Continuous Subcutaneous Insulin Infusion and Its Characteristics in Young People with Type 1 Diabetes with Optimal Glucose Control (Preprint)

BACKGROUND Continuous subcutaneous insulin infusion (CSII) is established model for mimicking physiological insulin, which can overcome some of these barriers. CSII therapy is becoming more popular treatment modality in young people with T1D.Several studies have demonstrated the superiority of CSII over MDI therapy in T1D patients in terms of improved glucose control, the rate of hypoglycemia, dawn phenomenon and glucose variability OBJECTIVE To describe Continuous Subcutaneous Insulin Infusion (CSII) characteristics in young people with Type 1 Diabetes (T1D) with optimal glucose control and to describe possible simple CSII settings for fine tuning. METHODS This retrospective study was conducted at University Clinic of Endocrinology, Diabetes and Metabolic Disorders in Skopje. The study enrolled CSII patients with T1D (age 12-25 years) visited our center from January to December 2016. Patient characteristics were collected through the electronic medical record system and CSII characteristics were obtained from 8 weeks reports prior to Hba1c, generated by Carelink Therapy Management Software (Medtronic, Northridge, USA). RESULTS Ninety-three patients were grouped according age: 12-18 years and 19-25 years. More than 70% of patients achieved HbA1c <7.5% (<58 mmol/mol). Significant difference in basal insulin was found between two age groups. Patients aged 12-18 years had five basal segments, less basal rate in early morning (03-07h) and slight decrease of afternoon basal rate (13-19h), comparing with patients aged 19-25 years with four basal segments, more basal rate in early morning (03-07h) and no decrease of afternoon basal rate (13-19h). CONCLUSIONS Optimal glucose control is achievable in real life conditions among T1D patients on CSII therapy. Bolus wizard, frequent bolusing, multiple basal segments, and close follow up can be determinants for better control. Simple CSII settings as a tool, derived from our data may help clinicians to fine tune T1D patients and achieve optimal glucose control. CLINICALTRIAL EN16-12