Impact on metabolic control in pediatric patients with use of technology applied to type 1 diabetes

Poch Estela Gil; Benito Lucía Babiano; Arroyo Díez Francisco Javier

Background and Aims: The treatment of type 1 diabetes (T1D) requires a great involvement of the patient to achieve optimal blood glucose levels. Technological devices have been developed for individualized treatment, fewer interventions of the patient, and evidence of improved metabolic control. The aim of the study is to know data on metabolic control in a group of pediatric patients with T1D treated with new technologies, compared to patients treated with multiple daily doses of insulin.

Methods: This is a retrospective observational study of 210 pediatric patients with T1D under follow-up in the Diabetes Unit of University Pediatric Hospital of Badajoz (Spain). Data on metabolic control and glycemic variability were studied in two groups of patients: patients treated with multiple daily doses of insulin with continuous glucose monitoring (DEXCOMG6™) or flash glucose monitoring (FREESTYLE2™), and patients treated with continuous subcutaneous insulin infusion (CSII): MiniMed™640G, MiniMed™670G and MiniMed™780G. In addition, we value the percentage of patients in each group that achieve the international standards of metabolic control.

Results: A statistically significant reduction in HbA1c was observed, as well as an increase in the time in target range of 70-180 mg/dl, a decrease in the time in hyperglycemia and a decrease in the average blood glucose and CV in the group of patients treated with CSII. No significant increase in time in hypoglycemia was observed. The results of the study are shown in table 1.

Table 1. Data on glucose control and glycaemic variability in both groups of patients, multiple daily doses of insulin and pump-sensor system (n=210).
	MDDI	CSII	p
HbA1c (%)	7,6	7	<0,001
TIR 70-180 mg/dl (%)	56,4	73,4	<0,001
Time <70 mg/dl (%)	3	2,2	0,117
Time <54 mg/dl (%)	0,6	0,5	0,661
Time >180 mg/dl (%)	26,5	20,7	<0,001
Time >250 mg/dl (%)	15,2	5	<0,001
Mean glucose (mg/dl)	174,5	150,6	<0,001
SD of glucose (mg/dl)	63,8	51,6	<0,001
CV (%)	37,3	33,8	<0,001

There is a higher percentage of patients in the group treated with CSII compared to the group treated with multiple daily doses of insulin who reach HbA1c target and time in range target (40,7% vs 26,8% and 63,4% vs 21,1% respectively), being evident in the age group between 6 and 12 years.

Conclusions: Treatment with continuous subcutaneous insulin infusion achieve greater benefit on metabolic control in pediatric patients with T1D compared to treatment with multiple daily doses of insulin.

ESPE Abstracts

P2-67