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Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion
- Publication Year :
- 2018
- Publisher :
- Elsevier B.V., 2018.
-
Abstract
- Background and aim: The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). Methods and results: Questionnaires investigating the organisation of diabetes care centres, individuals’ clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. The sample consisted of 6623 people with diabetes, which was obtained from 93 centres. Of them, 98.8% had type 1 diabetes mellitus, 57.2% were female, 64% used a conventional insulin pump and 36% used a sensor-augmented insulin pump. The median glycated haemoglobin (HbA1c) level was 60 mmol/mol (7.6%). The HbA1c target (i.e. 18 years) was achieved in 43.4% of paediatric and 23% of adult participants. Factors such as advanced pump functions, higher rate of sensor use, pregnancy in the year before the study and longer duration of diabetes were associated with lower HbA1c levels. The most common chronic complications occurring in diabetes were retinopathy, microalbuminuria and hypertension. In the year before the study, 5% of participants reported ≥1 episode of severe hypoglycaemic (SH) episodes (SH) and 2.6% reported ≥1 episode of ketoacidosis. Conclusions: Advanced personal skills and use of sensor-based pump are associated with better metabolic control outcomes in Italian people with diabetes who were treated with CSII. The reduction in SH episodes confirms the positive effect of CSII on hypoglycaemia. Clinical trial registration number: NCT 02620917 (ClinicalTrials.gov).
- Subjects :
- Blood Glucose
Male
Pediatrics
Acute and chronic complication
Glycated Hemoglobin A
Time Factors
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Medicine (miscellaneous)
Ketosi
Infusions, Subcutaneous
Settore MED/13 - Endocrinologia
Acute and chronic complications
Continuous subcutaneous insulin infusion (CSII)
Diabetes mellitus
Metabolic control
Nutrition and Dietetics
Cardiology and Cardiovascular Medicine
0302 clinical medicine
Endocrinology
Adolescent
Adult
Albuminuria
Biomarkers
Child
Cross-Sectional Studies
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Diabetic Nephropathies
Diabetic Retinopathy
Female
Health Care Surveys
Humans
Hypertension
Hypoglycemia
Hypoglycemic Agents
Insulin
Italy
Ketosis
Middle Aged
Risk Factors
Treatment Outcome
Young Adult
Insulin Infusion Systems
030212 general & internal medicine
Subcutaneous
Diabetic retinopathy
Diabetes and Metabolism
medicine.symptom
Type 2
Human
Type 1
Insulin pump
Infusions
medicine.medical_specialty
Diabetes mellitu
Time Factor
030209 endocrinology & metabolism
03 medical and health sciences
medicine
Cross-Sectional Studie
Glycated Hemoglobin
Type 1 diabetes
Hypoglycemic Agent
business.industry
Risk Factor
Biomarker
medicine.disease
Ketoacidosis
Infusions, Subcutaneou
Health Care Survey
Diabetic Nephropathie
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....f7ad5f75df250274f9908ca978da8bd5