A pilot study of factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy.
OBJECTIVE
To identify the knowledge and management factors associated with glycaemic control among adults with Type 1 diabetes mellitus treated with insulin pump therapy.


METHODS
A cross-sectional study of adults with Type 1 diabetes mellitus on insulin pump therapy for at least 12 months (n = 50, 18-70 years old) was undertaken between December 2013 and May 2014. A new questionnaire was developed to evaluate participants' knowledge and management related to insulin pump therapy, and were correlated with insulin pump data, HbA1c and frequency of hypoglycaemia.


RESULTS
Participants who changed their insulin pump settings when indicated had significantly better glycaemic control than those who did not (P = 0.04). Multivariate logistic regression analysis found that better overall insulin pump therapy management was a significant predictor of better glycaemic control (odds ratio 4.45, 95% confidence interval 1.61-12.3; P = 0.004) after adjusting for potential confounders including age, gender, duration of diabetes and insulin pump therapy. However, overall insulin pump therapy knowledge was not a significant predictor of glycaemic control (P = 0.058). There was no significant association between frequency of hypoglycaemia and insulin pump therapy knowledge or management.


CONCLUSIONS
We identified some key knowledge and management factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy using a newly designed questionnaire. The pilot study assessed the clinical utility of this evaluation tool, which may facilitate provision of targeted education to insulin pump therapy users to achieve optimal glycaemic control.
Department of Endocrinology, Eastern Health, Victoria, Australia.
W
W
Wen
Department of Medicine, Canberra Hospital, Australian Capital Territory, Australia.
R
R
Frampton
Department of Endocrinology and Diabetes, Canberra Hospital, Australian Capital Territory, Australia.
K
K
Wright
Department of Endocrinology and Diabetes, Canberra Hospital, Australian Capital Territory, Australia.
S
S
Fattore
Department of Epidemiology, Canberra Hospital, Australian Capital Territory, Australia.|Medical School, Australian National University, Australian Capital Territory, Australia.
B
B
Shadbolt
Department of Endocrinology and Diabetes, Canberra Hospital, Australian Capital Territory, Australia.|Medical School, Australian National University, Australian Capital Territory, Australia.
S
S
Perampalam
D000328:Adult; D001315:Australia; D003131:Combined Modality Therapy / Q000009:adverse effects; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy* / Q000628:therapy; D003927:Diet, Diabetic / Q000009:adverse effects; D015444:Exercise; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000009:adverse effects; D007333:Insulin Resistance; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D057566:Self Report
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human