Insulin pump therapy
Type 1 diabetes is an autoimmune disease characterised by absolute insulin deficiency due to the damage of insulin-producing beta-cells of pancreatic islets. Intensive insulin therapy is the standard treatment for type 1 diabetes and consists of an injection of basal insulin, independent of meals, and additional injections administered at mealtimes (bolus insulin). Insulin pumps are a special form of intensive insulin therapy that automatically administer basal insulin. Insulin pump therapy is of particular importance for children and adolescents with type 1 diabetes and is firmly integrated into the clinical guidelines (DDG, 2018; DDG, 2015).
- In 2019, more than half of children and adolescents with type 1 diabetes in Germany received insulin pump therapy.
- Girls with type 1 diabetes are more likely to use an insulin pump than boys.
- The proportion of children and adolescents with type 1 diabetes who receive insulin pump therapy has increased significantly since 2007.
In 2019, 57.4% of children and adolescents (girls 60.2%; boys 54.9%) aged 0 to 17 with type 1 diabetes received insulin pump therapy. During the 2007 to 2019 observation period, the use of insulin pumps increased continously from 25.1% (girls 27.5%; boys 23.0%) in 2007 to 57.4% (girls 60.2%; boys 54.9%) in 2019. On average, the prevelance of insulin pump therapy was around 5 percentage points higher among girls than boys.
In 2019, more than half of children and adolescents with type 1 diabetes received insulin pump therapy. The use of insulin pumps increased continuously during the observation period and was higher in girls than in boys. The reason for these stable differences between the sexes in the use of insulin pumps in this age group is unclear and further research is needed. Insulin pump therapy provides greater flexibility and a more physiological administration of insulin among people with type 1 diabetes. Studies indicate that insulin pump therapy can improve blood sugar control; however, it is unclear as to whether it yields long-term benefits such as by reducing secondary diseases (DDG, 2015).
Show more information on methodology and data sources
The indicator insulin pump therapy is defined as the proportion of children and adolescents with type 1 diabetes who are treated with an insulin pump.
Children and adolescents aged between 0 and 17 years who are resident in Germany.
Nationwide and regional diabetes registers (DPV register, ESPED incidence register, North-Rhein Westphalia register, Saxony diabetes register). The data are based on the September 2020 data set from the DPV database, which has been fully validated and committed to the database.
- Description: The rate of insulin pump therapy related to children and adolescents aged 0-17 years with type 1 diabetes in Germany during the 2007-2019 observation period.
- Extrapolation/weighting: the population data gathered by the Federal Statistical Office during the 2011 census were used for the nationwide estimates. Results with 95% confidence intervals were estimated using the person-years method. A Poisson distribution of cases was assumed (Woodward 2013; Sahai 1993).
- Age standardisation: Estimates were standardised by age and sex and were equally weighted for the age groups under consideration.
Data quality of the participating practices
The diabetes registries provide outpatient or inpatient diagnostic data and information on the type of therapy provided to people with statutory and private health insurance. This includes information about people with different types of diabetes and age groups. These data are provided by practices and clinics participating on a voluntary basis. The data quality depends on the practice providing the data. All documentation is subject to a thorough plausibility check. Statistical methods are used for extrapolation and to ensure full coverage of the reference population.