Comparación del tratamiento con infusión subcutánea continua de insulina frente a la terapia con múltiples dosis de insulina con calculador de bolus en pacientes con diabetes tipo 1

Abstract

ObjectivesA study of the glycemic control, quality of life, and fear and perception of hypoglycemia by comparing continuous subcutaneous insulin infusion (CSII) group with multiple daily inyections (MDI) with bolus calculator group. Material and methodsThis is a retrospective cohort study with following up during the first 12 months that CSII group (n=30) begins the use of “bolus wizard” and the MDI-calculator (n=30) group begins the use of the bolus calculator (Accu-Chek® Aviva Expert). Primary outcome: HbA1c (3, 6 and 12 months). Questionnaires used: EsDQOL (quality of life), FH-15 (fear of hypoglycemia), and Clarke (perception of hypoglycemia). Statistical analysis: T Student and nonparametric tests. ResultsThe average reduction in HbA1c during the study was significantly higher in CSII group (−0.56±0.84%) compared with the MDI group (0.097±0.94%), P=.028. The average basal insulin dose was significantly higher in the MDI group (at baseline, 6 and 12 months). No significant differences were found between the 2 treatment groups after analyzing the EsDQOL, FH-15 and Clarke questionnaires. In the CSII group, perceived quality of life assessed by the EsDQOL questionnaire was found to be better at the end of the study than at the beginning of using the insulin pump. ConclusionsThe average reduction in HbA1c was significantly higher in the CSII group. In the CSII group, perceived quality of life was better at the end of the study than at the beginning.