Real-world outcomes of insulin pump compared to multiple daily injection therapy in adult type 1 diabetes mellitus patients in a Mediterranean scenario

Author(s):  
Jesús Moreno-Ferández ◽  
José Alberto García-Seco ◽  
Miriam Herrera-Moraleda ◽  
Angela María Seco ◽  
José Ramón Muñoz-Rodríguez
2020 ◽  
Vol 16 ◽  
Author(s):  
Beáta Erika Nagy ◽  
Brigitta Munkácsi ◽  
Karolina Eszter Kovács

Background & Introduction: Due to the increasing prevalence of type-1-diabetes an increasing number of studies draws investigation draws attention to its psychological effects and long-term consequences. As Type 1 Diabetes Mellitus is a chronic, non-curable, yet maintanable condition, with the affected children and their families facing a lifelong challenge. Our research focuses on the factors influencing adherence. Methods & Results: The adherence of youth was examined in a sample involving 114 patients treated in the Medical and Health Science Centre at the University of Debrecen by employing a new adherence questionnaire (DAQ abbreviated version, Munkácsi et al, 2019) (DAF 2017; N=114). The influence of socio-demographic variables and those related to the disease (age at the diagnosis, time elapsed since diagnosis, method of treatment, the time elapsed since the use of the pump) were measured by linear regression. Furthermore, the between-group comparisons were made by independent sample t-tests and variance analysis. The investigation was carried out between September 2017 and May 2018. The effect of using insulin pump as therapy is significant and positive (0.36. p=0.045). The adherence of the patients using insulin pump is higher while the effect of the age at the diagnosis has a significantly negative effect (-.247, p=0.035). Thus, earlier detection of the disease may lead to a higher level of adherence. The effects of the socio-demographic variables (gender, family structure, educational level, type of the settlement, owning sibling and birth order) were not significant (p>0.05). Regarding the between-group comparisons, a significant difference could be pointed out concerning the siblings and birth-order as the adherence of the those with siblings was higher (p=0.044). Moreover, concerning insulin pump therapy, the adherence of patients using pump was significantly better (p=0.048). Also, regarding the age of the diagnosis, the adherence of those diagnosed before 12 was seemingly higher (p=0.039). Concerning the other socio-demographical and disease-related variables, no significant differences could be detected. Conclusions: The results suggest that the treatment has an outstanding role in the adherence of the disease. Moreover, the role of the appropriate treatment, living conditions as well as the early diagnosis is relevant.


2019 ◽  
Vol 2 (1) ◽  
pp. 20-21
Author(s):  
Jan Broz ◽  
Denisa Janickova Zdarska ◽  
Michal Policar ◽  
Viera Donicova ◽  
Marek Brabec ◽  
...  

2018 ◽  
Vol 19 (8) ◽  
pp. 1459-1466 ◽  
Author(s):  
Marie‐Anne Burckhardt ◽  
Grant J. Smith ◽  
Matthew N. Cooper ◽  
Timothy W. Jones ◽  
Elizabeth A. Davis

2020 ◽  
Author(s):  
Ajenthen G. Ranjan ◽  
Signe V. Rosenlund ◽  
Tine W. Hansen ◽  
Peter Rossing ◽  
Steen Andersen ◽  
...  

<b>Aim:</b> To investigate the association between treatment-induced change in continuous glucose monitored (CGM) time-in-range (TIR) and albuminuria in persons with type 1 diabetes (T1D) treated with sensor-augmented-pumps (SAP). <p><b>Methods: </b><a></a><a>Twenty-six of fifty-five participants with albuminuria and multiple daily injection-therapy (25% females, 51 (46-63) years, HbA<sub>1c</sub> 75 (68-88) mmol/mol [9.0 (8.4-10.4)%], UACR 89 (37-250) mg/g) were in a randomized-controlled trial assigned to SAP-therapy for one year</a>. Anthropometrics, CGM-data, blood and urine samples were collected every three months.</p> <p><b>Results: </b>Mean change (95%-CI) in %TIR was +13.2 (6.2;20.2)%, HbA<sub>1C</sub> was -14.4 (-17.4;-10.5) mmol/mol [-1.3 (-1.6;-1.0)%] and urinary albumin-creatinine-ratio (UACR) was -15 (-38;17)%, all p<0.05. UACR decreased with 19 (10;28)% per 10% increase in %TIR (p=0.04), 18 (1;30)% per 10 mmol/mol decrease in HbA<sub>1C</sub> (p=0.07), and 31% per 10 mmHg decrease in mean arterial pressure (p<0.001).<b></b></p> <b>Conclusion: </b>In this longitudinal study, treatment-induced increase in %TIR was significantly associated with decrease in albuminuria in T1D.


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