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[IP] CSII - study in Italy

Diabet Med 2002 Aug;19(8):628-34    <A
t=pubmed_pubmed&from_uid=12147142">Related Articles,</A> >Links</A>
Continuous subcutaneous insulin infusion (CSII) in the Veneto region:
efficacy, acceptability and quality of life.

Bruttomesso D, Pianta A, Crazzolara D, Scaldaferri E, Lora L, Guarneri G,
Mongillo A, Gennaro R, Miola M, Moretti M, Confortin L, Beltramello GP, Pais
M, Baritussio A, Casiglia E, Tiengo A.

Department of Clinical and Experimental Medicine, Cattedra di Malattie del
Metabolismo, University of Padua, Via Giustiniani 2, 35128 Padua, Italy.
email @ redacted

AIM: To study the effect of continuous subcutaneous insulin infusion (CSII)
on metabolic control and well-being in patients with Type 1 diabetes.
METHODS: Efficacy, safety and interference with everyday life associated with
CSII were studied retrospectively in 138 diabetic patients from the Veneto
region treated for 7.4 +/- 0.4 years. RESULTS: Glycosylated haemoglobin
decreased during the first year of CSII from 9.3 +/- 0.2% to 7.9 +/- 0.1% (P
 0.0001), and then remained unchanged. Serious hypoglycaemia decreased from
0.31 +/- 0.07/year to 0.09 +/- 0.02/year (P < 0.003), as did ketoacidosis
(from 0.41 +/- 0.12/year to 0.11 +/- 0.03/year, P < 0.013). During the first
year of therapy daily insulin requirement decreased from 49 +/- 1 to 42 +/- 2
U/day (P < 0.0001) and did not change thereafter. The number of out-patient
consultations and hospital admissions per year also decreased significantly.
CSII was associated with a progressive increase of body weight (P < 0.05) and
with 0.2 +/- 0.04 infections/patient per year at the infusion site. Infection
was rated as mild in 72%, moderate in 18%, severe in 10%. Patients reported
that CSII improved metabolic control (71%), sense of well-being (41%), and
allowed more freedom (40%). Quality of life, assessed using the DQOL, after 7
years of CSII was rated as good by patients (score of 73.0 +/- 1.8 on a scale
from 0 to 100). CONCLUSIONS: This retrospective analysis suggests that CSII
improves metabolic control in Type 1 diabetic patients, reduces hypoglycaemic
and ketoacidotic events, is well accepted, allows a good quality of life and
decreases out-patient consultations and hospital admissions
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