title: [Comparison between continuous subcutaneous insulin infusion and multiple daily injection regimens in adolescent with type 1 diabetes from a public health care system approach to severe hypoglycemia].
abstract: OBJECTIVE
  We compared the incidence of severe hypoglycemia episodes with therapy with multiple doses of insulin (MDI) and after changing to pump (CSII).
  
  
  METHODS
  7 T1DM patients with 14 years median and median duration of diabetes of 8 years. We analyzed insulin requirement (U/kg/day), BMI (Kg/m(2)), HbA1c (normal range: 3.5-6.7%) one year before and one year after changing therapy. The severe hypoglycemia episodes decreased from 1.3 to 0 episodes/patient/year; p = 0.00). The insulin requirement decreased from 1.33 +/- 0.26 U/Kg/day to 0.87 +/- 0.17 U/kg/day; p = 0.04 and HbA1c decreased from 8.7 +/- 0.7% to 7.8 +/- 0.9%; p = 0.05.
  
  
  CONCLUSIONS
  CSII is efficient in decreasing severe hypoglycemia in a subgroup of T1DM using MDI also in Public Health Care System (PHCS) conditions. However, these finding should be reproduced by other Diabetes Care centers and cost studies are necessary to confirm the viability and possibility of this therapy, when necessary, to T1DM patients, which correspond to the majority of these individuals in our country, seeing in the PHCS.
authors.affiliation: Departamento de Medicina, Centro de Diabetes, EPM, Federal University of São Paulo, SP. gabbay@ajato.com.br
authors.forename: Mônica A L
authors.initials: MA
authors.lastname: Gabbay
authors.forename: Sérgio A
authors.initials: SA
authors.lastname: Dib
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation; D015992:Body Mass Index; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy* / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems / Q000592:standards*; D008297:Male; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
vernacular_title: Comparação entre a bomba de infusão de insulina subcutânea e o esquema de múltiplas doses de insulina em adolescentes com diabetes melito do tipo 1 da rede pública de saúde na abordagem da hipoglicemia grave.