Long-term Benefits in Emergency Admissions, Hospitalization and Metabolic Control of an Integrated Continuous Glucose Monitoring and Insulin Pump System in a Cohort of Diabetic Patients

Abstract

Abstract Background: There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with type 1 diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. Our paper describes the outcomes of metabolic control, incidence of hospitalizations and emergency room visits in a Colombian population using this technology. Methods: A retrospective cohort study was carried out in patients with diabetes previously treated with an intensive insulin regimen at a specialized diabetes treatment center in Bogotá, Colombia, who required sensor-augmented insulin pumps due to poor metabolic control despite optimization of medical management. Glycated hemoglobin, severe hypoglycemic episodes, non-severe hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. Results: Sixty-four patients with a median age of 36 years (interquartile range 27-46) were included in the study. We found statistical reduction of glycated hemoglobin (8.35% vs. 7%), non-severe hypoglycemic episodes (95.9% vs. 87.7%), emergency room visits (57.5%to 6.45%) and hospitalization (50% vs. 13.79%) in patients using CSII. Conclusions: The use of sensor-augmented insulin pumps coupled with a strict follow-up program for patients with type 1 diabetes leads to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results encourage the adoption of this technology in patients who do not achieve metabolic control with optimal management of type 1 diabetes.