Follow up of type 1 diabetic patients treated with insulin continuous s.c. infusion
Victor M Andia, Elisa Fernandez, Antonino Jara, Rogelio Garcia, Marcel Sambo & Diego A Lezcano
Insulin continuous s.c. infusion (ICSI) is an alternative therapy in selected diabetic patients when a good metabolic control is not achieved with multiple insulin doses (MID). We report the follow-up of patients with ICSI at least during 1 year in our centre.
Patients and methods: Twenty-five patients (16 females, 9 males), with median age 38.4±12.5 years and diabetes evolution mean time 16.8±7.8 years, were changed from MID to ICSI due to deficient metabolic control (52%), non-correctable hypoglycemia (28%) or gestation planning (20%).
Clinical and analytical revisions were done each 3±1 months during the first 1.5 year and each 6±1 months thereafter.
One patient was missed 9 months after starting ICSI, reappearing 2 years later; none patient left ICSI for any reason.
Weight (BMI), HbA1c and insulin dosage (U/kg per day) were registered in all visits. Students t-test was used for comparisons with the basal values.
Results: A significant reduction in HbA1c levels along the first year was observed, from 8.26±1.4 to 7.30±0.75%, remaining stable in the following revisions. Insulin requirements followed a similar evolution, with reduction from 0.71±0.24 U/kg per day to 0.53±0.14 at the end of the first year.
A slight weight gain was observed, with a BMI increase from 24.53±3.11 to 25.32±3.79, but also remained stable afterwards.
There were no greater hypoglycemia frequency nor any other problem associated with ICSI.
Conclusions: In our patients, ICSI therapy produces a significant and sustained reduction of HbA1c levels that could be long-term costeffective. The only secondary effect observed is a slight weight gain produced in the first 12 months and stable afterwards.