Background and Aims

To determine the efficacy and safety of continuous subcutaneous insulin infusion (CSII) in attaining long-term glycaemic control and improved quality of life in Type 1 Diabetes Mellitus (DM) patients, who were previously treated with multiple daily injections (MDI).

Methods

From April 2006 to May 2018, 140 Type 1 DM patients were followed, (mean age 33,7±22,1 years; 54 males, 76 females, 10 children; duration of diabetes 19,1±8,4 years; total daily insulin dose on MDI (IU/day) 57,86±15,32; HbA1c (%) at the beginning of CSII treatment 8,67±1,54). HbA1c, glucose levels, BMI, severe hypoglycemic and diabetic ketoacidosis (DKA) episodes were recorded on a regular basis and compared to the data prior to CSII introduction. The evaluation of quality of life was assessed by a self-questionnaire adjusted from the SF-12 and diabetes quality of life (DQoL) questionnaires.

Results

Significant improvement was observed in all glycaemic parameters. HbA1c decreased from 8,67% ±1,54 at baseline to 6,85% ±0,52 (p0,001)(fig.1). Daily insulin requirements decreased to (36,40±12,20 IU/day) compared to baseline needs (57,86±15,32IU/day) (p0,001). BMI showed no significant alterations. The overall rate of hypoglycaemia was decreased by 71,5% (p0,001). Only 3 ketoacidosis incidents were recorded. Quality of life parameters were remarkably improved.

fig.1 Change in HbA1c levels

Conclusions

CSII treatment is superior to MDI schemes for Type 1 DM patients. CSII offers a safe, effective alternative to MDI schemes, with less side-effects, improved glycaemic control and quality of life.