title: Cross-sectional survey and retrospective analysis of a large cohort of adults with type 1 diabetes with long-term continuous subcutaneous insulin infusion treatment.
abstract: Background. Continuous subcutaneous insulin infusion (CSII) is an established modality for intensive insulin treatment of type 1 diabetes (T1D), but long-term data concerning satisfaction, CSII function use, safety, and efficacy in real-life conditions are scarce. Methods. We analyzed a cohort of adult patients with T1D treated with CSII for more than 1 year in a single diabetes center. We performed a cross-sectional survey in 2010 (tolerance/satisfaction and behavior forms) and a retrospective analysis of medical records (including HbA1c level, hospitalization, and catheter infections). The primary objective was to assess long-term tolerance/satisfaction, and secondary objectives were safety and efficacy. Results. There were 295 patients analyzed. After a median duration of CSII use of 5 years, overall satisfaction was high for about 90% of patients. Mean CSII-related discomfort scores were low for work, recreation, and sleep and moderate for sport and sexual activity (2.5 ± 1.9, 2.6 ± 1.8, 2.6 ± 2.1, 3.4 ± 2.3, and 4.0 ± 2.9 of 10, respectively). Despite a high level of diabetes education, only one third of patients were using advanced CSII functions. During long-term follow-up, the safety of CSII treatment was good; the hospitalization rate was 0.18 patients/year, and catheter infections were scarce. The HbA1c level dropped about -0.5% independently from CSII duration (P < .05). Conclusions. In this adult cohort, satisfaction and tolerance, together with safety, of CSII were maintained at long-term follow up. The sole basic functions of CSII were currently used by patients. A 0.5% decrease in the HbA1c level was maintained during the study period.
authors.affiliation: Endocrinology Department, Caen University Hospital, Caen, France joubert-m@chu-caen.fr.
authors.forename: Michael
authors.initials: M
authors.lastname: Joubert
authors.affiliation: Endocrinology Department, Caen University Hospital, Caen, France University of Caen (UNICAEN), Caen, France.
authors.forename: Julia
authors.initials: J
authors.lastname: Morera
authors.affiliation: Endocrinology Department, Caen University Hospital, Caen, France.
authors.forename: Angel
authors.initials: A
authors.lastname: Vicente
authors.affiliation: Endocrinology Department, Caen University Hospital, Caen, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Rod
authors.affiliation: University of Caen (UNICAEN), Caen, France Research and Biostatistic Department, Caen University Hospital, Caen, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Parienti
authors.affiliation: Endocrinology Department, Caen University Hospital, Caen, France University of Caen (UNICAEN), Caen, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Reznik
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems / Q000009:adverse effects; D008297:Male; D017060:Patient Satisfaction; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: HbA1c; continuous subcutaneous insulin infusion; insulin; quality of life; type 1 diabetes