FACTORS ASSOCIATED WITH CLINICALLY SIGNIFICANT HYPOGLYCEMIA IN PATIENTS WITH TYPE 1 DIABETES USING SUSPEND-BEFORE-LOW SENSOR AUGMENTED PUMP TECHNOLOGY.

Session Name
INSULIN PUMPS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:44 - 09:45
Presenter
  • Ana Maria Gomez, Colombia
Authors
  • Ana Maria Gomez, Colombia
  • Diana Henao, Colombia
  • Angelica M. Imitola, Colombia
  • Bruno Grassi corrales, Chile
  • Ignacio Conget, Spain
  • Marga Giménez, Spain
  • Clara Viñals, Spain
  • Rondon Martin, Colombia
  • Maira Garcia Jaramillo,
  • Fabian León-Vargas, Colombia

Abstract

Background and Aims

Despite using suspend-before-low sensor augmented pump (SBL-SAP), hypoglycemia is still an issue in 20% patients with type 1 Diabetes (T1D). Our aim was to determine factors associated with clinically significant hypoglycemia (<54mg/dl) in persons with T1D treated with SBL-SAP.

Methods

This is a longitudinal, multicenter study performed in Colombia, Chile and Spain. Patients with T1D treated with SBL-SAP using sensor 70 % of time, were included. Clinical and laboratory information closest the last upload of SBL-SAP was recorded from electronic records. Data regarding pump and sensor use and carbohydrate intake from 28 consecutive days were collected. A Poisson regression analysis was carried out, evaluating the number of events of <54mg/dl to identify the association with the variables described. A multivariate poisson regression analysis was performed, using the stepwise forward model for the significant variables in the bivariate analysis. The Akaike's and Bayesian information criterion was used to select the best model.

Results

188 subjects were included (41 years-old, 23 years disease duration, HbA1c 7.2%). The number of events <54 mg/dl were 6.70±9.06 events/patient/month, 77% of these events occurred during day time. The risk of hypoglycemia was higher in patients with previous severe hypoglycemia (IRR1.48; 95%CI[1.19-1.61];p=0.002), hypoglycemia unawareness (IRR1.36;95%CI[1.16-1.59];p=0.006), inadequate sensor calibration (IRR1.30;95%CI[1.11-1.51];p=0.017), >60% of total daily insulin dose as bolus (IRR1.31;95%CI[1.12-1.53];p=0.001) and CV% >36% (IRR 2,09;95%CI[1,79-2.45];p<0.001).

Conclusions

In spite of using advanced SAP technology, clinically significant hypoglycemia is still a non-negligible risk. Only the identification and intervention on factors related to that risk could help to prevent and reduce hypoglycemia in clinical practice.

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