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Journal of Diabetes 6 (2014) 384–386
RESEARCH LETTER
Can we predict success of insulin pump therapy? Zdenek JANKOVEC, Vojtech CESAK, Michal KRCMA, Michal ZOUREK and Zdenek RUSAVY Medical Department I, University Hospital, Charles University, Plzen, Czech Republic
Keywords: continuous subcutaneous insulin infusion, diabetes, insulin pump.
The efficacy and safety of insulin pump treatment (continuous subcutaneous insulin infusion [CSII]) have been proven in a number of larger and smaller studies, metaanalyses, and on the basis of clinical experience.1,2 However, apart from the indisputable benefits of CSII treatment, we are aware of the increased economic and personal demands of this treatment compared with bolus insulin administration. An integral part of the approach to treatment is an educated and cooperating patient.1,2 The aim of our study was to identify parameters that could be used to predict successful and/or adverse outcomes of insulin pump treatment. The National Register of patients treated with insulin pump in the Czech Republic (hereafter the Register) was founded in 1998. Data are obtained from 63 cooperating departments of diabetology in the Czech Republic. The findings from the Register repeatedly show that CSII treatment is effective, even in the long term, and have its justified indications.3 We evaluated 1729 patients with complete data for the first 2 years of insulin pump treatment from the database of patients treated by CSII over the period 1998–2012. Data were compared at the beginning of treatment and after 2 years CSII treatment. We chose HbA1c, or rather its change (ΔHbA1c), as a value characterizing the success or failure of CSII treatment. Patients were divided into three groups as follows: (i) Responders, in whom a reduction in HbA1c ≥10% occurred after 2 years treatment (892 patients; 51.6%); (ii) Non-responders, in whom HbA1c increased by ≥10% after 2 years CSII treatment (309 patients; 17.9%); and (iii) Neutrals, in whom HbA1c decreased or increased by
Journal of Diabetes 6 (2014) 384–386
RESEARCH LETTER
Can we predict success of insulin pump therapy? Zdenek JANKOVEC, Vojtech CESAK, Michal KRCMA, Michal ZOUREK and Zdenek RUSAVY Medical Department I, University Hospital, Charles University, Plzen, Czech Republic
Keywords: continuous subcutaneous insulin infusion, diabetes, insulin pump.
The efficacy and safety of insulin pump treatment (continuous subcutaneous insulin infusion [CSII]) have been proven in a number of larger and smaller studies, metaanalyses, and on the basis of clinical experience.1,2 However, apart from the indisputable benefits of CSII treatment, we are aware of the increased economic and personal demands of this treatment compared with bolus insulin administration. An integral part of the approach to treatment is an educated and cooperating patient.1,2 The aim of our study was to identify parameters that could be used to predict successful and/or adverse outcomes of insulin pump treatment. The National Register of patients treated with insulin pump in the Czech Republic (hereafter the Register) was founded in 1998. Data are obtained from 63 cooperating departments of diabetology in the Czech Republic. The findings from the Register repeatedly show that CSII treatment is effective, even in the long term, and have its justified indications.3 We evaluated 1729 patients with complete data for the first 2 years of insulin pump treatment from the database of patients treated by CSII over the period 1998–2012. Data were compared at the beginning of treatment and after 2 years CSII treatment. We chose HbA1c, or rather its change (ΔHbA1c), as a value characterizing the success or failure of CSII treatment. Patients were divided into three groups as follows: (i) Responders, in whom a reduction in HbA1c ≥10% occurred after 2 years treatment (892 patients; 51.6%); (ii) Non-responders, in whom HbA1c increased by ≥10% after 2 years CSII treatment (309 patients; 17.9%); and (iii) Neutrals, in whom HbA1c decreased or increased by
