Impact of the use of continuous subcutaneous insulin infusion versus multiple daily insulin injections in adults with type 1 diabetes mellitus

Aguilar Irene Zayas; Lucena Morales Cristian Jesus; Barea Almudena Lara; los Angeles Cutilla Munoz Maria de; Torres Barea Isabel Maria

doi:10.1530/endoabs.99.EP865

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Endocrine Abstracts (2024) 99 EP865 | DOI: 10.1530/endoabs.99.EP865

ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)

Impact of the use of continuous subcutaneous insulin infusion versus multiple daily insulin injections in adults with type 1 diabetes mellitus

Irene Zayas Aguilar ¹ , Cristian Jesús Lucena Morales ¹ , Almudena Lara Barea ¹ , María de los Ángeles Cutilla Muñoz ¹ & Isabel María Torres Barea ¹

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¹Hospital Universitario Puerta del Mar, Endocrinology and Nutrition Department, Cádiz, Spain

Objective: The aim of this study is to assess the impact of continuous subcutaneous insulin infusion (CSII) via a pump for patients with type 1 diabetes mellitus (DM1) on blood glucose and metabolic control.

Materials and methods: A descriptive study was performed in a cohort of patients with DM1, showing blood glucose measurements at one month, six months and one year after implantation of the CSII. In addition, we performed an intra-subject before-after study comparing the parameters with multiple daily insulin injections (MDI) and the use of CSII one month and six months after its implementation.

Results: The study included 34 patients with DM1 (70% women), the mean age was 34.38 años (28.22-40.54) years and the average time to progression of DM1 19.97 years (15.19-24.76). After one month of treatment the glucometric report a Time In Range (TIR) of 76.71% (73.02-80.41), Time Below Range (TBR) 1.93% (1.33-2.52) and Time Above Range (TAR) 21.00% (17.15-24.85); the Glucose Management Indicator (GMI) was 6.77% (6.64-6.91). At six months treatment we highlight: TIR 79.00% (76.29-81.71), TBR 2.10% (1.47-2.72), TAR 18.84% (16.23-21.45), GMI 6.74% (6.64-6.84); with a glycated hemoglobin (A1C) of 7.01% (6.72-7.30). At one year: TIR 80.65 % (78.14-83.15), GMI 6.69 %, (6.55-6.83). In the before-after study (n=24; 62.5% women) a significant improvement is observed one month after the use of the insulin pump with respect to MDI treatment: TIR (77.50 vs 55.62; P<0.001), TAR (20.55 vs 40.50; P< 0.001), TBR (1.95 vs 3.87; P=0.038), GMI (6.78 vs 7.35; P=0.003) and coefficient of variation (CV) (29.93 vs 35.38; P=0.01). After six months of treatment, improvements were also observed in TIR (79.41%; P<0.001), TAR (18.68%; P<0.001), TBR (1.91%; P=0.034), CV (30.70%; P=0.08) and GMI (6.73%; P=0.02).

Conclusions: In the descriptive study, a TIR >70% was observed with the use of CSII at one month, six months and one year after treatment. In the before and after study, we observed an improvement in glucometric parameters (TIR, TBR, TAR, GMI, CV).