Introduction: Strict metabolic control is the main purpose in the management of type 1 diabetes in order to prevent patients from macro or microvascular complications. The therapy of type 1 diabetes was optimized by the basal-bolus regimens with multiple daily injections in addition to the educational programs such as flexible insulin therapy. Nevertheless, despite all those therapeutic approaches, the metabolic control is not always obtained. The specific aim of our study is to demonstrate the effectiveness of insulin pump therapy in improving the metabolic control of patients with type 1 diabetes in Morocco.
Methods: In the Department of Endocrinology, Mohammed VI Hospital, Medical School, Mohamed the First University, Oujda, Morocco, we describe a prospective study collecting six moderately controlled patients with type 1 diabetes (HbA1c ≥7.5%), previously educated to insulin flexibly. Those patients were treated by the subcutaneous infusion pump in order to improve their metabolic control. Over a 3 months period of the study, the data collected: HbA1c, the rate of hypoglycemic events and the insulin requirements of the basic rate.
Results: The mean age was 20.1±5.9 years old, 5 girls and 1 boy. The average diabetes duration was 5.5±2 years. Over a 3 months period of the study, the frequency of the mild hypoglycemia decreased from 10±4.1 episodes/month to 1±0.5 episodes/months and the HbA1c decreased from 8.4% to 7% Δ 1.4%. The insulin basal requirements were reduced in 2/3 of patients by 0.04ui/24h and the adaptation of basal rates allowed the correction of the dawn phenomenon
Conclusion: The basal-bolus regimens with multiple daily injections or insulin pump were recommended for therapy of type 1 diabetic patients. In Morocco, the opportunity to be treated by the insulin pump therapy is not possible for all our patients with type 1 diabetes especially due to economic reasons. In our Department, we were able to offer to our poorly controlled patients the possibility to benefit from this approach.
18 - 21 May 2019
European Society of Endocrinology