Abstract
Background: This study compared the effects of insulin pump (IP) vs. multiple daily injection therapy (MDI) on glucose variability (GV) evaluated by professional Continuous Glucose Monitoring (CGM) in real-life condition of patients with type 1 diabetes (T1D). Methods: This was a parallel study in 120 T1D patients, with a mean age of 31.2 years, and hemoglobin A1c (HbA1c) level of 8.3%; 99 patients were treated MDI (66 patients with Glargine U100, 13 with Detemir, 20 with Degludec U100) and 21 with IP. The primary end point was the coefficient of variation (CV) of blood glucose. Secondary end points included HbA1c, mean amplitude of glycemic excursions (MAGE). We compared IP vs. MDI. Results: IP was not different to MDI respect to CV (37.94±1.68 vs. 40.32±075; p=0.12) and HbA1c (8.59±0.20 vs. 8.23±0.15; p=0.39). There were also no significant differences between treatment groups with respect to MAGE (308.75±11.28 vs. 309.22±5.17; p=0.92) and total doses of insulin (35.14±4.77 vs. 42.88±2,22; p=0.36). In multiple regression analyses, the CV was positively associated with MAGE and negatively with HbA1c only 22% (R2: 0,22, p = 0.01). Conclusion: In our population in real world data, no significant difference was observed in the GV indicators in patients treated with MDI vs. IP. Disclosure A.E. Proietti: None. A.V. Daghero: None. M.L. Scapuzzi: None. M.L. Iglesias: None. J.P. Nogueira: None.
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