Better Glycaemic Outcome, Low Levels of Acute Severe Complications, and High Patient Satisfaction in Routine Practice in Type 1 Diabetes Treated with an Insulin Pump ()
ABSTRACT
Treatment of patients with
Type 1 diabetes with continuous subcutaneous insulin infusion (CSII) was
re-introduced in Denmark in this millennium and initiated in the diabetes
clinic, Fredericia Hospital, in 2005. The aim of the present study was to
present yearly data of quality from 2005 to 2013 from a clinical database of
patients treated with CSII in routine practice. Methods: A database was established
in 2009-2010. Data from 2005 to 2009 are retrospective, data from 2009 to 2013
prospective. From 2009, patient satisfaction was measured by validated
questionnaires. Results: By 31 December 2013, the database contained data from
143 active patients. HbA1C (median and range) decreased from 64 (40 - 126)
mmol/mol (8.0 (5.8 - 13.7)%) (n = 104) to 60 (36 - 98) mmol/mol (7.6 (5.4 -
11.1)%) (n = 134) (p < 0.001) before and latest year on CSII. The improved
glycaemic control was maintained each year until ≥5 years after initiation of
CSII (p < 0.01). There was no change in weight. The number of attacks of
severe hypoglycaemia was reduced from 60 attacks in 21 patients (n = 104) the
year before CSII to only 5 attacks in 5 patients in 2013 (n = 134) (p < 0.01),
corresponding to an incidence of 3.7 episodes per 100 patient years. Each year
after initiation of CSII until ≥5 years, the number of episodes of severe
hypoglycaemia was reduced (p < 0.01). Since 2005, nine episodes of
ketoacidosis have been registered in eight patients corresponding to an
incidence of 1.4 episodes per 100 patient years. Patient satisfaction was high
one year after initiation of CSII (p < 0.01). Conclusion: Change of
treatment to CSII is accompanied by an improvement in glycaemic control, very
pronounced reduction in severe hypoglycaemia, low levels of diabetic
ketoacidosis, and pronounced patient satisfaction.
Share and Cite:
Gjessing, H. , Jørgensen, U. , Møller, C. , Pedersen, J. , Grodum, E. and Schousboe, K. (2014) Better Glycaemic Outcome, Low Levels of Acute Severe Complications, and High Patient Satisfaction in Routine Practice in Type 1 Diabetes Treated with an Insulin Pump.
Journal of Diabetes Mellitus,
4, 304-310. doi:
10.4236/jdm.2014.44042.