Quality of Life in Patients Treated with Insulin Pump Compared with MDI in Croatia

Abstract

Introduction: The aim of this study was to investigate parameters of glycemic control (HbA1c and incidence of hypoglycemia), and quality of life in patients treated with insulin pump compared to those treated with multiple daily injections (MDI). Methods: Out of 104 diabetes type 1 patients included in the study, 52 were treated with an insulin pump and the other 52 were treated with MDI. All participants filled out questionnaires containing sociodemographic data, data related to their disease, quality of life (WHOQoL-BREF) and depression and anxiety questionnaires. Results: Average age of patients was 26 years (interquartile range 22 to 35 years) without difference between groups. Patients treated with insulin pumps compared to those treated with MDI were more likely to visit diabetologist, majority of them were regularly counting carbohydrate units, however frequency of ketoacidosis was increased (p <0.01 for all). Patients treated with MDI had higher level of HbA1c and were more likely to experience hypoglycemia. Also, insulin pump group of patients had significantly lower values ​​of HbA1c and decreased number of hypoglycemia after initiating pump therapy (p <0.01 for all). Both groups of patients controlled glycemia on average 3-5 times per day, most common complication was glycemic variability which was also the most common reason for initiating pump therapy while majority considered insulin pump treatment more advantageous compared to MDI. Insulin pump treated patients had better quality of life (p <0.01) including physical health, mental health and environmental parameters. Regarding depression and anxiety there were no differences between groups. Conclusion: Our results are supporting the fact that the insulin pump therapy is one of the most successful diabetes treatments today which not only improves glycemic control but also significantly affects the quality of life. This fact should encourage authorities to provide greater access to insulin pump treatment for type 1 diabetes patients. Disclosure I. Bilic-Curcic: None. V. Vukojevic: None. M. Gradiser: None. M. Cigrovski Berkovic: None.