title: An observational 7-year study of continuous subcutaneous insulin infusion for the treatment of type 1 diabetes mellitus.
abstract: This work reports the experience with use of continuous subcutaneous insulin infusion (CSII) in 112 type 1 diabetic patients followed up for 7 years and previously treated with multiple daily insulin injections (MDII).
  
  
  METHODS
  A retrospective, observational study in 112 patients with diabetes mellitus treated with CSII from 2005 to 2012, previously treated with MDII and receiving individualized diabetic education with a specific protocol. Variables analyzed included: prevalence of the different indications of pump treatment; mean annual HbA1c and fructosamine values before and after CSII treatment; and hypoglycemia frequency and symptoms.
  
  
  RESULTS
  The most common reason for pump treatment was brittle diabetes (74.1%), followed by frequent or severe hypoglycemia or hypoglycemia unawareness (44.6%). Other indications were irregular food intake times for professional reasons (20.2%), dawn phenomenon (15.7%), pregnancy (12.3%), requirement of very low insulin doses (8.9%), and gestational diabetes (0.9%). HbA1c decreased by between 0.6% and 0.9%, and fructosamine by between 5.1% and 12.26%. Nine percent of patients experienced hypoglycemia weekly, 24% every two weeks, and 48% monthly. No hypoglycemia occurred in 19% of patients. Only 10% had neuroglycopenic symptoms. Hypoglycemia unawareness was found in 21%. Hypoglycemia was more common at treatment start, and its frequency rapidly decreased thereafter.
  
  
  CONCLUSIONS
  CSII therapy provides a better glycemic control than MDII treatment. Specific patient training and fine adjustment of insulin infusion doses are required to prevent hypoglycemic episodes, which are the most common complications, mainly at the start of treatment.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Papargyri
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España. Electronic address: sylvieclick@hotmail.com.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Ojeda Rodríguez
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Corrales Hernández
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Mories Álvarez
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Recio Córdova
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Delgado Gómez
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Sánchez Marcos
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: Rosa Ana
authors.initials: RA
authors.lastname: Iglesias López
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Herrero Ruiz
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: Myriam
authors.initials: M
authors.lastname: Beaulieu Oriol
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario, Salamanca, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Miralles García
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Continuous subcutaneous insulin infusion; Diabetes mellitus; Hipoglucemia; Hypoglycemia; Infusión subcutánea continua de insulina; Insulin therapy; Insulinoterapia