Metabolic control and hypoglycaemia 1 year after participation in the structured teaching and treatment programme "Insulin Pump Therapy for Adult Patients with Diabetes Mellitus Type 1 (SUBITO)" from Roche Diagnostics Ltd

Introduction: Structured diabetes treatment and teaching programmes with published evaluations are available for all target groups except for the treatment with continuous subcutaneous insulin infusion. There is up to now no refunding for a structured treatment and teaching programme for insulin pump therapy. Aim: The aim of this study is the evaluation of the structured treatment and teaching programme "Insulin pump therapy for adult patients with diabetes mellitus type 1 (SUBITO)" by Roche Diagnostics Ltd. Setting: 9 hospital departments for diabetology and 15 specialised private practices in Germany. Patients and Methods: In an uncontrolled cohort study 118 patients (age 39.6 years, duration of disease 15.4 years, BMI 26.5 kg/m(2)) took part in the "Insulin pump therapy for adult patients with diabetes mellitus type 1 (SUBITO)". The programme consists of 13 modules with 1-4 patients per group. HbA1c incidence of severe hypoglycaemia, incidence of ketoacidosis and fluctuation of blood glucose were measured at baseline and after 12 months. Study visits were before and immediately after the programme and after 3, 6, 9 and 12 months. 102 patients finished the study per protocol. Results: Basal insulin decreased from 23.87 IU/d before pump therapy to 19.871U/d after 12 months. HbA1c decreased by 0.3 % from 7.58 % to 7.28 % (p = 0.00084). The fluctuation of blood glucose was reduced (CV 38.3 % before, 33.0 % immediately after the programme and 33.1 % at 12 months). The incidence of severe hypoglycaemia (Glucose or glucagon injection) fell from 0.23 to 0.073 events / patient / year, i. e., 23 events in 14 patients before and 8 events in 7 patients within 12 months insulin pump treatment. The frequency of mild hypoglycaemia was reduced to half Severe ketoacidosis with the need of hospital admission did not occur before the programme, but in one patient during insulin pump treatment. Conclusion: The start of insulin pump therapy with the structured treatment and teaching programme "Insulin pump therapy for adult patients with diabetes mellitus type 1 (SUBITO)" by Roche Diagnostics Ltd. improves glycaemic control. Lower HbA1c is achieved with less insulin, reduction of hypoglycaemia and less fluctuation of blood glucose.