Insulin pump therapy in type 1 diabetes mellitus: Education effectiveness and quality of life

Abstract

Aim. To compare efficacy of special structured program for type 1 diabetes mellitus (DM) group education between users of an integrated real-time (RT) continuous glucose monitoring (CGM)/continuous subcutaneous insulin infusion (CSII) systems and patients on CSII and self-monitoring of blood glucose (SMBG). Methods. This 4 months trial included 39 adults (18 male, age 27 [24,0;35,0] years) with type 1 DM (duration of diabetes 12 [8,0;18,0] years). All subjects were randomized to study groups: 20 in the CSII/SMBG arm and 19 in the RT-CGM/CSII arm. All participants were provided with special structured program for group education of diabetes patients on insulin pump therapy. Quality of life (QoL) was assessed with questionnaire SF-36. Results. Both groups were not significantly different in HbA1c, BMI and QoL at baseline. After 4 months HbA1c was significantly lower in both study groups without increase in rate of hypoglycemia. Improvements in QoL were observed in psychic health score in the CSII/ SMBG arm and in physical health and psychic health scores in the RT-CGM/CSII arm. There was no significant difference in HbA1c, BMI and QoL between groups. Conclusion. Transfer to CSII during group training under special structured program for patients with type 1 DM significantly improves glycemic control regardless of glucose monitoring method. Both "RT-CGM+CSII" and "SMBG+CSII" amend several aspects of QoL. Finally, transfer to CSII during group training considerably reduces total consumption of trainer's time without loss of training quality.