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Abstract

Introduction: Proper use of insulin infusion sets (IIS) plays an important role in pump therapy of patients with type 1 diabetes mellitus (T1DM). We assessed the habits associated with the use of IIS in patients with T1DM treated with insulin pump.
Materials and Methods: This study included 79 T1DM patients who were examined for the presence of lipohypertrophy (LH) and retrained for proper IIS use. They completed a standard ques-tionnaire regarding IIS at the time of study entry and at the follow-up.
Results: At baseline, most of the patients declared to have been using a plastic cannula (n = 68; 86.1%), changing the infusion set regularly (n = 65; 82.3%), and placing the infusion sets on the abdomen wall (n = 68; 86.1%). The most common rotation habit was the “curve pattern” on both sides of the umbilicus (n = 16; 20.3%). After a median of 23 weeks (IQR 20–34), 58 patients were available for the follow-up. A rise in the proportion of patients who declared to change IIS regularly (n = 48; 82.8% vs. n = 57; 98.3%, p = 0.016), change IIS every 2 to 3 days (n = 27; 46.6% vs. n = 35; 60.3%, p = 0.043), use “crisscross” rotation (n = 5; 8.8% vs. n = 12; 21.4%, p = 0.027) was observed. There were less patients reporting not having repeatable rotation manner (n = 15; 26.3% vs. n = 2; 5.4%, p = 0.009).
Conclusions: A substantial proportion of T1DM patients on pump therapy declare that they do not follow the recommended principles of IIS use. The intervention consisting of LH assessment and retrain-ing of proper use of IIS might be effective in improving patient compliance.
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Authors and Affiliations

Damian Ucieklak
1 2
Sandra Mrozińska
1 2 3
Aleksandra Wojnarska
2 4
Maciej T. Małecki
1 2
Tomasz Klupa
1 2
Bartłomiej Matejko
1 2

  1. Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland
  2. University Hospital, Kraków, Poland
  3. Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland
  4. Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

A i m s: Gestational diabetes mellitus (GDM) is an emerging worldwide problem. Changes in clinical characteristics of women affected by GDM in a long-term perspective are still not properly investigated. We aimed to examine such changes over a decade in a retrospective single-center analysis.
M e t h o d s: The medical documentation from Department of Metabolic Diseases, Krakow, Poland was analyzed. We included 633 women consecutively diagnosed with GDM in one of three time intervals: 2007–2008 (N = 157), 2012–2013 (N = 272), 2016–2017 (N = 234). Statistical analyses were performed.
R e s u l t s: Comparison of the three groups identified differences in the mean age of women at the GDM diagnosis (30.7 ± 5.0 years vs. 31.2 ± 4.7 vs. 32.5 ± 4.7, respectively, starting from the earliest 2007–2008 group), pregnancy week at GDM diagnosis (28.0 ± 5.3 wks. vs. 25.9 ± 4.9 vs. 23.4 ± 6.8), the proportion of women diagnosed before the 24th week of pregnancy (12.8% vs. 16.5% vs. 31.3%), and gestational weight gain (12.4 ± 5.0 kg vs. 10.4 ± 5.2 vs. 10.0 ± 5.7); (p = 0.001 or less for all comparisons). We also found differences for glucose values on fasting and at 2 hours with the highest (0 min) and lowest level (120 min) in the 2016–2017, respectively. Finally, a borderline difference for the weight, but not for BMI, was found (64.1 ± 14.1 kg vs. 66.2 ± 13.1 vs. 67.8 ± 15.6; p = 0.04). Differences were also identified in the post hoc analysis between cohorts.
C o n c l u s i o n: This retrospective analysis illustrates changes in characteristics of women with GDM occurring over the period of decade in Poland. They likely result from both epidemiological trends and modifications of the WHO criteria for the GDM diagnosis.
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Bibliography

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Authors and Affiliations

Magdalena Wilk
1 2
Katarzyna Cyganek
1 2
Bartłomiej Matejko
1 2
Sabina Krzyżowska
1 2
Izabela Lasoń
1 2
Barbara Katra
1 2
Joanna Zięba-Parkitny
2
Przemysław Witek
1 2
Maciej T. Małecki
1 2

  1. Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland
  2. University Hospital, Kraków, Poland

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