Over the past years there was significant innovation in diabetes drug and device development. In Portugal, the universal access to continuous subcutaneous insulin infusion therapy (CSII) is recent; since 2019 all pediatric patients should receive this therapy. The objective of this study was to evaluate glycemic control in patients using CSII and to compare it according to the time of onset.
We performed a retrospective study, in which we analyzed the patients admitted in a level III Pediatric Hospital with the diagnosis of type 1 diabetes and treated with CSII. There were evaluated demographic and clinical characteristics and laboratory tests (sex, age, date of diagnosis of diabetes, HbA1c and C peptide at the diagnosis, date of CSII onset, HbA1c at CSII onset and six months later). Patients were divided into three different groups: those who started CSII during the first year of disease (1), between the second and the fifth year of disease (2) and after that (3).
We analyzed 124 patients, with a male predominance. The median age at the diagnosis was 8 years old. There were 30 patients in group 1, 64 in group 2 and 30 in group 3. Considering glycemic control, we described a decrease in HbA1c in all groups, which was higher in group 1 (0,83%, 0,65% and 0,23% in group 1, 2 and 3 respectively).
Although not statistically significant, due mostly to the small sample size, we should consider that CSII allows a better glycemic control when started soon after the diagnosis of diabetes.