Medical Faculty, Center for Insulin Pump and Sensor, University Clinic of Endocrinology , Diabetes and Metabolic Disorders, Skopje, Macedonia .
Diabetes Technol Ther. 2017 Dec;19(12):739-743. doi: 10.1089/dia.2017.0227. Epub 2017 Oct 4.
Subcutaneous insulin infusion (CSII) therapy is a challenge for both patients and healthcare providers. The long-term CSII use is scarce. The aim of this study is to describe the impact of CSII therapy for 10 years of use at our center.
This single-center retrospective study includes 162 type 1 diabetes patients using CSII for >3 years during October 2004 until October 2014. Data were collected through the electronic medical record system, cross-sectional analysis (telephone, e-mail, or social media), and CSII reports generated by Carelink Therapy Management Software (Medtronic, Northridge, CA).
Patients were analyzed in three age groups: 12-18, 19-24, and >25 years. All patients were treated with CSII for >3 years. Total daily dose of insulin was >0.9 U/(kg·day) in age group 12-18 years old, which was significantly higher than other two age groups (P < 0.05). Basal ratio was lower in younger age (<40%) and showed trend of increasing with age and longer diabetes duration (up to 44%). Younger patients used bolus wizard on regular basis (>75%), which was significantly higher than other age groups (P < 0.05). More than 50% of patients achieved glycated hemoglobin (HbA1c) <7.0% and >70% of patients achieved HbA1c <7.5%. HbA1c level significantly changed from baseline in all groups (P < 0.05).
Our study shows improved glucose control in long-term CSII users. A reduction of HbA1c levels by -1.1% was maintained during the study period.
皮下胰岛素输注（CSII）治疗对患者和医疗保健提供者都是一个挑战。长期使用 CSII 的情况很少见。本研究的目的是描述我们中心使用 CSII 治疗 10 年的影响。
这项单中心回顾性研究包括 162 名在 2004 年 10 月至 2014 年 10 月期间使用 CSII 超过 3 年的 1 型糖尿病患者。数据通过电子病历系统、横断面分析（电话、电子邮件或社交媒体）和 Carelink 治疗管理软件（Medtronic，Northridge，CA）生成的 CSII 报告收集。
患者被分为三组：12-18 岁、19-24 岁和>25 岁。所有患者均接受 CSII 治疗>3 年。12-18 岁年龄组的胰岛素日总剂量>0.9U/（kg·天），明显高于其他两组（P<0.05）。年轻患者（<40%）的基础比率较低，且随着年龄和糖尿病病程的延长呈上升趋势（高达 44%）。年轻患者经常使用常规剂量的推注向导（>75%），明显高于其他年龄组（P<0.05）。超过 50%的患者糖化血红蛋白（HbA1c）<7.0%，>70%的患者 HbA1c<7.5%。所有组的 HbA1c 水平均较基线显著降低（P<0.05）。
我们的研究表明，长期使用 CSII 的患者血糖控制得到改善。在研究期间，HbA1c 水平降低了-1.1%。
