Insulin pump therapy with continuous glucose monitoring improves metabolic control in brittle type 1 diabetes.

ABSTRACT

AIM: to evaluate the combination of insulin pump therapy and continuous glucose monitoring in outcome on metabolic control in patients with brittle type 1 diabetes. MATERIALS AND METHODS: Insulin pump therapy was initiated in eleven brittle type 1 diabetics with poor metabolic control (mean Hba1c = 9.6%). Metabolic control was evaluated with CGMS and HbA1c in the following 6 months. RESULTS: Glycated haemoglobin showed a reduction in 1.4% in the 6 months following initialisation of pump therapy. Physical activity, various foods and insulin were tested with CGMS. There were no severe hypoglycaemia and occasional postprandial hyperglycaemia, where patients and their family learned the practical issues of carbohydrate counting. During the next 6 months on pump therapy, the patients successfully managed their diabetes. CONCLUSIONS: Insulin pump therapy can be initiated and used effectively in brittle type 1 diabetics to improve metabolic control and quality-of-life. When diabetes and pump management are appropriately individualized, this kind of therapy can help type 1 diabetics to achieve and to sustain metabolic control. Lifestyle flexibility, quality-of-life improvement, and independence can be maintained throughout young adulthood.