Korean Diabetes Association

Short Communication

Type 1 Diabetes

Diabetes Metab J. 2022;46(1):149-153.

Published online: July 6, 2021

DOI: https://doi.org/10.4093/dmj.2020.0267

Real-World Analysis of Therapeutic Outcome in Type 1 Diabetes Mellitus at a Tertiary Care Center

Antonia Kietaibl^1,²

, Michaela Riedl¹

, Latife Bozkurt^1,³

¹Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

²Department of 5th Internal Medicine with Endocrinology, Rheumatology and Gerontology with Outpatient Department, Clinic Ottakring, Vienna, Austria

³Department of 3rd Internal Medicine with Metabolic Disorders and Nephrology, Clinic Hietzing, Vienna, Austria

Corresponding author: Latife Bozkurt https://orcid.org/0000-0002-3079-9226 Department of 3rd Internal Medicine with Metabolic Disorders and Nephrology, Clinic Hietzing, Wolkersbergenstraße 1, Vienna 1130, Austria E-mail: latife.bozkurt@gesundheitsverbund.at

Received November 10, 2020 Accepted February 10, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Insulin replacement in type 1 diabetes mellitus (T1DM) needs intensified treatment, which can either be performed by multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). This retrospective analysis of a real-world scenario aimed to evaluate whether glycaemic and cardiovascular risk factors could be controlled with CSII outclass MDI as suggested by recent evidence. Data from patients with either insulin pump (n=68) or injection (n=224) therapy at an Austrian tertiary care centre were analysed between January 2016 and December 2017. There were no significant differences with regard to the latest glycosylated hemoglobin, cardiovascular risk factor control or diabetes-associated late complications. Hypoglycaemia was less frequent (P<0.001), sensor-augmented therapy was more common (P=0.003) and mean body mass index (BMI) was higher (P=0.002) with CSII treatment. This retrospective analysis of real-world data in T1DM did not demonstrate the superiority of insulin pump treatment with regard to glycaemic control or cardiovascular risk factor control.

Keywords: Blood glucose self-monitoring; Diabetes mellitus, type 1; Glycemic control; Injections, subcutaneous; Insulin infusion systems; Treatment outcome

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Highlights

• Insulin pump treatment did not outclass injection therapy with regard to hemoglobin A1c, cardiovascular risk factor control or diabetes-associated complications in this real-world collective.

• Hypoglycemia and use of sensor-augmented therapy improved within the pump treatment group.

• Future research questions should address hybrid-closed and closed loop systems and incorporate newer target parameters.

• Rapid advancements in diabetic technologies need to be evaluated before implementation in daily diabetes management.

Articles

Articles

Real-World Analysis of Therapeutic Outcome in Type 1 Diabetes Mellitus at a Tertiary Care Center

Abstract

Highlights