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dc.contributor.authorBotros, Sandraen
dc.contributor.authorIslam, Nazrulen
dc.contributor.authorHursh, Brendenen
dc.date.accessioned2019-02-22T18:02:07Z
dc.date.available2019-02-22T18:02:07Z
dc.date.issued2019-06en
dc.identifier.issn1399-543X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/289891
dc.description.abstractBackground and Objectives: Indications for insulin pump therapy (IPT) in children with type 1 diabetes (T1D) are relatively non‐specific and therefore subject to provider discretion. Health professionals’ perceptions of which people will have difficulty with IPT, e.g., those with higher HbA1c, may not be correct. This study examined the effect of IPT on HbA1c, and the role of pre‐pump HbA1c on this effect. Methods: All children with T1D started on IPT at British Columbia Children’s Hospital from January 2011 through June 2016 were included if they had HbA1c values available both before and after IPT (n=125). Generalized Estimating Equations was used to estimate the effects of IPT on HbA1c, stratified by pre‐pump HbA1c levels (good: <7.5% [<58 mmol/mol], moderate: 7.5‐9.0% [58‐75 mmol/mol], poor: >9.0% [>75 mmol/mol]). Results: After adjusting for potential confounders, mean HbA1c decreased by 0.48% [5.2 mmol/mol] (95% confidence interval: –0.64, –0.33% [–7.0, –3.6 mmol/mol]; P<0.0001) after IPT initiation. The adjusted mean HbA1c decreased by 0.14% [1.5 mmol/mol] (–0.35, 0.07% [–3.8, 0.8 mmol/mol]; P=0.188), 0.54% [5.9 mmol/mol] (–0.74, –0.34% [–8.1, –3.7 mmol/mol]; P<0.0001), and 1.08% [11.8 mmol/mol] (–1.69, –0.46% [–18.5, –5.0 mmol/mol]; P=0.0006) after pump initiation in the good, moderate, and poor pre‐pump metabolic control groups, respectively. Conclusions: Pre‐pump HbA1c appears to play a significant role in the effects of IPT on HbA1c, with the largest decrease in HbA1c seen in the poor pre‐pump HbA1c group. Eligibility and consideration for IPT should be expanded to routinely include these children.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherWiley
dc.subjectHumansen
dc.subjectDiabetes Mellitus, Type 1en
dc.subjectInsulinen
dc.subjectInsulin Infusion Systemsen
dc.subjectRetrospective Studiesen
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectHospitals, Pediatricen
dc.subjectCanadaen
dc.subjectBritish Columbiaen
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectTertiary Care Centersen
dc.subjectGlycated Hemoglobin Aen
dc.titleInsulin pump therapy, pre-pump hemoglobin A<sub>1c</sub> and metabolic improvement in children with type 1 diabetes at a tertiary Canadian children's hospital.en
dc.typeArticle
prism.endingPage433
prism.issueIdentifier4en
prism.publicationDate2019en
prism.publicationNamePediatric diabetesen
prism.startingPage427
prism.volume20en
dc.identifier.doi10.17863/CAM.37130
dcterms.dateAccepted2019-02-11en
rioxxterms.versionofrecord10.1111/pedi.12834en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-06en
dc.contributor.orcidBotros, Sandra [0000-0001-6658-406X]
dc.contributor.orcidIslam, Nazrul [0000-0003-3982-4325]
dc.contributor.orcidHursh, Brenden [0000-0002-5195-2103]
dc.identifier.eissn1399-5448
rioxxterms.typeJournal Article/Reviewen
cam.orpheus.successThu Jan 30 10:50:06 GMT 2020 - Embargo updated*
rioxxterms.freetoread.startdate2020-06-30


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