Long‐term treatment effects of insulin pump therapy

This study was designed to examine potential long‐term effects on glycaemic control and treatment satisfaction in people with type 1 diabetes who changed from multiple daily insulin injections (MDI) to insulin pump therapy (CSII, continuous subcutaneous insulin infusion). Forty‐six patients who changed from MDI to CSII were recruited at a Swedish medical clinic. They were followed one year prior to starting CSII and four years afterwards. Repeated measurements of HbA 1c were performed during follow up. Treatment satisfaction was assessed using Bradley's Diabetes Treatment Satisfaction Questionnaire, status version. After initiation of CSII, reductions of HbA 1c were seen after the first year (0.66 units of percent [95% Cl 0.46–0.91, p<0.001]) and after two to four years (0.65 [95% Cl 0.38–0.95, p<0.001]). Moreover, treatment satisfaction increased significantly after six months (10.0 score units [95% CI 8.0–12.0, p<0.001]) and remained at the same level after three years (10.5 score units [95% CI 8.0–13.0, p<0.001]). It was concluded that, compared to MDI, insulin pump therapy improves glycaemic control with sustained treatment satisfaction after up to four years. Our long‐term data provide further support for CSII as an effective and well tolerated treatment regimen for patients with type 1 diabetes.