Insulin pump therapy in clinical practice: the results of a three-year follow-up

Abstract


Introduction: The attempts to improve the treatment efficacy of diabetes mellitus have led to the development of continuous subcutaneous insulin infusion systems (CSII). Nevertheless, the data on the duration as well as on the discontinuation rate of CSII is limited. Aim: to evaluate the outcomes of insulin pump therapy including the effects on diabetes management and discontinuation rates. Materials and methods: Adults with diabetes mellitus who were switched on insulin pump therapy in Moscow Region in 2015—2019 years. The data about the carbohydrate state and pump therapy discontinuation was received by personal visits, by phone calls or from medical records. The follow-up period was 36 months. Results: Data from 455 patients were received. About 275 (60,4%) patients continued CSII therapy during the first 6 months, but in 36 months only 171 (37,6%) continued the treatment. The main reasons reported were the high cost of monthly consumables (57,6% of patients) and not feeling comfortable wearing the device (29,7%). There was a correlation between monthly consumables supply, diabetic proliferative retinopathy (DPR), and insulin pump discontinuation. Thus, the duration of pump use in patients who were supplied with monthly consumables within state guarantee was 30 ± 1,1 months, in those without supplementation — 16,4 ± 0,9 months (p<0,01). The mean duration of pump use in patients with DPR was 14 months, in those without DPR — 18 months (р=0,031). The level of glycated hemoglobin decreased on almost 0,6% in insulin pump users during 36 months follow-up (p<0,01). Conclusion: Despite the increasing accessibility of insulin pumps the current regulatory documents don’t match in several essential aspects, that may lead to the decrease in the effectiveness of therapeutic interventions.

About the authors

Ilia A. Barsukov

Moscow Regional Research and Clinical Institute (MONIKI), 61/2 Shchepkina ul., Moscow, Russian Federation

Email: palantirr@inbox.ru

Anna A. Demina

Moscow Regional Research and Clinical Institute (MONIKI), 61/2 Shchepkina ul., Moscow, Russian Federation

Email: annagalitskova@gmail.com

Aleksandr V. Dreval

Moscow Regional Research and Clinical Institute (MONIKI), 61/2 Shchepkina ul., Moscow, Russian Federation

Email: endocrinolog-cab@yandex.ru

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