Assessing the Effects of the Transition from Multiple Daily Insulin Injections (MDI) to Continuous Subcutaneous Insulin Infusion in the Intensive Treatment of Type 1 Diabetes Mellitus

Autor: Oliveira, SC, Neves, C, Esteves, C, Neves, JS, Oliveira, AI, Pereira, M, Arteiro, Cristina, Costa, A, Redondo, MD, Baltazar, R, Carvalho, D
Přispěvatelé: Faculdade de Ciências da Nutrição e Alimentação, Faculdade de Medicina
Jazyk: portugalština
Rok vydání: 2019
Předmět:
Zdroj: Repositório Científico de Acesso Aberto de Portugal
Repositório Científico de Acesso Aberto de Portugal (RCAAP)
instacron:RCAAP
Popis: Introduction: Intensive insulin therapy is currently the main treatment in type I diabetes mellitus (DM) which includes multiple daily insulin injections (MDI) and continuous subcutaneous insulin infusion (CSII). The latter has become the preferred therapeutic mode, since it better mimics the physiological pancreatic action, althought there is limited evidence that supports its superiority to MDI. The aim of our study was to assess the effects of the transition from MDI to CSII in the intensive treatment of type 1 DM. Material and Methods: A retrospective longitudinal study was perfonned in MDI patients that transited to CSII between 2006 and 2014. Data were collected regarding to weight, HbA1c, plasma glucose, lipid profile, creatinine, weekly frequency of episodes of hypoglycemia and hyperglycemia and presence of microvascular complications. The effects of the transition to CSII were also compared according to the following subgroups: pre-CSII HbA1c (7.0%); age ( 35 years); gender (male versus female); BMI (25 kg/m2); duration of illness ( 15 years); total daily dose (TDD) of insulin ( 45 units of insulin); ISF ( 40) and microvascular complications (presence versus absence). Results: The sample included 85 patients, mean age 38 +/- 11 years, 50 (58.8%) female, with duration of the disease 21 +/- 9 years. There was a significant reduction in the frequency of hypo and hyperglycemia events after transition to CSII (3.0 +/- 5.0 vs 2 +/- 2.2 per week, p= 0.001 and 5.5 +/- 6.1 vs 2.5 +/- 2.6 per week, p = 0.05, respectively). We also observed a greater glycemic benefit in the subgroups of patients with poorer metabolic control (HbA1c > 7%) compared to those with HbA1c s
Databáze: OpenAIRE
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