title: Long-Term Efficacy and Safety of Sensor Augmented Insulin Pump Therapy with Low-Glucose Suspend Feature in Patients with Type 1 Diabetes.
abstract: Literature supports short-term efficacy and safety of Sensor Augmented Insulin Pump (SAP) therapy in patients with type 1 diabetes (T1D). However, no data are available showing long-term outcomes. Our study describes the long-term outcomes of SAP therapy with low-glucose suspend feature (SAP+LGS) in hypoglycemia in a Colombian population with T1D and hypoglycemia.
  
  
  
  A cohort study was conducted with T1D patients receiving SAP+LGS therapy who initiated this therapy because of hypoglycemia at San Ignacio University Hospital diabetes center in Bogotá, Colombia. Glycated hemoglobin (A1c) was assessed at least every 6 months, severe hypoglycemia (SH) and hypoglycemia unawareness (HU) incidence yearly. Adherence to therapy was also evaluated.
  
  
  
  One hundred eleven patients were included in the analysis. Total daily insulin dose was reduced during follow-up (mean difference -0.22 U/kg; 95% confidence interval [CI] -0.18 to -0.26; P < 0.001). A1c levels were reduced from a baseline value of 8.8% ± 1.9% to 7.5% ± 1.0% at 5 months (mean difference -1.3%; 95% CI -1.09 to -1.50; P < 0.001) and 7.1% ± 0.8% (mean difference -1.7%; 95% CI -1.59 to -1.90; P < 0.001) at the end of follow-up (47 months on average). The incidence of SH and HU episodes decreased significantly since the first year, and this effect was maintained over time (P < 0.001).
  
  
  
  SAP+LGS therapy in T1D patients with hypoglycemia led to a significant and sustained decrease in A1c during long periods of follow-up, as well as a significant reduction in SH and HU. Future randomized clinical trials are desired.
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .|2 Hospital Universitario San Ignacio , aUnidad de Endocrinología; bDepartamento de Medicina Interna; cDepartamenta de Epidemiologiía Clínica; Bogotá, Colombia .
authors.forename: Ana María
authors.initials: AM
authors.lastname: Gómez
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .|2 Hospital Universitario San Ignacio , aUnidad de Endocrinología; bDepartamento de Medicina Interna; cDepartamenta de Epidemiologiía Clínica; Bogotá, Colombia .
authors.forename: Lisseth Fernanda
authors.initials: LF
authors.lastname: Marín Carrillo
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .|2 Hospital Universitario San Ignacio , aUnidad de Endocrinología; bDepartamento de Medicina Interna; cDepartamenta de Epidemiologiía Clínica; Bogotá, Colombia .
authors.forename: Oscar Mauricio
authors.initials: OM
authors.lastname: Muñoz Velandia
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .|2 Hospital Universitario San Ignacio , aUnidad de Endocrinología; bDepartamento de Medicina Interna; cDepartamenta de Epidemiologiía Clínica; Bogotá, Colombia .
authors.forename: Martín Alonso
authors.initials: MA
authors.lastname: Rondón Sepúlveda
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .|2 Hospital Universitario San Ignacio , aUnidad de Endocrinología; bDepartamento de Medicina Interna; cDepartamenta de Epidemiologiía Clínica; Bogotá, Colombia .
authors.forename: Carol M
authors.initials: CM
authors.lastname: Arévalo Correa
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .
authors.forename: Edwin
authors.initials: E
authors.lastname: Mora Garzón
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .|2 Hospital Universitario San Ignacio , aUnidad de Endocrinología; bDepartamento de Medicina Interna; cDepartamenta de Epidemiologiía Clínica; Bogotá, Colombia .
authors.forename: Maria Camila
authors.initials: MC
authors.lastname: Cuervo Diaz
authors.affiliation: 1 Pontificia Universidad Javeriana , Facultad de Medicina, Bogotá, Colombia .|2 Hospital Universitario San Ignacio , aUnidad de Endocrinología; bDepartamento de Medicina Interna; cDepartamenta de Epidemiologiía Clínica; Bogotá, Colombia .
authors.forename: Diana Cristina
authors.initials: DC
authors.lastname: Henao Carrillo
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007332:Insulin Infusion Systems / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Continuous glucose monitoring; Continuous subcutaneous insulin infusion; Hypoglycemia unawareness.; Long-term follow-up; Low-glucose suspend function; Sensor augmented insulin pump therapy; Severe hypoglycemia; Type 1 diabetes