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Efficacy of continuous subcutaneous insulin infusion in Type 1 diabetes: a 2-year perspective using the established criteria for funding from a National Health Service.
Diabet Med. 2007 Dec; 24(12):1419-23.DM

Abstract

AIM

To determine the 2-year efficacy of continuous subcutaneous insulin infusion (CSII) following the current established criteria for funding of a National Health Service.

METHODS

Longitudinal, prospective, observational unicentre study. Included in the study were 153 Type 1 diabetes (T1D) subjects, previously treated with multiple daily injections (MDI) of insulin, in whom CSII was started in accordance with the criteria for reimbursement of the Catalan National Health Service. At baseline, we recorded data on age, gender, duration of the disease, body mass index (BMI), insulin dose and indications for CSII. Glycated haemoglobin (HbA(1c)) and the frequency of hypoglycaemic events were used to assess glycaemic control. Quality of life was assessed using three different self-report questionnaires. After 24 months, these same items were remeasured in all subjects. Serious adverse events and injection-site complications were also recorded.

RESULTS

In 96% of subjects, CSII indication included less than optimal glycaemic control using MDI. HbA(1c) fell from 7.9 +/- 1.3 to 7.3 +/- 1.1% (P < or = 0.001) after 24 months of CSII. Insulin requirements were significantly lower at the end of follow-up (0.55 +/- 0.21 U/kg body weight) in comparison with before use of CSII (0.70 +/- 0.20, P < or = 0.001). BMI increased from 24.0 +/- 3.1 to 24.4 +/- 3.2 kg/m(2) after 24 months (P < or = 0.025). The rate of episodes of diabetic ketoacidosis per year remained unchanged. Mild and severe hypoglycaemic episodes were significantly reduced. The scores in all subsets of the Diabetes Quality-of-Life (DQoL) questionnaire significantly improved after 24 months of CSII.

CONCLUSIONS

CSII, commenced according to the criteria for a nationally funded clinical programme, improves glycaemic control and quality-of-life outcomes with fewer hypoglycaemic episodes in T1D subjects previously conventionally treated with MDI.

Authors+Show Affiliations

Endocrinology and Diabetes Unit, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Hospital Clínic i Universitari, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17941861

Citation

Giménez, M, et al. "Efficacy of Continuous Subcutaneous Insulin Infusion in Type 1 Diabetes: a 2-year Perspective Using the Established Criteria for Funding From a National Health Service." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 24, no. 12, 2007, pp. 1419-23.
Giménez M, Conget I, Jansà M, et al. Efficacy of continuous subcutaneous insulin infusion in Type 1 diabetes: a 2-year perspective using the established criteria for funding from a National Health Service. Diabet Med. 2007;24(12):1419-23.
Giménez, M., Conget, I., Jansà, M., Vidal, M., Chiganer, G., & Levy, I. (2007). Efficacy of continuous subcutaneous insulin infusion in Type 1 diabetes: a 2-year perspective using the established criteria for funding from a National Health Service. Diabetic Medicine : a Journal of the British Diabetic Association, 24(12), 1419-23.
Giménez M, et al. Efficacy of Continuous Subcutaneous Insulin Infusion in Type 1 Diabetes: a 2-year Perspective Using the Established Criteria for Funding From a National Health Service. Diabet Med. 2007;24(12):1419-23. PubMed PMID: 17941861.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of continuous subcutaneous insulin infusion in Type 1 diabetes: a 2-year perspective using the established criteria for funding from a National Health Service. AU - Giménez,M, AU - Conget,I, AU - Jansà,M, AU - Vidal,M, AU - Chiganer,G, AU - Levy,I, Y1 - 2007/10/17/ PY - 2007/10/19/pubmed PY - 2008/4/17/medline PY - 2007/10/19/entrez SP - 1419 EP - 23 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 24 IS - 12 N2 - AIM: To determine the 2-year efficacy of continuous subcutaneous insulin infusion (CSII) following the current established criteria for funding of a National Health Service. METHODS: Longitudinal, prospective, observational unicentre study. Included in the study were 153 Type 1 diabetes (T1D) subjects, previously treated with multiple daily injections (MDI) of insulin, in whom CSII was started in accordance with the criteria for reimbursement of the Catalan National Health Service. At baseline, we recorded data on age, gender, duration of the disease, body mass index (BMI), insulin dose and indications for CSII. Glycated haemoglobin (HbA(1c)) and the frequency of hypoglycaemic events were used to assess glycaemic control. Quality of life was assessed using three different self-report questionnaires. After 24 months, these same items were remeasured in all subjects. Serious adverse events and injection-site complications were also recorded. RESULTS: In 96% of subjects, CSII indication included less than optimal glycaemic control using MDI. HbA(1c) fell from 7.9 +/- 1.3 to 7.3 +/- 1.1% (P < or = 0.001) after 24 months of CSII. Insulin requirements were significantly lower at the end of follow-up (0.55 +/- 0.21 U/kg body weight) in comparison with before use of CSII (0.70 +/- 0.20, P < or = 0.001). BMI increased from 24.0 +/- 3.1 to 24.4 +/- 3.2 kg/m(2) after 24 months (P < or = 0.025). The rate of episodes of diabetic ketoacidosis per year remained unchanged. Mild and severe hypoglycaemic episodes were significantly reduced. The scores in all subsets of the Diabetes Quality-of-Life (DQoL) questionnaire significantly improved after 24 months of CSII. CONCLUSIONS: CSII, commenced according to the criteria for a nationally funded clinical programme, improves glycaemic control and quality-of-life outcomes with fewer hypoglycaemic episodes in T1D subjects previously conventionally treated with MDI. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/17941861/Efficacy_of_continuous_subcutaneous_insulin_infusion_in_Type_1_diabetes:_a_2_year_perspective_using_the_established_criteria_for_funding_from_a_National_Health_Service_ L2 - https://doi.org/10.1111/j.1464-5491.2007.02287.x DB - PRIME DP - Unbound Medicine ER -