Whether metabolic outcomes improve with continuous subcutaneous insulin infusion (CSII) more than with glucose monitoring systems in patients with type 1 diabetes mellitus (T1DM) remains controversial.
Objective: to assess metabolic changes after CSII or flash glucose monitoring system (FGMS) implementation in T1DM patients from a university hospital in the North of Spain
prospective and real-life study assessing metabolic outcomes in 110 T1DM patients on multiple daily insulin injections (MDI) before and 1 year after FGMS (41 patients) and CSII (69 patients) implementation.
mean age and gender were similar between groups (42,8 and 44,4 years and 61-63% women). Patients on CSII had longer duration of diabetes: 25 vs 17 years (p<0,005) and more non-proliferative retinopathy (61 vs 12%) rates than patients on MDI+FGMS but there were no differences on proliferative retinopathy and nephropathy. Mean HbA1c was higher at baseline in CSII patients than in MDI+FGMS (7,9±0,9 vs 7,6±1,1%, p<0,05). There were no differences in mild and severe hypoglycaemia episodes, hypoglycaemia unawareness or ketoacidosis between the two groups at baseline. Patients on CSII showed a change in HbA1c (-0,36%, p<0,001) 1 year after but patients on MDI+FGMS did not (-0,16%, ns). There were no differences in mild hypoglycaemia or ketoacidosis in both groups 1 year after. Both groups experienced less severe hypoglycaemia episodes and hypoglycaemia unawareness 1 year after than in baseline (p<0,05).
T1DM patients starting CSII underwent a greater improvement than MDI+FGMS 1 year after. Both groups showed improvement in severe hypoglycaemia and hypoglycaemia awareness.