Influence of health locus of control and fear of hypoglycaemia on glycaemic control and treatment satisfaction in people with Type 1 diabetes on insulin pump therapy

2017 ◽  
Vol 34 (5) ◽  
pp. 691-697 ◽  
Author(s):  
L. Indelicato ◽  
V. Mariano ◽  
S. Galasso ◽  
F. Boscari ◽  
E. Cipponeri ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Locus Of Control ◽  
Glycaemic Control ◽  
Treatment Satisfaction ◽  
Insulin Pump ◽  
Health Locus Of Control ◽  
Insulin Pump Therapy ◽  
Pump Therapy

scholarly journals Effect of Optimization of Glycaemic Control on Mannan-Binding Lectin in Type 1 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Gry Høst Dørflinger ◽  
Charlotte Brink Holt ◽  
Steffen Thiel ◽  
Jakob Appel Østergaard ◽  
Troels Krarup Hansen
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Insulin Pump ◽  
Insulin Dose ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Mannan Binding Lectin ◽  
Improved Glycaemic Control ◽  
Binding Lectin

Objective. Mannan-binding lectin (MBL) concentration in plasma is increased in subjects with type 1 diabetes and associated with increased mortality and risk of diabetic nephropathy. Recent findings show that pancreas transplantation reduces MBL concentration. Whether the increased MBL concentration is reversed by improved glycaemic control remains unknown. We investigated the effects of improved glycaemic control on MBL concentration in patients with type 1 diabetes. Methods. We measured MBL, fructosamine, and HbA1cat baseline and after 6 weeks in 52 type 1 diabetic patients following the change from conventional insulin therapy to insulin pump therapy. Results. After initiation of insulin pump therapy, the total daily insulin dose was significantly reduced (from 51 ± 18 IE/day to 39 ± 13 IE/day, P<0.0001). There was a significant decrease in HbA1c from 8.6% to 7.7% (from 70 mmol/mol to 61 mmol/mol, P<0.0001) and in fructosamine levels (from 356 μmol/L to 311 μmol/L, P<0.0001). MBL levels decreased by 10% from 2165 μg/L (IQR 919–3389 μg/L) at baseline to 1928 μ/L (IQR 811–2758 μg/L) at follow-up (P=0.005), but MBL change was not significantly correlated with changes in insulin dose, HbA1c, or fructosamine. Conclusions. MBL concentration decreased following the initiation of insulin pump therapy in patients with type 1 diabetes and did not correlate with changes in glycaemic control.

scholarly journals Marked improvements in glycaemic outcomes following insulin pump therapy initiation in people with type 1 diabetes: a nationwide observational study in Scotland

Diabetologia ◽  
2021 ◽  
Author(s):  
Anita Jeyam ◽  
◽  
Fraser W. Gibb ◽  
John A. McKnight ◽  
Brian Kennon ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Mixed Models ◽  
Rate Ratio ◽  
Insulin Pump ◽  
Event Rate ◽  
Statistical Significance ◽  
Insulin Pump Therapy ◽  
Pump Therapy

Abstract Aims/hypothesis Our aim was to assess the use of continuous subcutaneous insulin infusion (CSII) in people with type 1 diabetes in Scotland and its association with glycaemic control, as measured by HbA1c levels, frequency of diabetic ketoacidosis (DKA) and severe hospitalised hypoglycaemia (SHH), overall and stratified by baseline HbA1c. Methods We included 4684 individuals with type 1 diabetes from the national Scottish register, who commenced CSII between 2004 and 2019. We presented crude within-person differences from baseline HbA1c over time since initiation, crude DKA and SHH event-rates pre-/post-CSII exposure. We then used mixed models to assess the significance of CSII exposure, taking into account: (1) the diffuse nature of the intervention (i.e. structured education often precedes initiation); (2) repeated within-person measurements; and (3) background time-trends occurring pre-intervention. Results HbA1c decreased after CSII initiation, with a median within-person change of −5.5 mmol/mol (IQR −12.0, 0.0) (−0.5% [IQR −1.1, 0.0]). Within-person changes were most substantial in those with the highest baseline HbA1c, with median −21.0 mmol/mol (−30.0, −11.0) (−1.9% [−2.7, −1.0]) change in those with a baseline >84 mmol/mol (9.8%) within a year of exposure, that was sustained: −19.0 mmol/mol (−27.6, −6.5) (−1.7% [−2.5, −0.6]) at ≥5 years. Statistical significance and magnitude of change were supported by the mixed models results. The crude DKA event-rate was significantly lower in post-CSII person-time compared with pre-CSII person-time: 49.6 events (95% CI 46.3, 53.1) per 1000 person-years vs 67.9 (64.1, 71.9); rate ratio from Bayesian mixed models adjusting for pre-exposure trend: 0.61 (95% credible interval [CrI] 0.47, 0.77; posterior probability of reduction pp = 1.00). The crude overall SHH event-rate in post-CSII vs pre-CSII person-time was also lower: 17.8 events (95% CI 15.8, 19.9) per 1000 person-years post-exposure vs 25.8 (23.5, 28.3) pre-exposure; rate ratio from Bayesian mixed models adjusting for pre-exposure trend: 0.67 (95% CrI 0.45, 1.01; pp = 0.97). Conclusions/interpretation CSII therapy was associated with marked falls in HbA1c especially in those with high baseline HbA1c. CSII was independently associated with reduced DKA and SHH rates. CSII appears to be an effective option for intensive insulin therapy in people with diabetes for improving suboptimal glycaemic control. Graphical abstract

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