Falla autonómica asociada a hipoglucemia

Houssay, Solange; Recalde, Maricel; Rey, Marcela Giménez; Garcı́a, Concepción; Urdaneta, Raquel; Huber, Fernanda; Flores, Claudia Lorena Urzua; Domínguez, Carolina; Nader, Emilio

doi:10.47196/diab.v55i2.473

Cited by 3 publications

(3 citation statements)

References 78 publications

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“…The body mass index (BMI) was ). Of the total population, 41 (55%) were female, and most had a diagnosis of T1D (71; 95%), with 20 years since diagnosis (IQR [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The median number of years of follow-up using the SAP was four years (IQR 2-7).…”

Section: Resultsmentioning

confidence: 99%

“…The assessment of adherence to treatment and the measurement of variables related to insulin pump use were reviewed through the Care-Link Medtronic system software. We used the Gold scale as an assessment tool for hypoglycemia, with lower values indicating a greater perception of hypoglycemia and higher values re ecting a total loss of its perception [30].…”

Section: Methodsmentioning

confidence: 99%

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Long-term Benefits in Emergency Admissions, Hospitalization and Metabolic Control of an Integrated Continuous Glucose Monitoring and Insulin Pump System in a Cohort of Diabetic Patients

O'Meara

Acuña

Uribe

2022

Preprint

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Background: There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with type 1 diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. Our paper describes the outcomes of metabolic control, incidence of hospitalizations and emergency room visits in a Colombian population using this technology. Methods: A retrospective cohort study was carried out in patients with diabetes previously treated with an intensive insulin regimen at a specialized diabetes treatment center in Bogotá, Colombia, who required sensor-augmented insulin pumps due to poor metabolic control despite optimization of medical management. Glycated hemoglobin, severe hypoglycemic episodes, non-severe hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. Results: Sixty-four patients with a median age of 36 years (interquartile range 27-46) were included in the study. We found statistical reduction of glycated hemoglobin (8.35% vs. 7%), non-severe hypoglycemic episodes (95.9% vs. 87.7%), emergency room visits (57.5%to 6.45%) and hospitalization (50% vs. 13.79%) in patients using CSII. Conclusions: The use of sensor-augmented insulin pumps coupled with a strict follow-up program for patients with type 1 diabetes leads to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results encourage the adoption of this technology in patients who do not achieve metabolic control with optimal management of type 1 diabetes.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Long-term Benefits in Emergency Admissions, Hospitalization and Metabolic Control of an Integrated Continuous Glucose Monitoring and Insulin Pump System in a Cohort of Diabetic Patients

O'Meara

Acuña

Uribe

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Adherence to treatment and the measurement of variables related to insulin pump use were reviewed using the CareLink Medtronic system software. We used the Gold scale as an assessment tool for hypoglycemia awareness, with lower values indicating a greater perception of hypoglycemia and higher values reflecting a lack of perception [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

Long-Term Benefits of an Integrated Continuous Glucose Monitoring and Insulin Pump System for Emergency Admissions, Hospitalization, and Metabolic Control in a Cohort of People With Diabetes: Retrospective Cohort Study

O'Meara,

Mateus Acuña,

Uribe

2023

JMIR Diabetes

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Background There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with high-complexity diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. This study describes outcomes for metabolic control, incidence of hospitalizations, and emergency room visits in a specific population using this technology. Objective We aimed to assess long-term glycemic and clinical outcomes after the use of continuous subcutaneous insulin infusion and continuous glucose monitoring in people with diabetes. Methods A retrospective cohort study was carried out in patients with diabetes previously treated with an intensive insulin regimen at a specialized diabetes treatment center who required a sensor-augmented insulin pump due to nonoptimal glycemic control. Glycated hemoglobin, severe hypoglycemic episodes, nonsevere hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. Results Between January 2013 and August 2020, 74 patients with a median age of 36 (IQR 27-46) years were included in the study with a median 4 (IQR 2-7) years of follow-up. We found a statistically significant reduction in glycated hemoglobin (8.35% vs 7%; P<.001), nonsevere hypoglycemic episodes (71/74, 96% vs 62/74, 84%; P=.01), emergency room visits (42/73, 58% vs 4/62, 6%; P<.001), and hospitalizations (36/72, 50% vs 10/72, 14%; P<.001) after use of continuous subcutaneous insulin infusion. Conclusions The use of a sensor-augmented insulin pump associated with a strict follow-up program for patients with high-complexity diabetes led to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results encourage the adoption of this technology in patients who do not achieve metabolic control with optimal management of diabetes.

show abstract

Long-term Benefits in Emergency Admissions, Hospitalization and Metabolic Control of an Integrated Continuous Glucose Monitoring and Insulin Pump System in a Cohort of Diabetic Patients

O'Meara¹,

Acuña

Uribe

2022

Preprint

View full text Add to dashboard Cite

Background There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with type 1 diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. Our paper describes the outcomes of metabolic control, incidence of hospitalizations and emergency room visits in a Colombian population using this technology. Methods A retrospective cohort study was carried out in patients with diabetes being treated with an intensive insulin regimen at a specialized diabetes treatment center in Bogotá, Colombia, who required sensor-augmented insulin pumps due to poor metabolic control. Glycated hemoglobin, severe hypoglycemic episodes, non-severe hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. Results Sixty-four patients with a median age of 36 years (interquartile range 2746) were included in the study. We found better long-term management in terms of glycated hemoglobin (8.35% vs. 7%), non-severe hypoglycemic episodes (95.9% vs. 87.7%), emergency room visits (57.5% to 6.45%) and hospitalization (50% vs. 13.79%). Conclusions The use of sensor-augmented insulin pumps coupled with a strict follow up program for patients with type 1 diabetes leads to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results incentivize the adoption of this technology in patients who do not achieve metabolic control with optimal management of type 1 diabetes.

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Falla autonómica asociada a hipoglucemia

Cited by 3 publications

References 78 publications

Long-term Benefits in Emergency Admissions, Hospitalization and Metabolic Control of an Integrated Continuous Glucose Monitoring and Insulin Pump System in a Cohort of Diabetic Patients

Long-term Benefits in Emergency Admissions, Hospitalization and Metabolic Control of an Integrated Continuous Glucose Monitoring and Insulin Pump System in a Cohort of Diabetic Patients

Long-Term Benefits of an Integrated Continuous Glucose Monitoring and Insulin Pump System for Emergency Admissions, Hospitalization, and Metabolic Control in a Cohort of People With Diabetes: Retrospective Cohort Study

Long-term Benefits in Emergency Admissions, Hospitalization and Metabolic Control of an Integrated Continuous Glucose Monitoring and Insulin Pump System in a Cohort of Diabetic Patients

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