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Elina Petkova, Valentina Petkova*, Konstantin Mitov, Milen Dimitrov, Maia Konstantinova and Guenka Petrova


There are no enough studies comparing the effect of continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI). Most of the available literature is restricted to small scale before and after studies. The aim of this study is to evaluate the costeffectiveness of continuous subcutaneous insulin infusion (CSII) to analogue multiple daily insulin injections (MDI), based on the achieved short term therapeutic results as insulin dosage per kg and average daily blood glucose level. This is the prospective, observational, comparative, controlled real life study performed at the Endocrinology Clinic with 26 children separated in two groups – active on SCII and passive on MDI. Cost-minimization, cost-effectiveness, sensitivity and statistical analyses are applied to studied short-term therapeutic results. The average dose of insulin per kg is slightly lower at 0.7323 IU/kg (SD 0.307 IU/kg) in the active group than in the control group at 0.8953 IU/kg (SD 0.165 IU/kg). The blood glucose level is decreasing significantly in active group to 6.59 mmol/l. No matter the literature evidences that MDI is more effective for short period of application, the statistical processing of our data shows that 46.15% from the active group (CSII) has statistically significant improvement in comparison with the control group (MDI). Based on this fact we can assume that CSII group better insulin management in comparison with the control group. We found that the CSII is cost-effective alternative when the decrease in blood glucose level is considered. Our study shows that the CSII pumps allows better diabetes control when even short come results are considered, as is the insulin dose per kg, and blood glucose level. They are also and cost-effective alternative for children with type 1 diabetes.

Keywords: continuous subcutaneous insulin infusion, diabetes mellitus, multiple daily injections, children, cost-effectiveness.

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