title: [Continuous insulin therapy versus multiple insulin injections in the management of type 1 diabetes: a longitutinal study].
abstract: OBJECTIVE
  To compare multiple doses of insulin and continuous insulin infusion therapy as treatment for type 1 diabetes melito.
  
  
  METHODS
  40 patients with type 1 diabetes melito (21 female) with ages between 10 and 20 years (mean=14.2) and mean duration of diabetes of 7 years used multiple doses of insulin for at least 6 months and after that, continuous insulin infusion therapy for at least 6 months. Each one of the patients has used multiple doses of insulin and continuous insulin infusion therapy. For analysis of HbA1c, mean glycated hemoglobin levels (mHbA1c) were obtained during each treatment period (multiple doses of insulin and continuous insulin infusion therapy period).
  
  
  RESULTS
  Although mHbA1c levels were lower during continuous insulin infusion therapy the difference was not statistically significant. During multiple doses of insulin, 14.2% had mHbA1c values below 7.5% vs. 35.71% while on continuous insulin infusion therapy; demonstrating better glycemic control with the use of continuous insulin infusion therapy. During multiple doses of insulin, 15-40 patients have severe hypoglycemic events versus 5-40 continuous insulin infusion therapy. No episodes of ketoacidosis events were recorded.
  
  
  CONCLUSIONS
  This is the first study with this design comparing multiple doses of insulin and continuous insulin infusion therapy in Brazil showing no significant difference in HbA1c; hypoglycemic events were less frequent during continuous insulin infusion therapy than during multiple doses of insulin and the percentage of patients who achieved a HbA1c less than 7.5% was greater during continuous insulin infusion therapy than multiple doses of insulin therapy.
authors.affiliation: Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Maria Estela Bellini
authors.initials: ME
authors.lastname: Ribeiro
authors.affiliation: Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil. Electronic address: rliberatore@fmrp.usp.br.
authors.forename: Raphael
authors.initials: R
authors.lastname: Del Roio Liberatore Junior
authors.affiliation: Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Custodio
authors.affiliation: Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Martinelli Junior
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008137:Longitudinal Studies; D008297:Male; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Adolescentes; Adolescents; Diabetes melito tipo 1; Insulin; Insulin infusion systems; Insulina; Sistemas de infusão de insulina; Type 1 diabetes mellitus
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