Background: Intensive insulin therapy is progressively replacing conventional therapy in young children to improve diabetes control. However, the specific skills required to manage insulin pumps may hamper social integration as the fear of severe hypoglycemia using conventional therapy.
Methods: Influences of a continuous education program targeting parents and their substitutes in their living places, was evaluated in 23 subjects aged 2.3 ± 0.2 years treated by insulin pump (CSII) for 3.2 ± 0.6 years and compared to 23 subjects aged 3.2 ± 0.2 years treated by conventional therapy (CV) for 3.5 ± 0.3 y.
Results: HbA1c levels were undistinguishable in both groups throughout the study period, remaining within recommended ADA target. Whereas a greater escalation of insulin dose was witnessed amongst the CV group (0.57 ± 0.to 0.79 ± 0.03 U/kg/day) versus 0.64 ± 0.to
0.70 ± 0.U/kg/day (ns) in the CSII group over time, inter-group differences failed to reach significance. BMI SDS increased significantly in the CSII group. No significant difference had been seen in the number of days of admission/ subject and the number of admissions for severe hypoglycemia. The number of admissions for ketoacidosis was high in the CSII group (p = 0.027) .
Conclusions: Externalizing targeted education programs on the child's living place allows minimizing hypoglycaemia risks of CV. This result may be particularly relevant for under-developed countries and contribute to the reduction of the costs of diabetes management without increasing side effects.