Background and Aims

Insulin infusion pumps have been used for several years to treat type 1 diabetes in patients with insufficient metabolic control or with complications while on multiple insulin injections treatment. We have analyzed the results of this type of treatment in all patients of our Hospital.

Methods

We have conducted a retrospective, observational and analytical study including all patients undergoing continuous subcutaneous insulin infusion (CSII) in HUCA since its introduction in 2003. All clinical and analytical data and events have been collected until the end of 2018.

Results

102 patients were studied, 25 children and 77 adults. There were 76 women (75%) 26 (25%) men. Median follow-up was 4.2 years. The indications for CSII were gestation, pregestation, poor metabolic control, unawareness hyppoglycemia, unstable control or children.

The device was removed from 12 patients (12%).The previous HbA1c was 7.72% and 3 months after the beginning of the CSII was 7.21% (p <0.01). Reduction of HbA1c occurred in all groups, except in pregnant women.

During the follow-up HbA1c progressively increased without reaching the previous level in all groups except for pregnant women. Final HbA1c was 7,47 %.

While 26% of patients had at least had one episode of severe hypoglycaemia in the year prior to CSII , during more than 4 years of evolution only 14% had severe hypoglycaemia. (p<0.05)

Conclusions

Insulin pump treatment gets

1.-An improvement in short-term metabolic control , 0.5% reduction in HbA1c (p<0.01) that worsened later but without reaching previous level

2.- A Significative decrease of patients suffering severe hypoglycaemia.