Endocrine Abstracts

Background: Continuous subcutaneous insulin infusion (CSII), alongside multiple daily injections (MDI) are the most frequent therapeutic of type 1 Diabetes Mellitus (DM). We aimed to evaluate the effects of the transition from MDI to CSII in the treatment of type 1 DM.

Patients and methods: This retrospective longitudinal study analysed patients that received treatment with CSII from 2006 to 2014. Our sample had 85 patients, 35 male (41.2%) and 50 female (58.8%) with ages between 19 and 77 years (mean age 37±11), and duration of disease of 15±9 years. We evaluated values such as HbA1c, serum glucose, lipid profile, creatinine, weekly frequency of hypoglycemias (<70 mg/dl) and hyperglycemia (>200 mg/dl) as well the presence of microvascular complications. The effects of CSII were compared according to the following subgroups: HbA1c pre-CSII (≤7.0% vs >7.0%); age (≤35 years vs >35 years); sex distribution; duration of disease (≤15 years vs >15 years); presence of microvascular complications. The statistical analysis was made recurring to Wilcoxon and Mann–Whitney tests. The results presented are means±S.D., median and percentages. A bilateral value of P<0.05 was considered statistically significant.

Results: We observed a decrease in the weekly frequency of hypoglycemias [3.0(1.5, −6.0) vs 2.0(1.0,−3.9);P=0.001] and hyperglycemias [5.5(3.0,−7.0) vs 2.5(1.8,−4.5); P<0.001]. Comparing patients with HbA1c pre-CSII≤7 and >7.0%, the latter group had a significant reduction of HbA1c [−0.40(−0.90.0) vs 0.25(−0.45,−0.80); P=0.002] after 6 months. No statistical difference was found on the subgroups of age, sex, duration of disease and microvascular complication. Serum glucose and HbA1c values on patients with HbA1c pre-ISCI≤7.0% had also no statistical difference.

Conclusions: The CSII therapy is more effective than MDI as demonstrated by the significant reduction of hypoglycemia and hyperglycemia episodes. We also observed benefits in the reduction of HbA1c with the CSII treatment in the HbA1c>7.0% subgroup, which had the worst metabolic control.