Sensor-augmented pump (SAP) therapy can improve glycemic control, compared with multiple daily insulin injections or with insulin pump therapy alone, without increasing the risk of hypoglycemia.
Subjects and Methods
A 12-month observational study in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII), upon the introduction of continuous glucose monitoring (CGM), was conducted in 15 countries (in Europe and in Israel) to document the real-life use of SAP and assess which variables are associated with improvement in type 1 diabetes management.
Data from 263 patients (38% male; mean age, 28.0±15.7 years [range, 1–69 years]; body mass index, 23.3±4.9 kg/m2; diabetes duration, 13.9±10.7 years; CSII duration, 2.6±3 years) were collected. Baseline mean glycated hemoglobin A1c (HbA1c) was 8.1±1.4%; 82% had suboptimal HbA1c (≥7%). The average sensor use for 12 months was 30% (range, 0–94%), and sensor use decreased with time (first 3 months, 37%; last 3 months, 27%). Factors associated with improvement in HbA1c after 12 months in patients with baseline HbA1c ≥7% were high baseline HbA1c (P<0.001), older age group (P<0.001), and more frequent sensor use (P=0.047). Significantly less hospitalization, increased treatment satisfaction, and reduced fear of hypoglycemia were reported after 12 months of SAP.
This is the largest and longest multicenter prospective observational study providing real-life data on SAP. These results are consistent with those of controlled trials showing the effectiveness of CGM in pump users.