Comparison of treatment with continuous subcutaneous insulin infusion versus multiple daily insulin injections with bolus calculator in type 1 diabetes

Abstract

Abstract Objectives A study of the glycemic control, quality of life, and fear and perception of hypoglycemia by comparing continuous subcutaneous insulin infusion (CSII) group with multiple daily injections (MDI) with bolus calculator group. Materials and methods This is a retrospective cohort study with following up during the first 12 months that CSII group (n = 30) begins the use of “bolus wizard” and the MDI-calculator (n = 30) group begins the use of the bolus calculator (Accu-Chek ® Aviva Expert). Primary outcome: HbA 1c (3, 6 and 12 months). Questionnaires used: EsDQOL (quality of life), FH-15 (fear of hypoglycemia), and Clarke (perception of hypoglycemia). Statistical analysis: Student's t and nonparametric tests. Results The average reduction in HbA 1c during the study was significantly higher in CSII group (−0.56 ± 0.84%) compared with the MDI group (0.097 ± 0.94%), p = 0.028. The average basal insulin dose was significantly higher in the MDI group (at baseline, 6 and 12 months). No significant differences were found between the 2 treatment groups after analyzing the EsDQOL, FH-15 and Clarke questionnaires. In the CSII group, perceived quality of life assessed by the EsDQOL questionnaire was found to be better at the end of the study than at the beginning of using the insulin pump. Conclusions The average reduction in HbA 1c was significantly higher in the CSII group. In the CSII group, perceived quality of life was better at the end of the study than at the beginning.