International survey of insulin pump users: Impact of continuous subcutaneous insulin infusion therapy on glucose control and quality of life

Abstract

To record the characteristics and attitude of patients treated with continuous subcutaneous insulin infusion (CSII), and the impact on glycaemic control in a large number of CSII patients in routine daily life. A structured questionnaire was distributed to 36,450 CSII patients from Europe and North America to determine patient characteristics, therapy characteristics, medical results, complications and treatment satisfaction. A 38% response rate was achieved, 92% from patients with Type 1 diabetes. The responses indicated that CSII users achieved good glycaemic control with a mean HbA(1c) level of 7.0+/-1.1%. A significant correlation was observed between HbA(1c) and the number of blood glucose measurements per day. Four to five blood glucose measurements are needed in a majority of patients to reach optimal glucose control in intensely treated diabetic patients. The clinical benefits of CSII therapy were matched by patient experience and improvements in quality of life. There were 5.74 episodes per patient year of hypoglycaemia needing assistance, although the number of serious adverse effects recorded was dependent on patient's self-reporting. These data suggest patients using CSII therapy achieve good metabolic control, are highly satisfied, and experience an acceptably small number of complications.