EVALUATION OF DIABETIC PATIENTS AFTER THREE MONTH USE OF CONTINUOUS SUBCUTANEOUS INSULIN INFUSION, DISPENSED BY A PROTOCOLLED FORM AT OUTPATIENT REFERENCE CLINIC OF TAGUATINGA REGIONAL HOSPITAL

Objective: This study evaluates the effects of continuous subcutaneous insulin infusion (CSII, insulin pump) on glycemic control of diabetic patients previously treated with multiple daily injections (MDI). Patient and methods: Eighty patients (49 female) took part in this observational and prospective study, mean age and disease duration were 27.9 years and 13 years, respectively; 96% patients had type 1 diabetes mellitus (DM1). Results: The entire cohort (ECO) and 3 subgroups (group 1 – A1c decrease, group 2 – A1c stable, and group 3 - A1c increase), stratified according to a ≥0.5% change in A1c, were analyzed. Group 1 involved 64% of the patients. The ECO showed a significant A1c decrease: MDI 8.1 ± 1.4% vs. CSII 7.3 ± 0.9%, p <0,0001 (0.8% difference pro CSII therapy). Group 1 demonstrated an A1c decrease from 8.7% to 7.3% (1.4% difference). Group 2 mean A1c was 7.1%. Rate of hypoglycemia (< 50 mg/dL) decreased 61% in the ECO and 79% in Group 2. Conclusion: This study reinforces the safety and efficacy of CSII with a robust A1c reduction, hypoglycemia episodes and A1c increase in only 17.5% of ECO. The CSII has not been dispensed by the Ministry of Health yet, but the pioneer outpatient reference clinic implemented at Health of State Secretary of Distrito Federal assures the free delivery benefit possible to be achieved in the Unified Health System (UHS) by means of a standardized protocol. This approach results in less wastage for patients and represents a rational policy for CSII therapy in the UHS.