Objectives: To evaluate and assess glycemic control, total daily insulin requirements, weight, and patient satisfaction after changing from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII) therapy in patients with type 2 diabetes.
Methods: This was a retrospective cross-sectional cohort analysis of an electronic medical records database from a private physician's clinic. Patients over 18 years of age who had type 2 diabetes and who utilized CSII for at least six months were analyzed. Variables of interest included glycosylated hemoglobin, total daily insulin requirements, and weight at the time of conversion from MDI to CSII. Patients were also asked to complete a satisfaction survey comparing MDI to CSII.
Results: Thirty patients who met the inclusion criteria were identified. Hemoglobin A1c (HbA1c) decreased from 9.25% ± 2.20 to 7.94% ± 1.65 (P < 0.001) at six months, total daily insulin dose decreased from 1.33 ± 0.66 u/kg/day to 1.08 ± 0.70 u/kg/day (P < 0.001) at six months, and weight increased from 106.66 ± 19.17 kg to 109.75 ± 18.01 kg (P < 0.001). After twelve months, HbA1c did not significantly change and weight returned to baseline; however, total daily insulin dose significantly decreased. 95% of patients preferred CSII therapy to previous injection regimen for various reasons.
Conclusion: Insulin pump therapy provided better glycemic control and reduced the total amount of insulin utilized. Patients who utilized CSII thought that the treatment was more convenient, less burdensome, and provided better control of fluctuations in blood glucose. CSII was preferred by patients over multiple daily injections.