Background: Real-world data regarding indications for use of insulin pump remain sparse. We investigated characteristics among individuals with type 1 diabetes (T1D) in relation to indication for use of insulin pump (CSII). Comparison was made with T1D subjects using multiple daily injections (MDI).
Methods: We included all individuals with T1D who had at least 1 registration in the National Diabetes Register during 2014-2015. Among 46 874 individuals, we excluded 2350 due to missing data. We examined 35 725 on MDI and 8799 on CSII regarding characteristics in relation to insulin delivery method, as well as association between insulin delivery and glycemic control (HbA1c) and presence of albuminuria.
Results: Unadjusted mean (SD) HbA1c was 63.84 (15.07) mmol/mol (7.99 [1.38]%) and 63.75 (13.19) mmol/mol (7.99 [1.21]%) in the MDI and CSII group, respectively. MDI and CSII users were on average 48.8 and 41.5 years old, respectively. MDI users were on average 26 years old and CSII users 17 years old at the time of diabetes diagnosis. Overall, a higher proportion of CSII users were females (53.5%). As compared with MDI, use of CSII was associated with up to 7.84 mmol/mol (0.72%) lower HbA1c in a multivariable adjusted model. Use of CSII was, however, not associated with risk of having albuminuria.
Conclusions: CSII was used more frequently in younger individuals, early-onset diabetes, and problematic glycemic control. The use of CSII was associated with lower HbA1c among CSII users except from those who started CSII due to high HbA1c.
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http://dx.doi.org/10.1177/1932296816650209 | DOI Listing |
J Diabetes Complications
September 2024
Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark. Electronic address:
Aim: This study aimed to investigate the short-and long-term effect on diabetic retinopathy (DR) in individuals with type 1 diabetes treated with continuous subcutaneous insulin injections (CSII) compared to those using multiple daily injections (MDI).
Methods: We conducted a register-based matched cohort study utilizing data from the Danish Registry of Diabetic Retinopathy as well as several other national Danish health registers. Our cohort consisted of all individuals with type 1 diabetes who attended the Danish screening program for DR from 2013 to 2022.
BMC Endocr Disord
August 2024
Department of Mechanical Engineering, Centre for Bioengineering, University of Canterbury, 20 Kirkwood Avenue, Christchurch, 8041, New Zealand.
Background: Use of Continuous Subcutaneous Insulin Infusion (CSII) has been shown to improve glycemic outcomes in Type 1 Diabetes (T1D), but high costs limit accessibility. To address this issue, an inter-operable, open-source Ultra-Low-Cost Insulin Pump (ULCIP) was developed and previously shown to demonstrate comparable delivery accuracy to commercial models in standardised laboratory tests. This study aims to evaluate the updated ULCIP in-vivo, assessing its viability as an affordable alternative for those who cannot afford commercially available devices.
View Article and Find Full Text PDFEndocr Pract
October 2024
Mayo Clinic Alix School of Medicine, Scottsdale, Arizona; Division of Endocrinology, Mayo Clinic Arizona, Scottsdale, Arizona.
Objective: Automated insulin delivery (AID) systems are a rapidly growing component in the area of continuous subcutaneous insulin infusion (CSII) therapy. As more patients use these systems in the outpatient setting, it is important to assess safety if their use is allowed to continue in the inpatient setting.
Methods: Analysis was conducted of the records of patients using AID technology upon admission to our hospital between June 2020 and December 2022.
J Diabetes
May 2024
Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Introduction: The study aimed to compare glycemic control and pregnancy outcomes in women with type 1 diabetes mellitus (T1DM) using multiple daily injection therapy (MDI) and continuous subcutaneous insulin infusion (CSII) and to compare outcomes of women treated with long-acting insulin or neutral protamine Hagedorn (NPH).
Methods: This multicenter prospective cohort study involved women with pregestational T1DM treated with MDI and CSII. Primary outcome was glycated hemoglobin (HbA1c) before and during pregnancy.
J Diabetes Sci Technol
November 2024
Tandem Diabetes Care, San Diego, CA, USA.
Background: Control-IQ technology version 1.5 allows for a wider range of weight and total daily insulin (TDI) entry, in addition to other changes to enhance performance for users with high basal rates. This study evaluated the safety and performance of the updated Control-IQ system for users with basal rates >3 units/h and high TDI in a multicenter, single arm, prospective study.
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