Continuous subcutaneous insulin infusion ("InsulinPump") in pediatric patients with type 1 diabetes:experience in a Chilean state hospital

Arriaza, M; Rios, B; Gonzalez, M; Chavez,K; Fuentes ,M,

Keywords: insuline pump


P361Continuous subcutaneous insulin infusion ("InsulinPump") in pediatric patients with type 1 diabetes:experience in a Chilean state hospitalM. Arriaza1, B. Rios1,2, M. Gonzalez1, K. Chavez3, M. Fuentes11Hospital Dr. Gustavo Fricke, Pediatric Department, Viña del Mar, Chile,2Universidad Andres Bello, Viña del Mar, Chile,3Universidad deValparaiso, Pediatric Department, Viña del Mar, ChileBackground: The DDCT and UKPDS highlight the importance ofintensive care in patients with T1D through MDI or CSII, achievingbetter metabolic control and prevention of complications. In pediat-rics, the goal is to reduce the incidence of severe hypoglycemia, gly-cemic variability and HbA1c by 7.5%. CSII is associated with a lesshypoglycemia, insulin doses, better glycemic control, and quality oflife. Despite these results it remains underused, particularly in chil-dren. In Chile until the year 2017 this therapy was self-financed limit-ing access in state hospitals.Objective: To describe the results of a pilot project in 8 pediatricpatients with T1D in CSII treatment without CGMS, between March2013 and June 2016. We report changes in HbA1c levels, severity ofhypoglycaemia, acute decompensations, hospitalizations, and changesin the quality of life of patients and their families.Methods: Retrospective patient file analysis of 8 T1D children inCSII. The selection of cases was performed based on age under5 years, good medical adherence, recurrent hypoglycemia, glycemicvariability independent of the value of HbA1C and parents with psy-chological competence. The PedsQL questionnaire was applied to all patients. Results: 6 of 8 patients were treated with MDI for at least 6 monthsprior to initiating CIIS. In 4 patients the HbA1C was reduced by0.77% and in 2 it was reduced by 1.25%. The HbA1c average in lastyear was 7.53% (7/8). There were no episodes of severe hypoglyce-mia or acute diabetes decompensation. All patients or relativesshowed improvement in their quality of life.Conclusions: Our experience is in agreement with the literature. Bet-ter metabolic control is achieved with the use of CIIS withoutincreasing the risk of complications. Although our patients did nothave CGMS, it is not possible to establish asymptomatic or inadvert-ent hypoglycemia. These results justify the incorporation of CSII intothe pediatric Chilean population with DT1.

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Fecha de publicación: 2017
Año de Inicio/Término: 18-20 octubre 2017
Página de inicio: 138
Página final: 177
Idioma: inglés