At the 4th International Conference on Advanced Technologies and Treatments for Diabetes held in London, Febuary 2011 Dr Nataša Bratina gave a presentation on data of 10 years of CSII treatment in children with type 1 diabetes in Slovenia.

She stated that starting CSII is a routine treatement plan.  Children attend University Children’s hospital in Ljublijana up to the age of 25 years, unlike Glasgow when a newly diagnosed child over 12 years is referred and treated in adult services. All costs for CSII are covered by the National health insurance company. A 24/7 helpline is available.  The choice of pump therapy is a joint decision between the patient, their family and diabetes team. Each patient has 3 annual visits to the clinic when data is collected.  Since 2000 - 750 pumps started.  75% of children are now using pumps.

Findings:

· HbA1c changes significantly. From 9.25 to 7.75 in 2009

· Insulin requirement also changed over the years: in 2000, it was 0.76 while in 2009, it was 0.68

· Acute severe complications in the whole group: 1.41 per 100 patient-years (DKA) and 0.73 per 100 patient-years (severe hypos)

· Incidence rate of acute severe complications in CSII (Insulin Pump Therapy) was: 1.05 per 100 patient-years (DKA)            and 0.65 per 100 patient-years (sever hypos)

Conclusion:

Analysis of 767 paediatric patients from a National childhood-onset diabetes registry demonstrated a significant and clinically meaningful decrease of HbA1c over a 10 years observation without an increase of severe DKA or severe hypos, possibly due to an extensive routine use of CSII