Sustained benefit of continuous subcutaneous insulin infusion on glycaemic control and hypoglycaemia in adults with Type 1 XXXX .

@entity1 @entity6 @entity4051
AIM: To evaluate the sustainability of the benefits of continuous subcutaneous insulin infusion therapy in routine practice in a cohort of adults with @entity6 . METHODS: The clinical records of all adults starting continuous subcutaneous insulin infusion over 12  years at our centre were included in this study. Baseline and mean annual HbA1c levels were recorded. The frequency of mild-to-moderate and severe hypoglycaemia and hypoglycaemia awareness were analysed in a subgroup. RESULTS: Adequate data were available from 327 @entity1 , of whom 71% were female. The @entity1 ' mean      sd age was 41      14  years, the mean      sd (range) follow-up for continuous subcutaneous insulin infusion was 4.3      2.7 (1-12) years. The mean      sd @entity4051 c concentration fell by 8      5  mmol/mol (0.7      0.5%) at year 1 [to 63      12  mmol/mol from 70      18  mmol/mol (7.9      1.1% from 8.6      1.6%); P  <  0.0005], sustained to year 5. In @entity1 with initial poor control, HbA1c dropped by 12      11  mmol/mol (1.1      1.0%; P  <  0.0005) at year 1, sustained to year 6. The percentage of @entity1 with >=   5 mild to moderate hypoglycaemic episodes per week fell from 29 to 12% (n  =  163; P  =  0.006). In the subgroup (n  =  87; follow-up 2.5      mean      sd 1.1  years), the frequency of severe hypoglycaemia fell from 0.6      1.7 episodes per @entity1 per year to 0.3      0.9 (P  =  0.047). Of 24 @entity1 with impaired awareness of hypoglycaemia (Gold score >=   4), the mean      sd Gold score improved from 4.9      0.9 to 3.8      1.7 (P  =  0.011). Nine @entity1 regained awareness. No deterioration in HbA1c was seen in the hypoglycaemia-prone groups. CONCLUSIONS: The benefits of continuous subcutaneous insulin infusion with regard to improving glycaemic control and reducing hypoglycaemia frequency, along with improvement in hypoglycaemia awareness without deterioration in glycaemic control, can be sustained over several years in clinical practice.
