Long-Term Efficacy and Safety of Sensor Augmented Insulin Pump Therapy with Low-Glucose Suspend Feature in Patients with Type 1 Diabetes.

Abstract

BACKGROUND:

Literature supports short-term efficacy and safety of Sensor Augmented Insulin Pump (SAP) therapy in patients with type 1 diabetes (T1D). However, no data are available showing long-term outcomes. Our study describes the long-term outcomes of SAP therapy with low-glucose suspend feature (SAP+LGS) in hypoglycemia in a Colombian population with T1D and hypoglycemia.

METHODS:

A cohort study was conducted with T1D patients receiving SAP+LGS therapy who initiated this therapy because of hypoglycemia at San Ignacio University Hospital diabetes center in Bogotá, Colombia. Glycated hemoglobin (A1c) was assessed at least every 6 months, severe hypoglycemia (SH) and hypoglycemia unawareness (HU) incidence yearly. Adherence to therapy was also evaluated.

RESULTS:

One hundred eleven patients were included in the analysis. Total daily insulin dose was reduced during follow-up (mean difference -0.22 U/kg; 95% confidence interval [CI] -0.18 to -0.26; P < 0.001). A1c levels were reduced from a baseline value of 8.8% ± 1.9% to 7.5% ± 1.0% at 5 months (mean difference -1.3%; 95% CI -1.09 to -1.50; P < 0.001) and 7.1% ± 0.8% (mean difference -1.7%; 95% CI -1.59 to -1.90; P < 0.001) at the end of follow-up (47 months on average). The incidence of SH and HU episodes decreased significantly since the first year, and this effect was maintained over time (P < 0.001).

CONCLUSIONS:

SAP+LGS therapy in T1D patients with hypoglycemia led to a significant and sustained decrease in A1c during long periods of follow-up, as well as a significant reduction in SH and HU. Future randomized clinical trials are desired.

• Authors: Ana María Gómez, Lisseth Fernanda Marín Carrillo, Oscar Mauricio Muñoz Velandia, Martín Alonso Rondón Sepúlveda, Carol M Arévalo Correa, Edwin Mora Garzón, Maria Camila Cuervo Diaz, Diana Cristina Henao Carrillo
• Journal: Diabetes technology & therapeutics (Diabetes Technol Ther) Vol. 19 Issue 2 Pg. 109-114 (02 2017) ISSN: 1557-8593 [Electronic] United States
• PMID: 28001445 (Publication Type: Journal Article)

Chemical References

• Blood Glucose
• Hypoglycemic Agents
• Insulin

Topics

• Adult
• Blood Glucose (analysis)
• Diabetes Mellitus, Type 1 (blood, drug therapy)
• Female
• Follow-Up Studies
• Humans
• Hypoglycemia (chemically induced)
• Hypoglycemic Agents (administration & dosage, adverse effects, therapeutic use)
• Insulin (administration & dosage, adverse effects, therapeutic use)
• Insulin Infusion Systems (adverse effects)
• Male
• Middle Aged
• Quality of Life
• Treatment Outcome