BACKGROUND: Continuous subcutaneous insulin infusion (CSII) mimics physiologic insulin release better than @entity2794 ( @entity2794 ) therapy and allows for greater flexibility in food intake and physical activity. Given these benefits, it raises the question "Is it required to wait to offer CSII to @entity1 with @entity1723 ( @entity1723 ) only after @entity2794 therapy has failed"? This study sought to determine if starting CSII in @entity1 with @entity1723 within 1 year of diagnosis results in better long-term glycemic control than starting it later. METHODS: This retrospective observational study was conducted in a tertiary-care medical center. The charts of 488 @entity1 with @entity1723 (273 females) 2.6-39 years old (mean, 19.9    7.7 years) who started CSII in 1998-2008 and used it for at least 1 year were reviewed for background, disease-related, and treatment-related variables. Study end points were glycosylated hemoglobin (HbA1c) level, rate of severe @entity4053 , and @entity6 events during CSII use. Findings were compared between @entity1 who started CSII within 1 year of diagnosis (Group 1, n=93) or later (Group 2, n=395). RESULTS: Compared with Group 2, Group 1 @entity1 were characterized by a significantly younger age at CSII initiation (10.7  5.7 vs. 16.4  7.0 years, P<0.001), more frequent blood @entity413 monitoring (5.4    1.8 vs. 3.9    1.5 times per day, P<0.001), and shorter total duration of @entity6 (4.3    2.1 vs. 11.9    6.4 years, P<0.001) and of CSII therapy (3.6    2.1 vs. 4.7    2.5 years, P<0.001). There were no significant between-group differences in @entity1 gender or ethnicity, indications for initiating CSII, mean HbA1c level, attainment of target HbA1c, or rates of severe @entity4053 or @entity1270 events after CSII initiation. CONCLUSIONS: Starting pump therapy at an @entity66 stage has no added benefit for glycemic control over time than starting later. The timing of CSII initiation should be tailored to the individual @entity1 by the @entity6 care team.

Does the timing of insulin pump therapy initiation after XXXX onset have an impact on glycemic control?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['early disease'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic ketoacidosis', 'diabetes'] @entity4053 :: ('MESH:D007003', 'Disease') :: ['hypoglycemia'] @entity1723 :: ('MESH:D003922', 'Disease') :: ['T1D', 'type 1 diabetes'] @entity2794 :: ('MESH:D020773', 'Disease') :: ['MDI', 'multiple daily injection'] @entity1270 :: ('MESH:D007662', 'Disease') :: ['ketoacidosis'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose']
@entity1723 :: (MESH:D003922,Disease) :: ['type 1 diabetes']
