Endocrine Abstracts

Background and objective: Several trials showed that sensor-augmented pump (SAP) therapy is safe and effective to reduce hypoglycemic events and improve glicemic control with high treatment satisfaction. Nevertheless patient adherence and sensor use in trials usually decrease with time. Our objective was to evaluate metabolic control and adherence and sensor use after initiation of SAP in a clinical trial.

Methods: In 2008 we recruited 25 patients in treatment with insulin pump (CSII) to start SAP for 6 months. After the trial the patients had the opportunity to maintain the SAP treatment, but only 15 patients did desire to goon with SAP therapy despite a high global evaluation of the device. We evaluate the 25 patients again 7 years after returning to clinical trial.

Results: Seven years after returning to standard clinical care, only 5 of the 25 patients (20%) were still continuously using the sensor. The HbA1c in patients with SAP was 6.9±0.4% and in patients without SAP was 7.3±0.4% withou statistically significant difference. The patients in SAP therapy made 6.3±0.8 SMBG tests per day and in the no SAP group the number of SMBG per day was 4.9±1.4 (P=0.04). No statistically differences were found in quality of life between SAP and no SAP group. Patients in SAP therapy were using it mean 60% of the time. Most problems about SAP use were referred with accuracy and daily life interference (no SAP group).

Conclusion: Our results show that in a standard clinical setting still long time benefits can be found in type 1 diabetes patients treated with SAP after a clinical trial. Nevertheless, new strategies to improve patient adherence to SAP should be developed.