Type 1 diabetes mellitus - Population characterization and metabolic control outcomes in a Portuguese patient sample

Prim Care Diabetes. 2023 Apr;17(2):175-179. doi: 10.1016/j.pcd.2023.01.001. Epub 2023 Jan 14.

Abstract

Aims: To characterize a cohort of T1D patients and to compare diabetes control between patients using different regimen of insulin therapy and glucose monitoring.

Methods: Were included all T1D patients followed at the Pediatric Endocrinology Unit, between April 1st and June 30th, 2021. Several clinical and demographic variables were analyzed.

Results: Our sample included 208 patients, 56.7 % males, mean age of 12.7 ± 4.6 years. The median HbA1c was 7.3 %. Most patients, 78.8% were treated with continuous subcutaneous insulin infusion (CSII) and 81.3 % used continuous glucose monitoring (CGM). CSII had a lower HbAc compared with multiple daily injections (MDI) users (7.1vs 8.1 %, p < 0.01). In the CSII group, those who used CGM had a lower HbAc (7.1 vs 7.5 %,p = 0.02). Analyzing the data of the ambulatory glucose report, the CSII users had a lower glucose management indicator, (7.2 % vs 7.6 %, p < 0.01), more time in range (58.0 % vs 52.4 %;p < 0.01) and less time above range > 250 mg/dL (12.4 % vs 20.5 %;p < 0.01) than MDI users.

Conclusions: The median HbA1c was 7.3% very close to the recommended target. In Portugal, pediatric patients can access a CSII provided by the national health service and a CGM system due to an elevated reimbursement of their cost. This healthy policy allows us to achieve better goals without the risk of hypoglycemia.

Keywords: Children; Glycemic control; Type 1 diabetes mellitus.

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring
  • Child
  • Diabetes Mellitus, Type 1* / diagnosis
  • Diabetes Mellitus, Type 1* / drug therapy
  • Female
  • Glycated Hemoglobin
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Insulin Infusion Systems / adverse effects
  • Male
  • Portugal
  • State Medicine

Substances

  • Hypoglycemic Agents
  • Glycated Hemoglobin
  • Blood Glucose
  • Insulin