ESPE Abstracts

Almost 100 years ago, a major turning point in the life expectancy of people with diabetes around the world was reached with the discovery of insulin. In 1936, Hagedorn had the ingenious idea of combining insulin with a protein, protamine, and zinc and his NPH was used almost mainly in pediatrics until the end of 2003, when glargine U100 made its appearance.

Objective: To evaluate the clinical experience in the incorporation of different insulin analogues and technology in our current practice Methods: DM1 patients older than 6 months from the start of follow-up in specialty consultations at our center. Assessment of age, sex, age of debut, HbA1c, type of technology used. Descriptive study IBM SPSS Stastistics 19.0.

Results: 71 children (35♂), mean age 9.8 a [2-17]. HbA1c (DCA): 7.9% [6.1-9.2], debut time 3.9a [0.8-10.1], mean weight -0.32 SDS [-1.2, + 0.8], mean BMI - 0.28 SDS [-1.4, + 0.9]. 84% use MDI, 6 insulin pumps. 98% use some non-capillary glucose monitoring or control system (1 patient refuses), either type continuous monitoring for age <4th or linked to CSII or flash type. Of the 6 pumps, they use lispro (4/6), aspartic (1/6) and another glulisine (1/6) Of the MDIs, as slow analogs NPH 0/65, detemir 12/65 (85% are <6 years), U100 10/65, U300 35/65 liraglutide 8/65. The indication has been for age, comfort, morning / night dissociated doses, variability control and switch due to poor previous basal adjustment. Of the MDIs, such as fast analogues è Actrapid 0/65, lispro 30/65 (1 U200 off labell per dose), aspartic 10/65, ultrafast (15/65) and glulisine 10/65 The indication has been for age, comfort, dose / need for stockings and a pen for this purpose and switch due to poor adjustment of the previous analog. 68/71 patients (100% of> 4th) are on inhaled glucagon. There was no impediment by medical inspection in any prescription except in 1 case (belonging to another health area) with BAQSIMI Previous severe hypoglycemia with previous loss of consciousness in <5% of cases (0.03 patient / year cases). ISCI offered to 70% of families. 80% initial rejection rate by the family or the patient himself.

Conclusion: We assume that this study may have some shortcomings due to the size of the sample, but our study demonstrates the implementation of the most modern analogs in the office, of measurement technology, but the need to advance in the use of insulin pumps.