2317-PUB: Diabetic Ketoacidosis in Adult Type 1 Diabetes Mellitus Patients on Insulin Pumps

Background: Insulin pumps are increasingly being used as a method of insulin delivery in patients with type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis (DKA) is a serious complication of T1DM. This study aims to identify causes of DKA in T1DM patients on insulin pump, and to compare these with patients with T1DM on multiple daily insulin injections (MDII). Methods: This was a prospective observational pilot study assessing DKA between 2 groups of patients with T1DM: (1) on insulin pump and (2) on MDII. Demographic and clinical data were obtained from chart review. Patients’ knowledge on insulin and diabetes care was assessed with a questionnaire we devised. Results: We enrolled 17 adult patients - 12 on insulin pump (7 Medtronic, 3 Tandem, 2 Animas) and 5 on MDII - who were admitted to the ICU for DKA management. Eleven (65%) were females, all were Caucasian, with median age in pump users 27.0 years (IQR 22.5,39.5) vs. MDII 38.0 (IQR 32.0,51.0)(p=0.045). The rest of the demographic data were comparable. Majority of the patients on insulin pump had a pump >5 years and had the current pump