Health-related quality of life in paediatric patients with Type 1 diabetes mellitus using insulin infusion systems. A systematic review and meta-analysis

Bastian Rosner, Andres Roman-Urrestarazu*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

15 Citations (Web of Science)

Abstract

Background

In 2017, more than 1.1 million children were living with type 1 diabetes mellitus (T1DM) globally. The goal in paediatric diabetes therapy is reaching optimal glycaemic control as early as possible in order to avoid complications and early mortality without compromising the quality of life (QoL) of children. Several different insulin regimens are available for T1DM patients to reach this goal.

Aims

This review set out to analyse whether continuous subcutaneous insulin infusion (CSII) regimens are superior to multiple daily injection (MDI) therapy in T1DM youth regarding QoL. Additionally, it assessed glycaemic control and adverse events as secondary outcomes and discussed potential future public health implications and justifications for using CSII as a first-line therapy in diabetic youth.

Methods

A systematic review and random effects meta-analysis was performed on studies investigating the association between QoL and diabetes treatment regimen. Differences in adverse event rates between groups were analysed using a Mann-Whitney U test. Lastly, differences in glycaemic control were assessed using a random effects meta-analysis.

Results

QoL and glycaemic control was significantly better in CSII subjects at baseline and follow-up. No significant differences in adverse events were found between study groups. No significant changes over time could be shown for either QoL or glycaemic control.

Conclusion

CSII proved to provide similar or slightly better outcomes in all analysed fields. This is consistent with previous research. However, to make credible recommendations, better-designed studies are needed to investigate the impact of CSII in children.

Original languageEnglish
Article number0217655
Number of pages21
JournalPLOS ONE
Volume14
Issue number6
DOIs
Publication statusPublished - 25 Jun 2019

Keywords

  • MULTIPLE DAILY INJECTIONS
  • PUMP THERAPY
  • CHILDREN
  • ADOLESCENTS
  • ASSOCIATION
  • BURDEN
  • IMPACT
  • ADULTS
  • TRIAL

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