Journal Article

Short- and long-term complications of insulin pump therapy in children and adolescents with type 1 diabetes: a multicenter cross-sectional study from Saudi Arabia

Aljuaid, Mutlaq, Alharthi, Lujain, Kamal, Wael, Alqahtani, Ibtisam, Alotaibi, Muhannad, Alsaedi, Abdulaziz, Bakkar, Ayman, Alotaibi, Turki, Althobaiti, Enad, Kamal, Naglaa M, Almalki, Samia, Althobaiti, Mohammed, Aljuaid, Saad, Alshehri, Haneen, Habib, Lura, Abualkhair, Lujain A, Althuwaybi, Maha

2025

Overview

Background: Insulin pump therapy improves glycemic control in children with type 1 diabetes but is associated with technical and dermatological complications that can impact adherence. Research on these adverse effects in pediatric populations is limited. Objectives: This study aimed to evaluate short- and long-term complications of insulin pump therapy in pediatric patients in Saudi Arabia, focusing on technical malfunctions, dermatological issues, and patient satisfaction. Design: A cross-sectional survey-based study conducted in multiple centers in Taif, Saudi Arabia. Methods: Fifty-nine parents of children with type 1 diabetes who used insulin pumps provided data for the study. Participants reported technical issues, skin-related complications, and overall satisfaction. IBM SPSS Statistics version 27.0.1 was used to conduct the statistical analysis. Results: Technical complications were frequent, with 64.4% experiencing tube blockages, 39.0% reporting needle dislodgment, and 39.0% observing air bubbles in the tubing. Dermatological issues included discomfort at the infusion site (54.2%), skin pigmentation (45.8%), and scarring (55.9%), with lipohypertrophy (22.0%) posing a concern for insulin absorption. Longer pump use was significantly associated with increased complications, particularly tube blockages and skin pigmentation. Despite these challenges, 84.7% of participants recommended insulin pumps over multiple daily injections. Conclusion: Technical and dermatological complications were common, increasing with longer pump use. Proper infusion site rotation, infusion set management, and improved patient education are key to reducing adverse effects. To improve safety and efficacy, future studies should concentrate on infusion set change patterns, newer pump technologies, and standardized guidelines. Plain language summary Understanding complications of insulin pump therapy in children and teens with type 1 diabetes: insights from Saudi Arabia Insulin pumps are increasingly used to manage type 1 diabetes in children, but there is limited knowledge about their complications in Saudi Arabia. This study investigated the challenges associated with insulin pump use among children and adolescents in Taif. Conducted over a year, the study included participants aged 18 or younger who used insulin pumps and excluded those who did not meet these criteria. Findings revealed that technical issues were common. Users who preferred pumps over injections frequently reported login problems (71.4%), and Medtronic MiniMed 670G users faced difficulties with data downloading and login (42.9%). Longer pump use (over one year) was linked to higher rates of occlusion (66.7%). Females experienced more synchronization issues, while males reported increased water damage. Abdominal pain at injection sites was a prevalent skin issue. Complications such as login errors, data download challenges, and catheter kinking were associated with lower satisfaction scores. The results underscore the importance of improved support and design for insulin pumps to enhance user experience and outcomes for young patients managing type 1 diabetes.

• Publisher: SAGE Publications,SAGE PUBLICATIONS, INC,SAGE Publishing
• Subject: Children & youth / Diabetes / Infusion pumps / Insulin / Original Research / Patient satisfaction / Pediatrics / Teenagers