Ulla Kampmann1, Lene Ring Madsen2, Lasse Bjerg3, Daniel R Witte4, Kjeld Hasselstrøm5, Torben Østergård6, Kirsten Alstrup7, Marianne Kleis Møller8, Dorrit Dylmer9, Klavs Würgler Hansen10. 1. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark. Electronic address: ulla@opstrup.dk. 2. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark. 3. Department of Public Health, Section of General Practice, Aarhus University, Denmark; Department of Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark. 4. Department of Public Health, Section of General Practice, Aarhus University, Denmark; Danish Diabetes Academy, Odense, Denmark. 5. Department of Internal Medicine, Herning Regional Hospital, Denmark. 6. Department of Internal Medicine, Viborg Regional Hospital, Denmark. 7. Department of Internal Medicine, Randers Regional Hospital, Denmark. 8. Department of Internal Medicine, Horsens Regional Hospital, Denmark. 9. Department of Internal Medicine, Holstebro Regional Hospital, Denmark. 10. Diagnostic Center, Silkeborg Regional Hospital, Denmark.
Abstract
AIMS: Insulin treatment in type 1 diabetes encompasses multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII). Both population-based studies and comparative studies regarding CSII use are sparse. The aim of the current study was to describe the prevalence and distribution of CSII use among adults with type 1 diabetes in the Central Denmark Region and to compare metabolic control in CSII-treated patients to those treated with MDI. METHODS: A database was constructed using the Danish Adult Diabetes Registry in 2014/2015 in combination with an audit of the patients' medical records. RESULTS: 3909 adults with type 1 diabetes patients were included. The proportion of patients treated with CSII differed significantly between the 8 regional hospitals from 12.0% to 31.1%. CSII users had a significantly lower HbA1c compared to MDI treated patients (7.6% (60 mmol/mol) versus 8.0% (64 mmol/mol)) in unadjusted analyses. After adjustment for clinically relevant characteristics the difference between CSII and MDI-treated patients was attenuated, but remained statistically significant. CONCLUSION: The distribution of CSII differed markedly between hospitals and CSII users had better glycemic control, even after adjustment for sex, age, BMI, diabetes duration, smoking, use of lipid-lowering and blood pressure-lowering medication.
AIMS: Insulin treatment in type 1 diabetes encompasses multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII). Both population-based studies and comparative studies regarding CSII use are sparse. The aim of the current study was to describe the prevalence and distribution of CSII use among adults with type 1 diabetes in the Central Denmark Region and to compare metabolic control in CSII-treated patients to those treated with MDI. METHODS: A database was constructed using the Danish Adult Diabetes Registry in 2014/2015 in combination with an audit of the patients' medical records. RESULTS: 3909 adults with type 1 diabetespatients were included. The proportion of patients treated with CSII differed significantly between the 8 regional hospitals from 12.0% to 31.1%. CSII users had a significantly lower HbA1c compared to MDI treated patients (7.6% (60 mmol/mol) versus 8.0% (64 mmol/mol)) in unadjusted analyses. After adjustment for clinically relevant characteristics the difference between CSII and MDI-treated patients was attenuated, but remained statistically significant. CONCLUSION: The distribution of CSII differed markedly between hospitals and CSII users had better glycemic control, even after adjustment for sex, age, BMI, diabetes duration, smoking, use of lipid-lowering and blood pressure-lowering medication.
Authors: Adnan Al Shaikh; Abdullah M Al Zahrani; Yousef H Qari; Abdulaziz A AbuAlnasr; Waseem K Alhawsawi; Khalid A Alshehri; Sahl A AlShaikh Journal: Clin Med Insights Endocrinol Diabetes Date: 2020-09-28