Comparative Study of Glycemic Control and Treatment Satisfaction in Patients With Type 1 Diabetes on Sensor-Augmented Insulin Pump, Insulin Pump, and Multiple Daily Insulin Injections: A Cross-Sectional Study

Background: Patients with type 1 diabetes mellitus (T1DM) depend on lifelong insulin therapy. In recent decades, advances in diabetes technology have introduced insulin pumps and continuous glucose monitoring (CGM) systems, offering new approaches to disease management. Despite these innovations, evidence regarding their impact on glycemic control and patient satisfaction within the Saudi population remains scarce. This gap is important, as cultural, lifestyle, and genetic factors may influence treatment outcomes. Patients and methods: A cross-sectional study was conducted at the Endocrine Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Eligible participants were patients aged 14 years and older with T1DM who had been on one of the following regimens for at least six months: a sensor-augmented insulin pump (MiniMed 640G or 740G, Medtronic, Dublin, Ireland), an insulin pump without a sensor (Paradigm VEO 754, Medtronic), or multiple daily insulin injections (MDIs). Results: The study enrolled 196 patients, the majority of whom were female (76.5%), with ages ranging from 14 to 55 years. Over half of the cohort (52.5%) were treated with MDI, while 25% and 8.2% used sensor-augmented pumps and non-sensor pumps, respectively. Regression analyses demonstrated that patients using sensor-augmented pumps achieved significantly lower glycosylated hemoglobin (HbA1c) levels compared to those treated with MDI. In addition, sensor-augmented pump users reported markedly higher satisfaction scores. The frequency of educator visits explained approximately 20% of the variability in satisfaction (R² = 0.202). Conclusions: Sensor-augmented insulin pumps provide superior outcomes compared with MDIs in patients with T1DM, offering both improved glycemic control and greater patient satisfaction. These findings underscore the importance of integrating advanced technologies into diabetes care, particularly in populations with unique cultural and lifestyle characteristics.