Author(s): Bassam S. Bin-Abbas, Abdullah Al-Fares, Nadia A. Sakati, Abdullah A. Al-Ashwal
Objective: To assess the efficacy and effectiveness of continuous subcutaneous insulin infusion (CSII) therapy in type 1 diabetic Saudi children. Methods: CSII was initiated in 10 Saudi children with type 1 diabetes mellitus through insulin pump therapy between October 2002 and April 2003. All children were followed at The Diabetes Clinic at King Faisal Specialist Hospital and Research Center. The patients were initially on conventional insulin therapy (CI) before shifting them to CSII. They were trained on carbohydrates counting and started on continuous basal insulin infusion in addition to meal and high blood glucose correction insulin boluses. Results: The patients included in the study had type 1 diabetes mellitus for a mean duration of 5.9 years + 1. The age of the children ranged from 9 to 18 years (mean 13.5 + 3). They were followed on insulin pump therapy for a mean duration of 25 months + 2. There was a significant reduction in hemoglobin A1c (HbA1c), mean blood glucose level, total insulin requirement, frequency of hypoglycemic episodes and frequency of diabetic ketoacidosis (DKA) events during CSII therapy. HbA1c and blood glucose level reduction was maintained for more than 2 years. All children continued to monitor their blood glucose at least 3 times per day and count carbohydrates and match that with insulin meal boluses. Conclusion: CSII improved the glycemic control in diabetic Saudi children and its metabolic effect on blood glucose control was sustained for more than 2 years. Medical, psychosocial and family support is continuously needed for this modality of insulin therapy to achieve its targeted goal.