Real-world effectiveness and safety of sensor-augmented insulin pump therapy in adults with type 1 diabetes: Long-term follow-up.
OBJECTIVE
To evaluate the effectiveness and safety of sensor-augmented insulin pump therapy (SAP) in addition to a comprehensive diabetes program on glycated hemoglobin (HbA1c), severe hypoglycemia, ketoacidosis, and the hospital admission rate in patients with type 1 diabetes under real-world settings during a 2-year follow-up.


METHODS
This was a retrospective real-life study comparing diabetes control before and after SAP therapy initiation. Patients ≥18 years old with type 1 diabetes were included. They were followed for 2 years with clinical assessments at months 3, 6, 12, 18, and 24. Effectiveness was estimated by difference in medians of HbA1c from baseline and at each follow-up visit. Safety was assessed by comparing the annual rates of severe hypoglycemia, hyperglycemic crisis, and hospital admission related to diabetes.


RESULTS
162 patients were included, median age 32 years, women 73%). The main indication for SAP was poor metabolic control (51.2%). At 2 years HbA1c decreased from 8.4% to 7.5% (-0.9%, 95% CI: 0.5-1.2; p<0.0001), HbA1c ≤7% improved from 14.2% to 25.3% (11.1%, 95% CI: 19.7-2.5; p=0.006), and severe hypoglycemia decreased from 22.2% to 14.1% (-8.1%, 95% CI: -16.5 to 0.3; p=0.03).


CONCLUSIONS
SAP therapy improved glycemic control after the third month of use and for up to 2 years of follow-up, with lower rates of hospital admission and severe hypoglycemia. More studies are needed to assess the add-on impact of education programs and technologies for diabetes care.
['Coronel-Restrepo|Nicolás|N|', 'Blanco|Víctor Manuel|VM|', 'Palacio|Andres|A|', 'Ramírez-Rincón|Alex|A|', 'Arbeláez|Sebastián|S|', 'Duque|Valentina|V|', 'Pino|Juan José|JJ|', 'Carvajal|Javier|J|', 'Bedoya|Jorge|J|', 'Cuesta|Diana Paola|DP|', 'Botero|José Fernando|JF|']
Sensor-augmented insulin pump therapy Continuous glucose monitoring Continuous insulin infusion systems Diabetes mellitus tipo 1 Diabetes mellitus tipo 2 Glycated hemoglobin A1c Hemoglobina glicada A1c Monitoreo continuo de glucosa Sistemas de infusión continua de insulina Terapia con bomba de insulina aumentada por sensor Type 1 diabetes mellitus Type 2 diabetes mellitus