• child;
  • insulin infusion systems;
  • preschool;
  • quality of life;
  • T1DM

Objective:  To compare medical, nutritional, and psychosocial outcomes of continuous subcutaneous insulin infusion (CSII) therapy and multiple daily insulin injections (MDI) in preschoolers with type 1 diabetes mellitus (T1DM) in a randomized controlled trial.

Study design:  Sixteen children (mean age 4.4 ± 0.7 yr, range 3.1–5.3 yr) with T1DM were randomly assigned to CSII or MDI. Hemoglobin A1c (HbA1c) was measured monthly for 6 months. Glucose variability was measured at baseline and at 6 months using continuous blood glucose sensing. Quality of life, adverse events, and nutrition information were assessed.

Results:  Parents of the CSII group reported a significant decrease in diabetes-related worry, while parents of the MDI group reported an increased frequency of stress associated with their child’s medical care. Mean HbA1c levels from baseline (CSII 8.3 ± 1.4%, MDI 8.0 ± 0.8%) to 6 months (CSII 8.4 ± 0.8%, MDI 8.2 ± 0.4%) remained stable, and group differences were not significant. There were no significant group differences in duration of hypo- or hyperglycemic events or frequency of adverse events.

Conclusion(s):  For young children with T1DM, CSII therapy is comparable to MDI therapy with regard to glucose control but is associated with higher treatment satisfaction and improved quality of life.