Abstract: Aim: To analyze the clinical effect of continuous subcutaneous insulin infusion (CSII) in type 1 diabetes mellitus (T1D) patients in the Spanish real-world scenario.
Methods: All T1D patients on CSII registered in the SPAnish Insulin Pump (SPAIP) registry were included. The primary efficacy outcome was change in HbA1c during follow-up. Secondary efficacy outcomes included: insulin pump indications, diabetes complication rates, insulin and pump use, and continuous glucose monitoring (CGM) glycometrics. Patient data were typed through the web-based SPAIP registry.
Results: Data from 2979 T1D patients treated with CSII were analyzed. The median age was 44 years (interquartile range [IQR] 34?52 years), and T1D duration was 27 years (IQR 18?35 years). The median duration of CSII therapy was 6 years (IQR 3?10 years). The main indications for treatment were suboptimal glycemic control (33.8%), hypoglycemia (22.1%), and increased glycemic variability (18.8%). Glycated hemoglobin decreased by 6?mmol/mol (95% CI, ?5 to ?6?mmol/mol, P?0.001) [?0.5%, 95% CI, ?0.4 to ?0.5, P?0.001] during the follow-up. The percentage of patients with severe hypoglycemia decreased from 14.9% to 0.9% (P?0.001). We observed an inverse correlation between final HbA1c levels and CGM adherence (R?=??0.24, P?0.001) or percentage of time with active hybrid closed-loop functions (R?=??0.25, P?0.001).
Conclusions: CSII treatment was associated with a sustained improvement in glycemic control in the Spanish population. This benefit was greater among patients with higher CGM or active hybrid closed-loop functions adherence. The protocol was publicly registered at ClinicalTrials.gov (NCT04761094).
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Fuente: Diabetes Technology and Therapeutics, 2022, 24(12), 898-906
Editorial: Mary Ann Liebert
Año de publicación: 2022
Nº de páginas: 9
Tipo de publicación: Artículo de Revista
Url de la publicación: https://doi.org/10.1089/dia.2022.0207