Introduction: Type 1 diabetes mellitus (T1-DM) is a common chronic disease in childhood. This study aimed to investigate the effects of flexible insulin therapy (FIT) and insulin infusion pump therapy (IIPT) on clinical, metabolic parameters and quality of life in patients followed.
Materials and Methods: The study included 50 patients with type 1 diabetes who were followed in our pediatric endocrinology outpatient clinic. All patients who received detailed instruction on carbohydrate counting were receiving flexible insulin therapy. After six months of FIT, 20 willing patients were switched to IIPT. Before and after each treatment period, patients' HbA1c values, hypoglycemia frequency, basal/bolus/total insulin requirements, blood lipid levels, body mass index (BMI), glucose levels were measured by glucometer and continuous subcutaneous glucose monitoring (CSGM). In addition, quality of life scores of all patients were compared.
Results: The mean age of the patients was 13.1 and average duration of diabetes was 8.4 years. HbA1c levels were significantly lower in the IIPT period compared to the FIT period (p:0.011). However, there was no difference in other parameters. A significant decrease in the frequency of hypoglycemia was observed in the IIPT period compared to the other period (p:0.032). No significant differences were found between the two periods in BMI, insulin doses, and lipid levels (except for the increase in LDL cholesterol). When the quality of life of patients after IIPT was examined, significant improvement was observed in general health and mental health parameters compared to the FIT period.
Conclusion: IIPT provide significant improvements in metabolic parameters and quality of life in children and adolescents with T1-DM compared to FIT treatment methods. IIPT has also been shown to reduce the frequency of hypoglycemia.