Experiences and real life management of insulin pump therapy in adults with type 1 diabetes

Objective There is scarce information regarding the performance of a specific, structured education program addressed to patients with type 1 diabetes (T1D) using continuous subcutaneous insulin infusion (CSII) including both routine use of the therapy and patient experience evaluation. We aimed to assess the routine use of CSII and patient's experience and satisfaction regarding a specific structured patient self-management education and care program. Methods A retrospective, observational, cross-sectional study collecting CSII routine use downloaded data. Patient experience and satisfaction were evaluated using an anonymous online survey covering different aspects of CSII self-management education and care program. Results 380 T1D subjects were included (aged 45.3 ± 12.17 years, 62.1% women, diabetes duration 27.8 ± 10.3 years, 9.7 ± 4.7 years on CSII, HbA1c 7.7 + 1.0%; 61.0 ± 7.9 mmol/mol). Participants with HbA1c ≤ 7.5% (58 mmol/mol, n = 178) did more SMBGs per day (4.4 ± 2.1 vs. 3.9 ± 1.9); used more boluses (5.0 ± 1.8 vs. 4.5 ± 2.0); the percentage of insulin given as bolus was higher (50.1 ± 12.8 vs. 44.9 ± 13.2%); the night bolus wizard (BW) high glucose target was lower (125.9 ± 4.4 vs. 130.5 ± 12.8 mg/dl) and time on CSII therapy was shorter (8.9 ± 4.6 vs. 10.3 ± 4.6 years. p Conclusions The analysis of routine clinical use of CSII by T1D patients demonstrates that glucose control may be associated with some pump usage and adherence parameters. The overall user experience and satisfaction with our CSII self-management education and care program was remarkably favorable.