Background and Aims

After 30 years of diabetes, an equilibrium state must be achieved regarding T1D management. A change in this state implies a lot of effort, creativity and work for physician’s side and acceptance, understanding and learning for patient’s side.

This study aims to show a 5 years’ experience in introducing technology in T1D management in patients with 30+ year’s duration of diabetes, materialized in a model of efficiency of this process.

Methods

Over 38 patients were part of this study. Process started with an evaluation both of, medical, knowledge and understanding, control and lifestyle situation. Communication is the central part of the process the binder which allow transition through the stages of the process. Permanent learning and transformation of equilibrium status supervised by physician allow overcoming resistance to change.

All the process is illustrated bellow:

Results

After implementing CGMS with/without Pump in all our patients with long diabetes duration, and with a carefull follow up of the entire process, we were able to develop a model that helps implementing this kind of technology.

Following this model and after the treatment change we have obtained a 1.3% reduction of HbA1c and significantly less hypoglicemic events RR 34% (p<0.01). Patients' acceptance of the new treatment increased in time by 92%.

Conclusions

Overcoming resistance to change and transitioning to technology-based management is a major problem for patients with long-term diabetes.
The proposed model has proven its effectiveness not only in achieving this transformation and reaching glycemic targets but also in changing their lifestyle.