Lifestyle, metabolic control and social implications of pump therapy in 54 routine type I diabetic patients

Abstract

Our aims were to evaluate the clinical and social implications of continuous subcutaneous insulin infusion (CSII) in ordinary type 1 diabetics, followed on a routine basis using a simple (Mill Hill) or a more complex (Microject MC20, Ames) pump. Fifty four type 1 diabetics were studied during 2 randomized periods of 4 months, one of conventional treatment (CT) (2 to 3 injections/day, self blood glucose (BG) monitoring) and the other of CSII. Each period was preceded by a 5 day training course. We studied clinical parameters, metabolic control (daily values of BG strips, urine analysis, insulin reactions, HbA1c), and acceptability of the treatment to the patient and their relatives. We also recorded all their unexpected phone-calls, consultations and admission to hospital. Thirty-four patients the initial cohort, completed the study, 7 dropped-out, 9 interrupted CSII, mainly because of skin problems and 4 refused to revert back to CT. During CSII, patients noted slight disturbance of sleep (30%), sexual activity (68%), and the wearing of clothes (26%). The main concern was with moderate skin problems (71%) whereas the main advantages were dietary liberalization, reduced numbers of insulin reactions and an improved feeling of well being. The type of pump used did not affect the results. Though acceptability was good in every patient trying the pump, it was better in those who asked to keep the pump after the trial (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)