New study comparing MDI and pump therapy in young persons.

[TheBigNewt]

I get the JAMA, don't read it much. Usually skim it for cardiac articles. This week's issue had an article which compared about 30,000 young German/Austrian/Luxembourg Type 1 diabetics, average age was only 14.5 years of age (82% were over 11), had disease average of 7 yrs. So these were pretty young diabetics. Half on MDI, half pumpers. They pulled out about 20k of "matched" diabetics into the 2 groups and compared them for: all hypos, severe (coma) hypos, DKA episodes, severe DKA episodes, and A1C's. The pump group had about 30% fewer total hypos, 20% fewer hypo "comas", 15% fewer DKA episodes, and 15% fewer severe DKA's. But only 7.3% of the MDI patients had any hypo in the last year they kept track (pumpers only 5%). The pumpers' A1C was 8.0% and the MDI's was 8.2%, only 2.5% higher. They regarded the differences as significant. Being an MDI person for over 30 years I thought that both groups did pretty darn well. Pumpers used 15% less daily insulin. MDI's used about 1U/kg of insulin which is what I was always told was the average. I mean some of the pumpers (2%) were under 5 years old!

 

[Celsus]

Agreed @TheBigNewt, that are some pretty darn good results for those young guns!
For us old-timers, such results would have been paradise if we had been able to achieve such great control when we were young. (please pee in this little test tube, add the chemical tablet and the color change will tell if you are in good control.. ahmmm ;o)
Interesting observation you noted that the pumpers used 15% less insulin. Just wondering if the personality traits of those individuals (and their parents) are significant different compared to the MDI group? As the A1c value difference did not appear to indicate that many more hypers that needed that more insulin. I suppose the two study groups had an equal age distribution curve? E.g. same number of individuals in each age segment from youngest to oldest across the spectre? For some reason, I have an assumption that parents would try harder to be on the pump system when having a very young diabetic child versus older kids.