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Diabetes tipo 1: avaliação do controlo metabólico com injeções múltiplas de insulina comparativamente a sistemas de perfusão subcutâneos de insulina híbridos
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Abstract(s)
Introdução: a perfusão subcutânea contínua de insulina (PSCI) e as múltiplas injeções
diárias (MID) constituem duas estratégias de insulinoterapia para pessoas com diabetes
tipo 1 (DT1) manterem o controlo glicémico ideal e prevenir complicações a longo prazo.
Objetivo: comparar o controlo glicémico entre utilizadores de sistemas híbridos de
perfusão subcutânea contínua de insulina (PSCI) e utilizadores de múltiplas injeções
diárias de insulina (MID) sob utilização de sistemas de monitorização contínua de
glicemia (MCG).
Métodos: este estudo observacional do tipo coorte retrospetiva e comparativa envolveu
69 participantes com DT1 seguidos na clínica de Diabetes da APDP. Os participantes
foram divididos em dois grupos conforme o regime terapêutico utilizado: grupo 1 (PSCI),
composto por utilizadores de bombas de insulina Medtronic 780G com sistema de MCG
Guardian 4Ó; e grupo 2 (MID+MCG), formado por utilizadores de múltiplas injeções
diárias associadas ao FreeStyle Libre 2Ó. Foram recolhidos dados clínicos e de controlo
glicémico, incluindo a glicemia média, tempo no alvo (TIR), hipoglicemias e
hiperglicemias com base nos registos clínicos e dados extraídos dos dispositivos de
monitorização contínua da glicose, avaliados aos 3, 6 e 12 meses.
Resultados: a amostra incluiu 69 pessoas com diabetes tipo 1, divididas entre o grupo
PSCI (n=35) e o grupo MDI+MCG (n=34), com idade média de 26,05 ± 15,21 anos e
duração média da diabetes de 15,29 ± 12,32 anos. O grupo PSCI apresentou um TIR
significativamente superior em todos os períodos: 78,88 ± 6,20% vs. 60,74 ± 18,54% aos
3 meses; 79,91 ± 8,28% vs. 62,32 ± 16,93% aos 6 meses; e 76,78 ± 10,01% vs. 57,82 ±
22,83% aos 12 meses (p<0,001).
Conclusão: a utilização de sistemas PSCI híbridos esteve associada a um controlo
glicémico, evidenciado pelo TIR, significativamente superior, em comparação com a
MID associada a MCG ao longo de um período de 12 meses.
Introduction: Continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) are two insulin therapy strategies used by individuals with type 1 diabetes (T1D) to achieve optimal glycemic control and prevent long-term complications. Objective: To compare glycemic control between users of hybrid continuous subcutaneous insulin infusion (CSII) systems and users of multiple daily insulin injections (MDI) combined with continuous glucose monitoring (CGM) systems. Methods: This was a retrospective, comparative cohort study involving 69 individuals with T1D followed at the APDP Diabetes Clinic. Participants were divided into two groups based on their treatment regimen: Group 1 (CSII), consisting of users of Medtronic 780G insulin pumps with the Guardian 4Ó CGM system; and Group 2 (MDI+CGM), consisting of users of multiple daily injections combined with the FreeStyle Libre 2Ó system. Clinical and glycemic control data were collected, including average glucose, time in range (TIR), hypoglycemia, and hyperglycemia, based on clinical records and data extracted from CGM devices, evaluated at 3, 6, and 12 months. Results: The sample included 69 individuals with type 1 diabetes, divided into the CSII group (n=35) and the MDI+CGM group (n=34), with a mean age of 26.05 ± 15.21 years and a mean diabetes duration of 15.29 ± 12.32 years. The CSII group presented a significantly higher TIR at all time points: 78.88 ± 6.20% vs. 60.74 ± 18.54% at 3 months; 79.91 ± 8.28% vs. 62.32 ± 16.93% at 6 months; and 76.78 ± 10.01% vs. 57.82 ± 22.83% at 12 months (p<0.001). Conclusion: The use of hybrid CSII systems was associated with significantly better glycemic control, as measured by TIR, compared to MDI combined with CGM over a 12- month period.
Introduction: Continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) are two insulin therapy strategies used by individuals with type 1 diabetes (T1D) to achieve optimal glycemic control and prevent long-term complications. Objective: To compare glycemic control between users of hybrid continuous subcutaneous insulin infusion (CSII) systems and users of multiple daily insulin injections (MDI) combined with continuous glucose monitoring (CGM) systems. Methods: This was a retrospective, comparative cohort study involving 69 individuals with T1D followed at the APDP Diabetes Clinic. Participants were divided into two groups based on their treatment regimen: Group 1 (CSII), consisting of users of Medtronic 780G insulin pumps with the Guardian 4Ó CGM system; and Group 2 (MDI+CGM), consisting of users of multiple daily injections combined with the FreeStyle Libre 2Ó system. Clinical and glycemic control data were collected, including average glucose, time in range (TIR), hypoglycemia, and hyperglycemia, based on clinical records and data extracted from CGM devices, evaluated at 3, 6, and 12 months. Results: The sample included 69 individuals with type 1 diabetes, divided into the CSII group (n=35) and the MDI+CGM group (n=34), with a mean age of 26.05 ± 15.21 years and a mean diabetes duration of 15.29 ± 12.32 years. The CSII group presented a significantly higher TIR at all time points: 78.88 ± 6.20% vs. 60.74 ± 18.54% at 3 months; 79.91 ± 8.28% vs. 62.32 ± 16.93% at 6 months; and 76.78 ± 10.01% vs. 57.82 ± 22.83% at 12 months (p<0.001). Conclusion: The use of hybrid CSII systems was associated with significantly better glycemic control, as measured by TIR, compared to MDI combined with CGM over a 12- month period.
Description
Keywords
Diabetes Tipo 1 Monitorização Contínua de Glicemia Múltiplas Injeções Diárias Perfusão Subcutânea Contínua de
Insulina Tempo no Alvo