ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P185

Metabolic improvement in diabetic patients under education before implantation of the insulin sibcutaneous continuous infusion (ISCI)

Silvia Maraver, Guillermo Martinez de Pinillos, Cristobal Morales, Juan Manuel Garcia-Quiros, Monica Tome, Isabel Serrano, Teresa Garcia, Carmen Cuesta & Angel Sendon

Virgen Macarena Hospital, Seville, Spain.

Introduction: ISCI treatment is useful to optimize treatment in patients with DM1. Before implantation, is necessary the education of patients, as in technical aspects so in the handling of diabetes with this therapy.

Objective: Evaluate the results of the diabetological education previous to the implantation of the ISCI and the repercussion of this program in patients metabolic control.

Material and method: Forty-seven diabetic patients with indication of insulin pump were educated. They were distributed in 4–5 people groups. Age: 31.7 years ±12.45 (12–64). Fifty-six percent women and 44% men. Evolution of diabetes: 16.2 years ±10 (4–40). Indication of pump determined by bad metabolic control in 21 patients (44.6%), hypoglycemia in 15 (31.7%), gestation in 7 (14.8%) and glycemic instability in 4 (8.5%). It was organized in classes of 1.5 h, 1 or 2 afternoons weekly, with theoretical and practical contents. The program consisted of 6 classes: approach to the therapy (indications, advantages and disadvantages), basic concepts (factor of sensitivity, ratio, basal line and bolus), feeding by CH countings, daily and pump life (deports, disconnection, trips, hour change), acute complications and technical handling of the pump.

Results: Once completed program, the average HbA1c descended respect to 2 months previous one (−0.67%), being higher when in the group in whom the pump was indicated by bad metabolic control (1.12%).

HbA1c (%)Total (n=47)Bad metabolic control (n=21)Glycemic inestability (n=4)Pregnancy (n=7)Hypoglycemias (n=15)
Pre 8.48±2.4910.12±2.747.75±0.707.58±1.606.79±0.86

Conclusions: In candidates to pump by bad control, a program of diabetological education served to improve this control before initiate this therapy. The educative programs make an improvement in the metabolic control and a motivation in the self-care of the patient. Its application to all the diabetics would be advisable.