TY - JOUR
T1 - Efficacy and safety of sensor augmented insulin pump therapy with low-glucose suspend feature in older adults
T2 - A retrospective study in Bogota, Colombia
AU - Morros-González, Elly
AU - Gómez, Ana María
AU - Henao Carrillo, Diana Cristina
AU - Ursida, Valentina
AU - Serrano, Sergio
AU - Rondón Sepúlveda, Martín Alonso
AU - Muñoz Velandia, Oscar Mauricio
N1 - Copyright © 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.
PY - 2021
Y1 - 2021
N2 - BACKGROUND AND AIMS: The literature has supported the efficacy and safety of insulin pump therapy in young adults diagnosed with type 1 diabetes (DM1). However, there is limited evidence in older adults with DM1 and DM2.METHODS: A retrospective cohort study was conducted in patients ≥60 years-old with DM1 and DM2, who started Sensor Augmented Insulin Pump therapy with low-glucose suspend feature (SAP + LGS) at Hospital Universitario San Ignacio diabetes center in Bogotá, Colombia. Patients were evaluated between 2009 and 2019 and were treated with Paradigm VEO or Medtronic MiniMed 640 insulin pumps and continuous glucose monitoring system. Glycated hemoglobin (A1c), severe hypoglycemia and hypoglycemia unawareness were assessed at least every 3 months, and hospitalizations and ketoacidosis episodes incidence were assessed yearly.RESULTS: 36 patients were analyzed, (67.36 ± 4.88 years-old) (body mass index 25.48 ± 4.61 kg/m2). The most common indications for starting SAP + LGS were hypoglycemia (58.3%), high glycemic variability (25.0%) and poor metabolic control (16.7%). 26 patients used VEO (72.2%) whereas 27.8% started 640 insulin pump. Data from 32 participants showed A1c decreased from 8.57 ± 1.73% to 7.42 ± 0.96 after a year of therapy (Mean difference -1.15%, p < 0.05); 28.12% reached A1c levels <7% and 42.85% < 7.5%. There was a significant decrease in the proportion of patients with at least one severe hypoglycemia (56.7 vs 3.3%), one or more hospitalizations (20 vs 3.3%), and hypoglycemia unawareness after the first year of follow-up (p < 0.05).CONCLUSIONS: These results suggest that SAP + LGS is safe and effective in people 60 years or older after one year of therapy. Future randomized clinical trials are needed in the elderly.
AB - BACKGROUND AND AIMS: The literature has supported the efficacy and safety of insulin pump therapy in young adults diagnosed with type 1 diabetes (DM1). However, there is limited evidence in older adults with DM1 and DM2.METHODS: A retrospective cohort study was conducted in patients ≥60 years-old with DM1 and DM2, who started Sensor Augmented Insulin Pump therapy with low-glucose suspend feature (SAP + LGS) at Hospital Universitario San Ignacio diabetes center in Bogotá, Colombia. Patients were evaluated between 2009 and 2019 and were treated with Paradigm VEO or Medtronic MiniMed 640 insulin pumps and continuous glucose monitoring system. Glycated hemoglobin (A1c), severe hypoglycemia and hypoglycemia unawareness were assessed at least every 3 months, and hospitalizations and ketoacidosis episodes incidence were assessed yearly.RESULTS: 36 patients were analyzed, (67.36 ± 4.88 years-old) (body mass index 25.48 ± 4.61 kg/m2). The most common indications for starting SAP + LGS were hypoglycemia (58.3%), high glycemic variability (25.0%) and poor metabolic control (16.7%). 26 patients used VEO (72.2%) whereas 27.8% started 640 insulin pump. Data from 32 participants showed A1c decreased from 8.57 ± 1.73% to 7.42 ± 0.96 after a year of therapy (Mean difference -1.15%, p < 0.05); 28.12% reached A1c levels <7% and 42.85% < 7.5%. There was a significant decrease in the proportion of patients with at least one severe hypoglycemia (56.7 vs 3.3%), one or more hospitalizations (20 vs 3.3%), and hypoglycemia unawareness after the first year of follow-up (p < 0.05).CONCLUSIONS: These results suggest that SAP + LGS is safe and effective in people 60 years or older after one year of therapy. Future randomized clinical trials are needed in the elderly.
KW - Aged
KW - Biomarkers/blood
KW - Blood Glucose/analysis
KW - Blood Glucose Self-Monitoring
KW - Colombia/epidemiology
KW - Diabetes Mellitus, Type 1/drug therapy
KW - Diabetes Mellitus, Type 2/drug therapy
KW - Female
KW - Follow-Up Studies
KW - Glycated Hemoglobin/analysis
KW - Humans
KW - Hyperglycemia/epidemiology
KW - Hypoglycemia/epidemiology
KW - Hypoglycemic Agents/administration & dosage
KW - Insulin/administration & dosage
KW - Insulin Infusion Systems/standards
KW - Male
KW - Prognosis
KW - Retrospective Studies
U2 - 10.1016/j.dsx.2021.02.029
DO - 10.1016/j.dsx.2021.02.029
M3 - Artículo
C2 - 33813236
SN - 1871-4021
VL - 15
SP - 649
EP - 653
JO - Diabetes & metabolic syndrome
JF - Diabetes & metabolic syndrome
IS - 3
ER -