title: Why is insulin pump treatment rarely used in adolescents and young adults with cystic fibrosis-related diabetes?
abstract: BACKGROUND
  In type 1 diabetes (T1D), the use of continuous subcutaneous insulin infusion (CSII) has increased steadily in the last years. Compared with conventional insulin injection regimes, major advantages might be a nearly physiological insulin secretion, lower rates of hypoglycemia, higher flexibility in daily life, and increased quality of life. Data on CSII in cystic fibrosis-related diabetes (CFRD) are scarce.
  
  
  OBJECTIVE
  To analyze current use of insulin pumps in CFRD and compare demographics of pump-treated patients between CFRD and T1D.
  
  
  METHODS
  Data from the prospective German/Austrian diabetes patient registry on insulin-treated patients with either CFRD (n = 515) or T1D (n = 43 165) aged >10 yr at manifestation of diabetes were analyzed.
  
  
  RESULTS
  A total of 4.1% (n = 21) of CFRD and 17.7% (n = 7647) of T1D patients received insulin pump treatment within the recent year of care (p < 0.001). Pump-treated patients with CFRD had a significantly shorter duration of diabetes [median (Q1 ; Q3 ): 5.8 (2.9; 9.5) vs. 7.8 (4.3; 20.4) yr, p = 0.026] and tended to be younger [22.0 (18.2; 30.1) vs. 24.9 (17.3; 45.9) yr] than pump-treated T1D patients. Age at initiation of CSII seemed to be lower in CFRD [19.2 (16.5; 29.2) vs. 23.3 (14.8; 43.5) yr]. Insulin pump therapy was used slightly more often in male CFRD patients than females (4.7 vs. 3.6%), whereas in T1D the opposite was observed (14.9 vs. 21.2%, p < 0.001). Discontinuation rate of CSII was higher in CFRD than T1D (30.0 vs. 12.7%, p = 0.005).
  
  
  CONCLUSIONS
  Despite potential advantages, insulin pump therapy was rarely used among adolescent and young adult CFRD patients.
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Scheuing
authors.forename: Klaus
authors.initials: K
authors.lastname: Badenhoop
authors.forename: Martin
authors.initials: M
authors.lastname: Borkenstein
authors.forename: Katja
authors.initials: K
authors.lastname: Konrad
authors.forename: Eggert
authors.initials: E
authors.lastname: Lilienthal
authors.forename: Katharina
authors.initials: K
authors.lastname: Laubner
authors.forename: Andrea
authors.initials: A
authors.lastname: Naeke
authors.forename: Birgit
authors.initials: B
authors.lastname: Rami-Merhar
authors.forename: Angelika
authors.initials: A
authors.lastname: Thon
authors.forename: Dagobert
authors.initials: D
authors.lastname: Wiemann
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007328:Insulin
keywords: adolescent; cystic fibrosis; diabetes mellitus; insulin infusion system; young adult