The transition from the Pediatric clinic to the adult care is a challenging period for young adults with type 1 diabetes, due to the high risk of poor glycemic control. Achieving the glycemic target without hypoglycemia and/or large glucose excursions is of paramount importance for type 1 diabetic patients, who have high variability of daily glucose levels . Both insulin pump therapy and multiple daily injections of insulin are recommended strategy to achieve glycemic control in type 1 diabetes; however, no studies investigated the effects of insulin pump vs insulin injections on glycol-metabolic outcomes in the transition phase. The aim of this study was to evaluate the effects of continuous subcutaneous insulin infusion (CSII) therapy, as compared with multiple daily injections of insulin (MDI), on glycemic and metabolic control, in young type 1 diabetic patients transitioned to the adult diabetes care.
T1DM for at least 12 months
persistent HbA1c levels ≥ 7.5% (58 mmol/mol) despite optimized education therapy,
recurrent severe hypoglycemic episodes or high glucose variability
willingness to wear the insulin pump
previous use of insulin pump
pregnancy or planning to become pregnant in the next 2 years,
lack of ability to use the study devices
history of severe chronic diseases