Better treatment of outpatients with type 1 diabetes after introduction of continuous subcutaneous insulin infusion.
BACKGROUND
Continuous subcutaneous insulin infusion (CSII) was introduced in the outpatient diabetes clinic in Fredericia, Denmark, in 2005. The aim of this study was to evaluate the quality of metabolic control and patient satisfaction in type 1 diabetic patients treated with CSII.


METHODS
In 2009-2010, a database with registration of metabolic variables and patient satisfaction was established. The collected material is a combination of retrospective and prospective data. Patient satisfaction was measured by use of the Diabetes Treatment Satisfaction Questionnaire Status (DTSQs) and change (DTSQc) versions.


RESULTS
By 31 December 2010, the database contained data from 68 active patients. Compared with before the initiation of CSII, glycohaemoglobin (HbA1c) had decreased significantly from 8.0% (5.8-13.7%) to 7.6% (6.1-9.5%). The improved glycaemic control was maintained each year until ≤ 4 years after initiation of CSII (p < 0.01).The fraction of patients with an HbA1c ≤ 7% had increased from 13% to 24%, the fraction of patients with an HbA1c > 9% had decreased from 18% to 3%, and the number of serious attacks of hypoglycaemia had decreased (p < 0.05). Only three episodes of ketoacidosis were observed. The DTSQs and DTSQc showed a higher patient satisfaction during CSII treatment (p < 0.01) than before its introduction. Compared with before the introduction of CSII, the patient satisfaction score had increased from 19 (12-33) to 34.5 (27-36) (p < 0.01).


CONCLUSIONS
Type 1 diabetes patients who were changed from treatment with multi-injection therapy to CSII showed improved glycaemic control, a reduced number of hypoglycaemic attacks and improved and very high levels of patient satisfaction.
Fredensgade 4, 5000 Odense C, Denmark. ea.sofie.marmolin@ouh.regionsyddanmark.dk
Ea Sofie
ES
Marmolin
Jane
J
Brødsgaard
Hans Jørgen
HJ
Gjessing
Karoline
K
Schousboe
Ellen
E
Grodum
Ulla Linding
UL
Jørgensen
Charlotte Chrois
CC
Møller
Jette
J
Pedersen
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001786:Blood Glucose / Q000378:metabolism; D003718:Denmark; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D055104:Infusions, Subcutaneous / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin