THE INSULIN PUMP THERAPY IN TYPE 1 DIABETES: THE IMPORTANCE OF GLUCOSE VARIABILITY
Abstract
Introduction: The continuous subcutaneous insulin infusion regimen proved its effectiveness over multiple daily insulin doses. Although HbA1c has been brought to an optimal range, glucose variability remains one of the main challenges of this method.
Aim: The aim of this study was to investigate control of glucose variability in patients switched from MDII to the CSII therapeutic method.
Material and methods: This study is a retrograde analysis of data from the electronic database and files of 65 patients who were treated at the Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia. Data of HbA1c levels were analyzed, frequency of hypoglycemia on a weekly basis and daily glycemic profile, which determined parameters of glucose variability.
Results: The HbA1c value was lower after than before the insulin pump (p < 0.01). Individual glycemic values from the daily profiles, mean, SD, CV and MAGE of all glycemic profiles, were lower after than before insulin pump therapy (p < 0.05). The correlation was observed between HbA1c prior to the pump and the SD and MAGE prior to the pump (p < 0.01); HbA1c three months after the pump and SD and MAGE prior to the pump (p < 0.05); HbA1c six months after the pump and MAGE prior to the pump (p < 0.05); SD three months after the pump (p < 0.01), SD six months after the pump (p < 0.05) and CV three months after the pump (p < 0.01).
Conclusion: The therapeutic method of continuous subcutaneous insulin infusion regulates the level of HbA1, reduces the values of all glucose variability parameters and reduces the frequency of hypoglycemia compared to multiple daily insulin injections.
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