Endocrine Abstracts

Aim: The use of continuous subcutaneous insulin infusion (CSII) systems in type 1 diabetic patients (DM1) is progressively increasing, leading to an increase in cases in which its maintenance during hospitalization is considered. The objective of the study is to analyze the safety of glycemic control with CSII therapy during hospitalization in DM1 adults.

Material and Methods: Retrospective observational study on a cohort of DM1 people hospitalized the last five years who maintained CSII therapy, at the Virgen Macarena University Hospital (Sevilla). We evaluated the differences in glycemic control between the hospitalization period, the month before and the month after hospitalization using the variables: “HbA1C” and percentages of glucometric ranges of the patient’s “ambulatory glucose profile” (AGP). To avoid information bias, we performed a subanalysis according to type of CSII therapy and glycemic monitoring method.

Results: 24 patients were analyzed: 62.5% women, average age 48.8 years. HbA1C 7.33%. Days of admission hospitalizated without CSII 11.68%. Most frequent reason for disconnection: surgery (7) and need for IV insulin infusion (3). Classification according to type of CSII and glucometry source: 640 + capillary controls (20.8%), 640 + integrated system (16.7%), 640 + flash glucose monitoring (45.8%), 670 (9.3 %) and 780 (8.3%). The overall analysis did not show serious complications associated with CSII treatment (severe hypoglycemia, diabetic ketoacidosis, severe isolated hyperglycemia). When subanalyzing the glucometric data in the subset of patients with interstitial glucose monitoring systems (n=12), limiting by the days of admission and the month before and the month after it, no significant differences were recorded in the AGP variables: <54 mg/dl: 1.29%, standard deviation (SD) 2.18 (during admission); 0.57%, SD 0.94 (previous); 1.04, SD 1.05 (later). P=0.193. 55-69 mg/dl: 3.44%, SD 3.75 (during admission); 2.02%, SD 2.56 (previous); 3.42%, SD 2.85 (later). P=0.1 70-180 mg/dl: 55.94%, SD 16.35 (during admission); 57.90%, SD 20.34 (previous); 55.78%, SD 20.89 (later). P=0.87. 181-250 mg/dl: 32.79%, SD 13.40 (during admission); 30.09%, SD 15.07 (previous); 29.78%, SD 14.86 (later). P=0.779. >251 mg/dl: 6.53%, SD 8.44 (during admission); 9.41%, SD 9.94 (previous); 9.98%, SD 12.39 (later). P=0.387.

Conclusion: With adequate protocolization and supervision, maintaining CSII therapy during hospitalization is safe and allows glycemic control similar to the previous one.