Quality of life outcomes in subjects with type 1 diabetes with and without repeated hypoglycaemia. Short-term results of CSII treatment
Artículos originales -
Vol.25 N.3 mayo-junio 2009M. Giménez Álvarez1, M. Lara2, M. Jansà3, M. Vidal4, I. Levy5, I. Conget Donlo61. Servicio de Endocrinología y Diabetes. Hospital Clínic i Universitari. IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer).
CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDM). Barcelona; 2. Endocrinology and Diabetes Unit. IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer). CIBERDM. Hospital Clínic i Universitari. Barcelona; 3. Unidad de Diabetes. Servicio de Endocrinología y Nutrición. Institut de Malalties Digestives i Metabòliques (ICMDiM).
Hospital Clínic i Universitari. Barcelona; 4. Servei d’Endocrinologia i Nutrició. Unitat de Diabetis. Hospital Clínic. Barcelona; 5. Unitat de Diabetis. Servei d’Endocrinologia. Institut de Malalties Digestives i Metabòliques. Hospital Clínic. Barcelona; 6. Servicio de Endocrinología y Diabetes. Hospital Clínic i Universitari. IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer).
CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDM). Barcelona
Resumen
Objectives: To evaluate quality of life (QoL) characteristics and outcomes
in subjects with T1D with and without non-severe (NSH)/severe
hypoglycaemia (SH) as a main indication for CSII. Patients
and methods: Two groups of T1D subjects were selected from
candidates to CSII following the criteria of the Catalan National Health
Service. Twenty-one subjects (aged 34.6±7.5 years; 13 women) in
whom CSII was started because of recurrent NSH and SH) were included
(H Group). They were compared to 18 T1D subjects (aged
32.3±10.1 years; 14 women) in whom CSII was initiated because
of non-optimal control without repeated NSH/SH (NH group). General
characteristics, metabolic control and QoL/health state (DQoL/
SF-12 questionnaires) were evaluated (baseline/after 12-months).
Results: In the H group, the number of NSH/week diminished from
5.01±1.56 (baseline) to 2.76±1.09 after 12 months (p <0.001).
SH diminished from 1.24±0.62 per subject year (baseline) to
0.12±0.21 (12 months, p <0.001). There were no differences in
A1c (6.9±1.3 vs 6.5±0.8%; NH and H) after 12-months of CSII.
The H group scored better in DQoL-impact of treatment subscale at
baseline (45.7±7.0 vs 33.7±7.3; p <0.001, NH and H). QoL improved
similarly after 12 months in both groups, but the difference
in DQoL-impact of treatment (41.5±8.5 vs 31.0±5.8; p <0.001)
was maintained. Conclusions: CSII improves QoL independently of
its main indication. Subjects who initiate CSII because of repeated
hypoglycaemic episodes display a different QoL perception than
those without this indication when starting this therapy. Although this finding does not preclude favorable results, probably it has to be
considered in order to encourage patients to start this modality of
treatment.
Correspondencia
Correspondencia: I. Conget. Endocrinology and Diabetes Unit. IDIBAPS (Institut d’Investigacions
Biomèdiques August Pi i Sunyer). CIBER de Diabetes y Enfermedades
Metabólicas asociadas (CIBERDEM). Villarroel, 170. 08036 Barcelona (Spain).
E-mail:
iconget@clinic.ub.esPalabras clave
calidad de vida diabetes mellitus tipo 1 ISCI repeated hypoglycaemia Documento
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