Improved glycemic control through continuous glucose sensor-augmented insulin pump therapy: Prospective results from a community and academic practice patient registry

Ohad Cohen, Anna Körner, Rudolf Chlup, Christos S. Zoupas, Anton K. Ragozin, Krisztina Wudi, Dagmar Bartaskova, Aggelos Pappas, Tamás Niederland, Zoltán Taybani, Lubomir Barák, Andriani Vazeou

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Conducted by highly experienced investigators with abundant time and resources, phase III studies of continuous glucose sensing (CGS) may lack generalizability to everyday clinical practice. Method: Community or academic practices in six Central and Eastern European or Mediterranean countries prospectively established an anonymized registry of consecutive patients with type 1 insulin-dependent diabetes mellitus starting CGS-augmented insulin pump therapy with the Paradigm® X22 (Medtronic MiniMed, Northridge, CA) under everyday conditions, without prior CGS with another device. We compared glycosylated hemoglobin (GHb) values before and after 3 months of CGS and assessed relationships between insulin therapy variables and glycemia-related variables at weeks 1, 4, and 12 of CGS. Results: Of 102 enrolled patients, 85 (83%) with complete weeks 1, 4, and 12 sensor data and baseline/3-month GHb data were evaluable. Evaluable patients were ∼54% male and ∼75% adult (mean age, 33.2 ± 16.9 years) with longstanding diabetes and high personal/family education levels. Mean GHb declined significantly after 3 months of CGS (7.55 ± 1.33% at baseline to 6.81 ± 1.08% after 12 weeks, 0.74% absolute decrease, P < 0.001). The absolute GHb reduction correlated significantly (P < 0.0005) with baseline GHb: larger absolute reductions tended to occur when baseline levels were higher. An increased basal insulin dose as a percentage of the total daily insulin dose and a decreased daily bolus count from week 1 to week 12 of CGS predicted GHb improvement from baseline to week 12. Conclusions: CGS-augmented insulin pump therapy appears to improve glycemic control in type 1 diabetes in varied everyday practice settings.

Original languageEnglish
Pages (from-to)804-811
Number of pages8
JournalJournal of Diabetes Science and Technology
Volume3
Issue number4
DOIs
Publication statusPublished - Jul 2009

Keywords

  • Continuous glucose sensing
  • Continuous subcutaneous insulin infusion
  • Everyday practice
  • Glycemic control
  • Hypoglycemic excursions
  • Patient registry

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Bioengineering
  • Biomedical Engineering

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