GSB 7.1 Standardlösung

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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. Instead of an additional injection, the bolus insulin can be administered at the push of a button on the insulin pump. The use of the insulin pump in children and adolescents with type 1 diabetes is therefore of particular importance and is firmly integrated into the guideline for the treatment of type 1 diabetes (DDG 2023).

Key messages

  • Almost two thirds of children and adolescents with type 1 diabetes in Germany were treated with an insulin pump in 2022.
  • Girls with type 1 diabetes are more likely to use an insulin pump than boys.
  • In the observation period 2014 to 2022, the proportion of children and adolescents with type 1 diabetes on insulin pump therapy increased significantly.

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trend

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cross-section

By state

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  • By gender

    Indikatoren_ScreenreaderHinweis_Datentabelle

  • By age

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  • By education group

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Results

In 2022, 63.7% of children and adolescents with type 1 diabetes used an insulin pump. Girls (66.6%) used an insulin pump more frequently than boys (61.3%). The use of insulin pump therapy decreased with age from 96.7% in the under 3-year-olds to 56.9% in the 14 to 17-year-olds. Over the observation period 2014 to 2022, the use of insulin pump therapy rose continuously from 53.4% to 66.6% for girls and from 46.5% to 61.3% for boys. Over the entire observation period, the difference between girls and boys remained constant at around 6 percentage points. The increase over time was more pronounced in the age groups 7 years and older than in the younger age groups.

Conclusion

In 2022, almost two thirds of children and adolescents with type 1 diabetes were treated with an insulin pump. Girls and younger children and adolescents used an insulin pump more frequently. The use of insulin pumps increased continuously in the 2014-2022 observation period. The reason for the stable sex differences in the use of insulin pumps in childhood and adolescence is unclear and needs to be investigated further (Boettcher et al. 2021). Insulin pump therapy is associated with greater flexibility and more physiological insulin administration for people with type 1 diabetes. Studies suggest that blood glucose control can be improved with pump therapy (Pala et al. 2019, Karges et al. 2017), but the data regarding long-term benefits, such as a reduction in secondary diseases, is not certain (Calderon Martinez et al. 2024).

Show more information on methodology and data sources

Definition

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. 

Reference population

Children and adolescents aged between 0 and 17 years who are resident in Germany.

Data Sources

Nationwide and regional diabetes registers (DPV register, ESPED incidence register, North-Rhein Westphalia register, Saxony diabetes register). The data are based on the September 2023 data set from the DPV database, which has been fully validated and committed to the database.

Calculation

  • Description: The rate of insulin pump therapy related to children and adolescents aged 0 to 17 years with type 1 diabetes in Germany during the 2014 to 2022 observation period.
  • Extrapolation/weighting: The extrapolated 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 and Kurshid 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 centers

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.

Data download

Referencen and external links

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