Discontinuation of insulin pump treatment in children, adolescents, and young adults. A multicenter analysis based on the DPV database in Germany and Austria
Article first published online: 29 JUN 2009
© 2009 John Wiley & Sons A/S
Volume 11, Issue 2, pages 116–121, March 2010
How to Cite
Hofer, S., Heidtmann, B., Raile, K., Fröhlich-Reiterer, E., Lilienthal, E., Berghaeuser, M., Holl, R. and for the DPV-Science-Initiative and the German working group for insulin pump treatment in pediatric patients (2010), Discontinuation of insulin pump treatment in children, adolescents, and young adults. A multicenter analysis based on the DPV database in Germany and Austria. Pediatric Diabetes, 11: 116–121. doi: 10.1111/j.1399-5448.2009.00546.x
- Issue published online: 26 FEB 2010
- Article first published online: 29 JUN 2009
- Accepted for publication 19 May 2009
- childhood diabetes;
- discontinuation of insulin pump treatment;
- insulin pump therapy;
- type 1 diabetes
Hofer SE, Heidtmann B, Raile K, Fröhlich-Reiterer E, Lilienthal E, Berghaeuser MA, Holl RW for the DPV-Science-Initiative and the German working group for insulin pump treatment in pediatric patients. Discontinuation of insulin pump treatment in children, adolescents, and young adults. A multicenter analysis based on the DPV database in Germany and Austria.
Background: Insulin pump therapy is well established in the treatment of children and adolescents with type 1 diabetes. Most studies focus on outcome parameters like hemoglobin A1c (HbA1c), hypoglycemia, and quality of life, whereas few reports address patients who discontinue pump therapy.
Objective: This survey focuses on the discontinuation rate of insulin pump treatment in the pediatric and young adult age group.
Subjects and methods: The prospective multicenter Diabetes Patienten Verlausdokumentation (DPV) (electronic diabetes patient documentation system) database has been established since 1990 and is broadly used in Germany and Austria. All pump users among the participating centers documented since 1995 were included in this analysis.
Results: In total, 11 710 patients with type 1 diabetes were recorded as treated with insulin pumps. In total, 463 patients (4%) switched from insulin pump treatment to multiple daily injections (MDI). In the group of patients who stopped with pump treatment, the mean duration of pump therapy was 1.7 yr (SE ± 0.06 yr), 60.5% of patients were female. Subdivided into age groups, the discontinuation rate was lowest in the age group < 5 yr (0.1%), followed by the groups aged 5–10 yr (0.3%) and 15–20 yr (0.8%). The group aged 10–15 yr showed the highest rate of discontinuation (2%).
Conclusions: The discontinuation rate of insulin pump therapy is, in general, low (4%). The younger the patients at the time of initiating insulin pump treatment, the lower is the discontinuation rate. The highest rate was seen in adolescents aged 10–15 yr. Girls stopped insulin pump treatment more often than boys (60.5% vs. 39.5%).