Comparison between Continuous Subcutaneous Insulin Infusion and Multiple Daily Insulin Injections, its Effects on Quality of Life among Children with Type 1 Diabetes

Abstract

Type 1 diabetes mellitus (T1DM) is a common chronic disease in childhood. Fifty percent of subjects with T1DM are diagnosed within the first 15 years of life. Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily insulin Injections (MDI) are both strategies aiming to achieve a tight glycemic and metabolic control. However, the choice between them remains controversial. The aim of the present study was to compare between continuous subcutaneous insulin infusion and multiple daily insulin injections and assess its effects on quality of life among children with type 1 diabetes. A comparative randomized design was conducted at maternal and children's hospital in Sakaka city of Aljouf area. Twenty five children with type 1 diabetes mellitus on CSII and 25 children on MDI were selected randomly, glucosylated Hemoglobin (HbA1c), frequency of hypoglycemia, frequency of hyperglycemia, body weight and number of hospital admissions were evaluated at baseline and after 6 months in both groups. In addition, the children answered the Ped QOL questionnaire Results: there is a significant difference between both groups at the onset of the study and after six months (p=0.0001) regarding mean glycelated hemoglobin with no difference in body weight. Also there was significant difference between the both groups after six months of the study to all subscales and total scores of all diabetic modules of PedQOl except communication subscale. Conclusions: CSII is effective in improving the glycemic control with no difference in metabolic control and a significant difference in the associated complication with time in type 1 diabetic Saudi children than using multiple daily insulin injection. Also the results expressed better quality of life among diabetic children using CSII than those using MDI. Recommendation: we recommend the implementation of this mode of intensive insulin therapy in all diabetic Saudi children.

Keywords: continuous subcutaneous insulin infusion, multiple daily insulin injection, type 1      diabetes, quality of life.