Endocrine Abstracts (2011) 26 P665

Evaluation of long term outcomes of intensive treatment with s.c. insulin infusion (CSII) in type 1 diabetic patients

I González-Molero, M Domínguez-López, E Rubio, M Carreira, M S Ruiz de Adana, S González-Romero, A Machado & F Soriguer


Endocrinology and Nutrition Service, Carlos Haya Hospital, Málaga, Spain.


Introduction: Several studies have shown that treatment with insulin pump is an effective therapy for selected type 1 diabetes. Nevertheless, most of them analyse results in short period of time. The objective of this study is to evaluate long term effects on quality of life (DQOL) and metabolic control of CSII.

Material and methods: We did a longitudinal study of type 1 diabetic patients previously treated with multiple daily insulin (MDI) therapy who iniciated insulin pump and maintained it for longer than 3 years. Inicially we recluted 105 patients and after we excluded pregnant and patients using combined sensor-pump systems. Finally we analysed in 69 patients: diabetes duration, complications, cause of initiating CSII, total daily insulin requirements, hypoglycaemias, HbA1c, DQOL, physical evaluation, number of controls and number of medical visits.

Results: The criteria for CSII initiation were: 21.9% hypoglycaemic events, 37.5% poor metabolic control and 40.6% glycemic lability. After 3 years, 79.64% continue using insulin pump, 12.2% dropped out and 8.16% withdrawn following medical reasons.

Basal6 month12 month24 month36 month
HbA1c8.11±2.27.6±1.3*7.8±0.9*7.2±2.6*8.2±0.97
Severe hypoglycemic events/year0.430.06000.03
Hypoglycemic events/week4.5±33.3±2.82.1±1.7*2.8±2.2*2.7±1.6
Ketoacidosis with hospitalary admission00000
Sensibility factor37.6±17.845.3±19.0440.7±18.938.8±18.441.3±10.3
CHRatio1.05±0.50.88±0.440.95±0.460.97±0.441.03±0.29
Autoanalysis/day3.6±2.53.1±1.993.8±1.93.7±2.23.2±1.4
Visits/month0.62±0.220.28±0.140.30±0.110.30±0.11
DQOL92±16.1580.82±19.2*82.12±19.1*82.5±14.0*82.5±14.0*
Long term evaluation of CSII. *P<0.05.

Conclusions: CSII achieve a good metabolic control during the first 2 years and an improvement in DQOL that is mantained during all the evaluated period of time.

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