A group of investigators led by Dr Zeina Nabhan of the Riley Hospital for Children in Indianapolis, USA, identified factors that predict glycaemic control in paediatric patients with type 1 diabetes on continuous subcutaneous insulin infusion (CSII). A total of 93 patients (57 girls, 36 boys; mean duration of diabetes of 4.7 years) were evaluated. All patients had received CSII for 1 year or more, and the mean age at CSII initiation was 11.6 years. “Good” glycaemic control was defined as HbA1c 9% or less in patients aged <12 years and 8%or less in patients aged >12 years.

The investigators found that CSII significantly reduced HbA1c, compared with pre-CSII values (8.7% vs 8.3%; p<0.01). Two factors were identified that correlated with good glycaemic control: number of basal rates (4.4 versus 3.4) and younger age (10.0 years versus 13.1 years). Other factors that were evaluated, including diabetes duration, CSII duration, pre-CSII regimen, frequency of clinical visits, and gender, did not correlate with glycaemic control.

The investigators concluded that, in children and adolescents with type 1 diabetes, increased basal rates and younger age were predictive of good glycaemic control while using CSII.

Diabetes Research and Clinical Practice 2006;74:217-21