 Department of Medicine, School of Medicine, Nazarbayev University, Astana, KAZAKHSTAN * Corresponding Author

Abstract

While many studies compared multiple daily injections (MDI) and insulin pump therapy on various clinical outcomes, the results remain inconclusive. This multicenter retrospective cohort study included 175 patients and aimed to evaluate the effects of different insulin therapy methods on various clinical outcomes, including hemoglobin A1c (HbA1c), total daily insulin dosage, body mass index, glomerular filtration rate, in pediatric patients with type 1 diabetes. In a linear mixed-effects regression analysis, a statistically significant interaction between time and treatment type on HbA1c was found. It suggested significantly higher reduction of HbA1c values between 12-month visit and baseline in the group receiving MDIs compared to insulin pump therapy. Patients using MDIs observed higher reduction of HbA1c levels and lower total daily insulin dose relative to insulin pump therapy group. Other changes of clinical indicators were the same for group of patients. Various studies report controversial results on long term effects of these treatments on HbA1c values necessitating large population-based cohort studies in this field.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, 2024, Volume 21, Issue 2, Article No: em580

https://doi.org/10.29333/ejgm/14403

Publication date: 25 Mar 2024

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