P-394: “Low-cost insulin pump therapy for optimizing glycemic control in children and adolescents with diabetes: experience from a tertiary care center in Himachal Pradesh, India”
A GuptaAbstract
Introduction
Type 1 diabetes is an autoimmune condition characterized by destruction of the pancreatic β-cells. The glycemic control varies among patients depending on the pattern of food consumed, insulin used and autoimmunity patterns. Autoantibodies such as GAD65, IAA, IA2, ZnT8, and ICA are specific for T1D diagnosis, while TPO antibodies and TTGA may also be detected. This study aims to correlate glycemic control in these patients with use of low cost insulin pumps while providing Diabetes Self-Management Education (DSME) and insulin therapy to all enrolled participants.
Objectives
1 To monitor glycemic control over a period of six months in patients with low cost insulin pumps 2 To monitor HbA1c levels 3 To compare the effect of low cost insulin pump Vs MDI on glycemic control in resource limited settings
Methods
T1D patients enrolled in the Pediatric Diabetes Clinic (6-18 yrs) were grouped according to their autoantibody profiles. Each patient and parents received Diabetes Self-Management Education (DSME) and attended regular follow-up sessions at each clinic visit. Insulin therapy was provided through the institution to all participants.Glycemic control was assessed using HbA1c measurements at 3-month intervals (two readings over six months). The subjects were grouped into two groups. Group A was provided low cost insulin pumps and their daily RBS levels were monitored after DSME. Group B was continued on MDI and their progress was monitored. Both groups were compared after 3 and 6 months. The data obtained were analyzed to compare glycemic control among groups.
Results
Low cost insulin pumps were more effective in providing better glycemic control. HbA1C improved in visits at 3 and 6 months with better quality of life. Patients had decrease in number of injections per day which resulted in better adherence to treatment
Conclusions
Glycemic control is better in low cost insulin pump as compared to MDI. Mean HbA1c decreased from 12.5% baseline to 8.95% (3 months) and 7.93 at (6 months).