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Pediatric Quality of Life in Transitioning to the Insulin Pump: Does Prior Regimen Make a Difference?
Fran R. Cogen, MD, CDE
Division of Endocrinology and Diabetes, Department of Pediatrics, Washington University
Celia Henderson, RN, CDE
Division of Endocrinology and Diabetes, Department of Pediatrics, Washington University
Jennifer A. Hansen, MA
Departments of Psychiatry and Behavioral Sciences and of Pediatrics, Children's National Medical Center and the George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
Randi Streisand, PhD, CDE
Departments of Psychiatry and Behavioral Sciences and of Pediatrics, Children's National Medical Center and the George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, rstreis{at}cnmc.org
A shift in conventional diabetes management has graduated to basal (glargine) and bolus (rapid-acting analogue) therapy via multiple daily injections or continuous subcutaneous insulin infusion (CSII). Continuous subcutaneous insulin infusion is considered the most intensive type of diabetes management, and before transitioning, consideration of regimen benefits should include lifestyle and quality-of-life issues in addition to medical benefits. Short-term and long-term changes in children's quality of life, as a function of their pre-CSII diabetes regimen, was assessed in 52 children before their transition to CSII from a conventional or multiple daily injection regimen. Results demonstrated significant improvement in quality of life only for those children transitioning to CSII from conventional vs multiple daily injection regimens; results were maintained at 6 months following pump initiation. Quality of life is an important consideration as children transition from more traditional to intensive regimens, and CSII devices may not necessarily improve satisfaction with diabetes control in all pediatric patients. Risks and benefits of both intensive regimens should be discussed before making the transition.
Key Words: type 1 diabetes mellitus • pump • Lantus • NPH/regular • quality of life • insulin regimen
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This version was published on December
1, 2007
Clinical Pediatrics, Vol. 46, No. 9,
777-779 (2007)
DOI: 10.1177/0009922807303224
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