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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.
trend
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cross-section
By state
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By gender
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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).