Bern/Hanover-Although AID systems (“automatic insulin dosing”), which combine continuous blood sugar measurement with an insulin pump, are now recommended for all children with type 1 diabetes-for preschool children they are even used to use.

Current study results showed at the Diabetes Congress (DDG) in Berlin that the AID systems are safe (Abstract 11.03, 11.08 and 12.02). A disadvantage could be a tendency to gain weight.

Claudia Boettcher from the Inselspital in Bern has followed the use of AID in the figures of the DPV register, in which 512 centers in Germany and German-speaking countries take part. From 2019 to 2024, 1,806 of 3,360 preschool children with type 1 diabetes (53.8 %) used an AID system. The school children were 8,023 of 22,848 (35.1 %).

According to Boettcher, this is too low, especially among the preschool children. The fact that diabetologists and/or parents are hesitant also show that only 40 preschool children were supplied with the AID system within 6 months of diagnosis.

The reasons cannot be determined from the DPV register. Boettcher suspects that the limited availability of the AID systems and possible structural difficulties in pediatric diabetology (e.g. personnel resources) could also play a role.

Clinical studies show that preschool children in particular benefit from the use. Torben Biester from the children’s and youth hospital “Auf der Bult” in Hanover shows this using 27 preschool children who have been closely observed over 3 months as part of a study. The proportion of the time in which the blood sugar was in a corridor from 70 to 180 mg/dl rose from 52 % to 64 %. This level was kept in the following months.

The proportion of the time in which blood sugar remained in a closer corridor from 70 to 140 mg/dl rose from 31 % to 40 %. Here, too, the advantage remains in the following months.

The time when the blood sugar rose to over 250 mg/dl dropped from 21 % to 10 % after the beginning of the AID treatment. Hypoglycaemia with measured values ​​under 70 mg/dl increased from 15 in 14 days to 25 in 14 days. However, there were no changes regarding the percentage time in the hypoglycemic area and in the applied daily insulin amount.

In a host questionnaire, the values ​​for sleep disorders (16 versus 13 points) and for psychological stress were reduced (10 versus 7.6 points). Most parents and children seem to be satisfied and happy with the AID system. However, with the trust in the AID system, the discipline in nutrition may decrease a little.

Jantje Weiskorn from the children’s and youth hospital “Auf der Bult” in Hanover in the DPV register gave evidence of an increase in body weight: The preschool children were increased by the “Body Mass Index Standard Deviation Score” (BMI-SDS) from 0.74. In the school children, the BMI SDS rose from 0.44 to 0.50 and from 0.68 to 0.72.

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