Continuous Subcutaneous Insulin Infusion Systems: The Experience of a Tertiary Center

Introduction: Continuous subcutaneous insulin infusion systems (CSIIS) are an option in the treatment of type 1 diabetes (DM1). They require an high degree of motivation by the patient and a close follow-up by a multidisciplinary team. The objective was to evaluate the metabolic control and acute complications of patients under CSIIS in our Hospital. Methods: Non-comparative, retrospective study. Data extraction from clinical processes. Statistical analysis in Excel 2010 and SPSS 21. Results: 46 patients were included, 33 (77.1%) females and 13 males (22.9%), mean age 38.5 +/- 9.9 years old, mean age at diagnosis of DM1 16.5 +/- 8.5 years old and mean age when the CSIIS was started of 35.5 +/- 9.5 years old. The reason for the initiation of the CSIIS was: preconception/pregnancy in 14 (30.4%), poor metabolic control in 12 (26.1%) patients, severe hypoglycemic episodes in seven (15.2%), glycemic variability in five (10.9%), low doses of insulin in four (8.7%) and lifestyle flexibility in four (8.7%). The mean HbA1c and total cholesterol previous/posterior placement of CSIIS was respectively 7.7% (+/- 1.1%)/7.5% (+/- 0.8%), +/-= 0.187, and 185.3 mg/dL (+/- 29.5 mg/dL)/177.0 mg/ dL (+/- 39.9 mg/dL), p = 0.811. The average weight before/after the start of treatment with CSIIS was 66.4 +/- 65.9 +/- 11.8 kg and 10.4 kg, p - 0.6, respectively. The average endocrine consultations/year per patient were 3.6. Regarding the complications of the CSIIS treatment, we have registered one case of severe hypoglycemia, one case of local skin complications (skin infection) and zero cases of diabetic ketoacidosis. Conclusion: Although not significant, there was a decrease in HbA1c and triglycerides after CSIIS treatment, without a significant increase in weight neither occurence of acute complications.