Continuous subcutaneous insulin infusion in diabetes mellitus type 1 and 2: lower HbA1c-values and a high level of patient satisfaction

OBJECTIVE: To determine the HbA1c-values and the degree of satisfaction of patients who had switched from multiple subcutaneous insulin injections to continuous subcutaneous insulin infusion (CSII). DESIGN: Retrospective. METHOD: Data were collected and evaluated from all patients with type 1 or 2 diabetes mellitus who started treatment with CSII in the period from 1 January 1999 to 31 December 2001 in the Rijnmond-Zuid Medical Centre, Zuider site, Rotterdam, the Netherlands. The data included the insulin dosage and HbA1c-percentages before and three months after the start of CSII, and the degree of satisfaction of the patients on a scale from 1 (poor) to 10 (good). RESULTS: Of the 57 patients who started CSII, two resumed multiple daily subcutaneous injections within a few months. Of the other 55 patients, 36 (including 15 men) had type-1 diabetes, with an average age of 36.1 years, and 19 (including 8 men) had type-2 diabetes, with an average age of 49.7 years. Poor regulation of the blood glucose levels was the main reason (n = 40; 73%) for switching to CSII. In the 36 patients with type-1 diabetes, there was no significant change in the total dose of insulin before and during CSII, while the mean HbA1c-level decreased from 8.2 (SD: 1.2) to 7.3% (SD: 1.0; p = 0.0005). In the 19 patients with type-2 diabetes, there was also no significant change in insulin dosage, while the HbA1c-level decreased from 8.1 (SD: 1.0) to 7.6% (SD: 1.1; p = 0.056). All 47 interviewed patients were satisfied with the treatment. The mean score was 8.3 in type-1 diabetes mellitus and 8.1 in type-2 diabetes mellitus. CONCLUSION: Following three months on CSII, the average HbA1c-percentages were lower than during the previous treatment with multiple subcutaneous insulin injections. The patients were satisfied with the convenience of the treatment.