Introduction: Continuous subcutaneous insulin infusion (CSII) represents a treatment option that helps patients with type 1 diabetes (PwT1D) to achieve better glycemic control, reduces hypoglycemia and improves quality of life. In Portugal, the National Health System (SNS) affords CSII treatment to PwT1D, according to certain criteria. Over the years, the number of patients treated with CSII devices supported by SNS has grown exponentially. We analyzed these patients profile.
Methods: Descriptive analysis of PwT1D registered in the National CSII platform on January 1, 2019 (corresponding to Continental Portugal SNS registers). Data on gender, birth date, diagnosis date, eligible criteria for CSII, date of initiation of CSII treatment and treatment center were collected. The SPSS 23 program was used for statistical analyses.
Results: There are currently 2364 PwT1D registered as being under CSII treatment. 54% are females and 46% are males. Mean age is 22±15 years-old, and 56% have 18 years-old or less. Mean age at diagnosis was 10±9 years-old (n=1644) and initiation of CSII treatment occurred 14±11 years later (n=381). 958 patients have eligible criteria for CSII treatment filled in their records. Of those, 58% had high glycaemic variability; 57% had HbA1c level over 7.0%; 40% were 14 years-old or less; 38% needed a more flexible lifestyle; 28% used small doses of insulin; 26% suffered from hypoglycaemia unawareness; 8% presented dawn phenomena; and 2% were preconception women. Continental Portugal is divided into five health care regions and CSII spreading is not uniform. Accordingly, each health region, assists the following proportion of PwT1D using CSII: North 39,8%; Center 17.7%; Lisbon and Tejos valley 40.0%; Alentejo 1.4%; Algarve 1.1%.
Discussion and conclusion: There are currently 2364 patients on CSII treatment in Continental Portugal, supported by the SNS. Most of them are young, and the main reasons for CSII treatment choice were paediatric age, glycaemic variability and poor glycaemic control. Over the last years, CSII treatment has quickly expanded in Portugal. This year we expect that more than 850 new CSII systems will be made available by the SNS, namely covering all eligible children with 18 years old or less. In 2010 there were only around 500 patients treated with CSII systems, but by the end of 2019 this number is expected to overcome 3000. The National Diabetes Program will keep efforts to increase the availability of CSII systems and to promote the best health care practice for PwT1D.
18 - 21 May 2019
European Society of Endocrinology