Original Article

Efficacy and Safety of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Injections on Type 1 Diabetes Children Aged ≤ 18 Years Old, a Meta-Analysis with Randomized Control Trials

10.4274/jcrpe.0053

  • Yuan Qin
  • Lu-Hong Yang
  • Xiao-Li Huang
  • Xiao-Hong Chen
  • Hui Yao

Received Date: 14.03.2018 Accepted Date: 17.07.2018 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 30015622

Objective:

This meta-analysis was performed to evaluate efficacy and safety of Continuous subcutaneous insulin infusion (CSII) vs. Multiple daily injections (MDI) in children with type 1 diabetes.

Methods:

A literature search was conducted on databases including PubMed and Embase up to June 2017. The pooled weighted mean difference (WMD) or risk ratio (RR) as well as 95% confidence intervals (CIs) were calculated by Revman 5.3.

Results:

8 studies involving 310 children with type 1 diabetes were included. Results showed that HbA1c (%) was significantly lower (P = 0.007) after treating by CSII compared with MDI in children with type 1 diabetes. In addition, there was no significant difference between groups in HbA1c (%) change, total daily insulin doses per day, change of total daily insulin doses per day and incidence of ketoacidosis and severe hypoglycemia. However, subgroup analyses indicated that age, treatment duration and study design are factors impacting the efficacy of CSII and MDI in children with type 1 diabetes.

Conclusions:

In conclusion, CSII is associated with lower HbA1C levels in children with type 1 diabetes but may have no effect on insulin requirement and reducing incidence of ketoacidosis and severe hypoglycemia.

Keywords: Continuous subcutaneous insulin infusion, Multiple daily injections, children, type 1 diabetes, meta-analysis