A randomized, controlled study of insulin pump therapy in diabetic preschoolers

DiMeglio, Linda A.; Pottorff, Tina M.; Boyd, S.; Fineberg, Naomi S.; Eugster, Erica A.

doi:10.1016/j.jpeds.2004.06.022

Cited by 156 publications

(128 citation statements)

References 17 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…1 In contrast, parents in the present study may have reported higher worry scores than mothers of conventionally managed young children 22 because the pump may prevent their child from experiencing as much glycemic variability as conventionally managed children do, leading to parents of children on pumps having less experience and lower confidence in managing hypoglycemia successfully and higher fear. 23,24 Interestingly, consistent with previous research using the HFS-P, 25 we found that parents of young children on pumps reported lower mean scores on the HFS-PYC behavior subscale compared with parents of conventionally managed young children. 22 One possible explanation for this finding is the increased flexibility of pump therapy, which allows parents to make insulin adjustment more easily and to reduce reliance on behaviors that may overcompensate for hypoglycemia, such as feeding large snacks.…”

Section: Discussionsupporting

confidence: 88%

Reexamining the Hypoglycemia Fear Survey for Parents of Young Children in a Sample of Children Using Insulin Pumps

Patton

Noser

Clements

et al. 2017

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Background: We update the psychometric properties of the Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC), a 26-item measure of parents' hypoglycemia fear for young children using an insulin pump. Methods: We combined three similar datasets for the analyses. The data analyzed included parents' responses to the HFS-PYC and a demographic form. For a subset of children (n = 91), we also analyzed self-monitoring of blood glucose data. We used confirmatory factor analysis (CFA) to confirm the measure's original factor structure. Additional analyses examined reliability and validity of a revised HFS-PYC for parents of young children using pumps. Results: We analyzed data from 116 parents (93% mothers). Mean child age and HbA1c were 5.2 -1.3 years and 8.2% -1.1%, respectively. CFA identified a 22-item two-factor solution (v 2 (208, n = 116) = 368.688, P < 0.001, root mean square error of approximation = 0.08, comparative fit index = 0.94, and Tucker-Lewis index = 0.93) with factors corresponding to the original subscales: worry and behavior. The revised subscales demonstrated at least adequate internal consistency (Cronbach's alpha >0.65). Correlations revealed significant negative associations between current HFS-PYC worry scores and children's mean daily blood glucose and percent of very high glucose levels per day, suggesting less fear among parents of young children with elevated glycemic levels. In addition, there was a positive association with the percent of glucose levels in target, suggesting greater hypoglycemia fear among parents of children who have better control. Conclusions: Results provide preliminary evidence for the reliability and validity of a reduced 22-item HFS-PYC for parents of children using insulin pumps.

show abstract

Section: Discussionsupporting

confidence: 88%

Reexamining the Hypoglycemia Fear Survey for Parents of Young Children in a Sample of Children Using Insulin Pumps

Patton

Noser

Clements

et al. 2017

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

show abstract

“…Several randomized clinical trials, usually on small samples of patients, comparing CSII using short-acting analogs and multiple daily injections (MDI) have been performed, reporting either a similar efficacy of the two approaches [6][7][8][9][10][11][12][13][14][15][16] or a superiority of CSII [17,18]. A meta-analysis on patient-level data from three clinical trials suggests an improvement of HbA1c with CSII (with lispro) as compared with MDI [19].…”

Section: Introductionmentioning

confidence: 99%

Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: A Meta-analysis

Monami¹,

Lamanna²,

Marchionni³

et al. 2009

Exp Clin Endocrinol Diabetes

View full text Add to dashboard Cite

Continuous subcutaneous insulin infusion (CSII) is considered an option for type 1 diabetic patients unsatisfactorily controlled with multiple daily injections (MDI). Short-acting analogs are superior to regular human insulin in CSII. This meta-analysis is aimed at assessing the advantages of short-acting analog-based CSII over MDI in type 1 diabetes. Randomized clinical trials (RCTs) comparing CSII (with analogs) and MDI for at least 12 weeks in type 1 diabetic patients were retrieved, assessing between-group differences in HbA1c and incidence of hypoglycemia. A total of 11 RCTs was included in the analysis. CSII was associated with a significant improvement of HbA1c in comparison with MDI (standardized difference in mean: -0.3 [-0.4;-0.1]%; P \ 0.001). No significant difference was observed in the rate of severe hypoglycemic episodes. The reduction of HbA1c with CSII was evident in trials enrolling patients with mean age greater than 10 years, but not in younger children. Available data justify the use of CSII for basal-bolus insulin therapy in type 1 diabetic patients unsatisfactorily controlled with MDI.

show abstract

“…associated with pump therapy [3][4][5], although some report no improvement or an initial improvement followed by a return to pre-pump levels after a short time [6][7][8][9]. Reports have also suggested that insulin pumps may be associated with a reduction in severe hypoglycaemia [3,10,11].…”

mentioning

confidence: 99%

Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study

et al. 2013

View full text Add to dashboard Cite

Aims/hypothesis We determined the impact of insulin pump therapy on long-term glycaemic control, BMI, rate of severe hypoglycaemia and diabetic ketoacidosis (DKA) in children. Methods Patients on pump therapy at a single paediatric tertiary hospital were matched to patients treated by injections on the basis of age, duration of diabetes and HbA 1c at the time of pump start. HbA 1c , anthropometric data, episodes of severe hypoglycaemia and rates of hospitalisation for DKA were collected prospectively.

show abstract

A randomized, controlled study of insulin pump therapy in diabetic preschoolers

Cited by 156 publications

References 17 publications

Reexamining the Hypoglycemia Fear Survey for Parents of Young Children in a Sample of Children Using Insulin Pumps

Reexamining the Hypoglycemia Fear Survey for Parents of Young Children in a Sample of Children Using Insulin Pumps

Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: A Meta-analysis

Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study

Contact Info

Product

Resources

About