Beyond the barriers of the use of continuous subcutaneous insulin therapy in type 1 diabetes: a new opportunity from catheter-less insulin pumps
DOI:
https://doi.org/10.33393/ao.2021.2266Keywords:
CSII, Glycemic control, Hypoglycemia/prevention and control, Insulin/administration and dosage, Subcutaneous infusion, Type 1 diabetes mellitusAbstract
Although it represents a valid alternative for patients with type 1 diabetes (T1DM) with insufficient glycemic control and/or with recurrent hypoglycemia, insulin pump therapy (Continuous Subcutaneous Insulin Infusion, CSII) in Italy is nowadays still relatively uncommon. The following review aims to investigate the barriers that limit the transition to CSII and the reasons behind the widespread cases of drop-out, particularly evident in younger patients. Among the interventions that could contribute to the solution of the problem, catheter-less insulin pumps (or patch-pumps) will be described: a tool potentially able to reduce, if not eliminate, some of the main obstacles encountered by patients. In particular, a new opportunity has become available today thanks to the evolution of the generation of catheter-less insulin pumps represented by Accu-Chek® Solo (Roche Diabetes Care GmbH), therefore three clinical cases of patients with T1DM undergoing therapy with the Accu-Chek® Solo insulin pump will be presented and discussed herein.
Downloads
References
Associazione Medici Diabetologi (AMD) – Società Italiana di Diabetologia (SID). Standard italiani per la cura del diabete mellito. 2018. https://aemmedi.it/wp-content/uploads/2009/06/AMD-Standard-unico1.pdf (Accessed March 17, 2021).
Addendum. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl.1):S98-S110 - August 01, 2020. https://doi.org/10.2337/dc20-ad08a PMID: 32503835/
Commissariat PV, Boyle CT, Miller KM, et al. Insulin Pump Use in Young Children with Type 1 Diabetes: Sociodemographic Factors and Parent-Reported Barriers. Diabetes Technol Ther. 2017;19(6):363-369. CrossRef Medline. https://doi.org/10.1089/dia.2016.0375 PMID:28581817
Jeitler K, Horvath K, Berghold A, et al. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia. 2008;51(6):941-951. CrossRef Medline. https://doi.org/10.1007/s00125-008-0974-3 PMID:18351320
Blackman SM, Raghinaru D, Adi S, et al. Insulin pump use in young children in the T1D Exchange clinic registry is associated with lower hemoglobin A1c levels than injection therapy. Pediatr Diabetes. 2014;15(8):564-572. CrossRef Medline. https://doi.org/10.1111/pedi.12121PMID:24494980
Johnson SR, Cooper MN, Jones TW, Davis EA. Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case-control study. Diabetologia. 2013;56(11):2392-2400. CrossRef Medline. https://doi.org/10.1007/s00125-013-3007-9 PMID:23963323
Pozzilli P, Battelino T, Danne T, Hovorka R, Jarosz-Chobot P, Renard E. Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics. Diabetes Metab Res Rev. 2016;32(1):21-39. CrossRef Medline. https://doi.org/10.1002/dmrr.2653 PMID:25865292
Documento del Gruppo di Studio Intersocietario AMD-SID-SIEDP “Tecnologia e Diabete”. 2019. http://www.siedp.it/files/2019_GruppoIntersocietarioDiabTecnologie.pdf (Accessed March 17, 2021).
American Diabetes Association. Continuous subcutaneous insulin infusion. Diabetes Care. 2004;27(suppl 1):S110. CrossRef Medline. https://doi.org/10.2337/diacare.27.2007.S110PMID:14693943
Bonora E, Sesti G. Società Italiana di Diabetologia. Il diabete in Italia. Bononia University Press; 2016. https://www.siditalia.it/pdf/Il%20Diabete%20in%20Italia_p.pdf (Accessed March 17, 2021).
Manicardi V, Adinolfi V, Aricò N et al. Annali AMD 2020. Diabete di tipo 1. 2020. https://www.diabete.com/wp-content/uploads/2020/10/Annali-nuova-versione-2020_2-ok_DT1-min.pdf (Accessed March 17, 2021).
Renard E. Insulin pump use in Europe. Diabetes Technol Ther. 2010;12(S1)(suppl 1):S29-S32. CrossRef Medline. https://doi.org/10.1089/dia.2009.0189 PMID:20515303
Tanenbaum ML, Hanes SJ, Miller KM, Naranjo D, Bensen R, Hood KK. Diabetes Device Use in Adults With Type 1 Diabetes: Barriers to Uptake and Potential Intervention Targets. Diabetes Care. 2017;40(2):181-187. CrossRef Medline. https://doi.org/10.2337/dc16-1536PMID:27899489
Ronsin O, Jannot-Lamotte MF, Vague P, Lassman-Vague V. Factors related to CSII compliance. Diabetes Metab. 2005;31(1):90-95. CrossRef Medline. https://doi.org/10.1016/S1262-3636(07)70173-8 PMID:15803120
Cortina S, Repaske DR, Hood KK. Sociodemographic and psychosocial factors associated with continuous subcutaneous insulin infusion in adolescents with type 1 diabetes. Pediatr Diabetes. 2010;11(5):337-344. CrossRef Medline. https://doi.org/10.1111/j.1399-5448.2009.00593.x PMID:19761529
de Vries L, Grushka Y, Lebenthal Y, Shalitin S, Phillip M. Factors associated with increased risk of insulin pump discontinuation in pediatric patients with type 1 diabetes. Pediatr Diabetes. 2011;12(5):506-512. CrossRef Medline. https://doi.org/10.1111/j.1399-5448.2010.00701.xPMID:20723097
Tanenbaum ML, Adams RN, Hanes SJ, et al. Optimal Use of Diabetes Devices: Clinician Perspectives on Barriers and Adherence to Device Use. J Diabetes Sci Technol. 2017;11(3):484-492. CrossRef Medline. https://doi.org/10.1177/1932296816688010 PMID:28745093
Seereiner S, Neeser K, Weber C, et al. Attitudes towards insulin pump therapy among adolescents and young people. Diabetes Technol Ther. 2010;12(1):89-94. CrossRef Medline. https://doi.org/10.1089/dia.2009.0080 PMID:20082590
Sullivan-Bolyai S, Knafl K, Tamborlane W, Grey M. Parents’ reflections on managing their children’s diabetes with insulin pumps. J Nurs Scholarsh. 2004;36(4):316-323. CrossRef Medline. https://doi.org/10.1111/j.1547-5069.2004.04058.x PMID:15636411
Lombardo F, Scaramuzza AE, Iafusco D. Failure of glycated hemoglobin drop after continuous subcutaneous insulin infusion initiation may indicate patients who discontinue: a 4-year follow-up study in children and adolescents with type 1 diabetes. Acta Diabetol. 2012;49(S1)(suppl 1):S99-S105. CrossRefMedline. https://doi.org/10.1007/s00592-011-0344-3PMID:22008950
Wong JC, Boyle C, DiMeglio LA, et al; T1D Exchange Clinic Network. Evaluation of Pump Discontinuation and Associated Factors in the T1D Exchange Clinic Registry. J Diabetes Sci Technol. 2017;11(2):224-232. CrossRef Medline. https://doi.org/10.1177/1932296816663963PMID:27595711
Hofer SE, Heidtmann B, Raile K, et al; DPV-Science-Initiative and the German working group for insulin pump treatment in pediatric patients. Discontinuation of insulin pump treatment in children, adolescents, and young adults. A multicenter analysis based on the DPV database in Germany and Austria. Pediatr Diabetes. 2010;11(2):116-121. CrossRef Medline. https://doi.org/10.1111/j.1399-5448.2009.00546.x PMID:19566740
Wong JC, Dolan LM, Yang TT, Hood KK. Insulin pump use and glycemic control in adolescents with type 1 diabetes: predictors of change in method of insulin delivery across two years. Pediatr Diabetes. 2015;16(8):592-599. CrossRef Medline. https://doi.org/10.1111/pedi.12221 PMID:25387433
Wood JR, Moreland EC, Volkening LK, Svoren BM, Butler DA, Laffel LM. Durability of insulin pump use in pediatric patients with type 1 diabetes. Diabetes Care. 2006;29(11):2355-2360. CrossRef Medline. https://doi.org/10.2337/dc06-1141 PMID:17065667
Ulbrich S, Waldenmaier D, Haug C, Freckmann G, Rendschmidt T, Künsting T. Concept and Implementation of a Novel Patch Pump for Insulin Delivery. J Diabetes Sci Technol. 2020;14(2):324-327. CrossRef Medline. https://doi.org/10.1177/1932296819871626PMID:31452394
Heinemann L, Waldenmaier D, Kulzer B, Ziegler R, Ginsberg B, Freckmann G. Patch Pumps: Are They All the Same? J Diabetes Sci Technol. 2019;13(1):34-40. CrossRef Medline. https://doi.org/10.1177/1932296818795150 PMID:30132698
Layne JE, Parkin CG, Zisser H. Efficacy of a tubeless patch pump in patients with type 2 diabetes previously treated with multiple daily injections. J Diabetes Sci Technol. 2017;11(1):178-179. CrossRef Medline. https://doi.org/10.1177/1932296816653143 PMID:27290736
Layne JE, Parkin CG, Zisser H. Efficacy of the OmniPod insulin management system on glycemic control in patients with type 1 diabetes previously treated with multiple daily injections or continuous subcutaneous insulin infusion. J Diabetes Sci Technol. 2016;10(5):1130-1135. CrossRef Medline. https://doi.org/10.1177/1932296816638674 PMID:27290737
Danne T, Schwandt A, Biester T, et al; DPV Initiative. Long-term study of tubeless insulin pump therapy compared to multiple daily injections in youth with type 1 diabetes: data from the German/Austrian DPV registry. Pediatr Diabetes. 2018;19(5):979-984. CrossRef Medline. https://doi.org/10.1111/pedi.12658 PMID:29446511
Mehta SN, Tinsley LJ, Kruger D, et al. Improved Glycemic Control Following Transition to Tubeless Insulin Pump Therapy in Adults With Type 1 Diabetes. Clin Diabetes. 2021;39(1):72-79. CrossRef Medline. https://doi.org/10.2337/cd20-0022 PMID:33551556
Mader Jk, Oliver N, Vesper I, et al. First results from PRO Solo: patient reported outcomes from a clinical trial comparing a new patch pump with MDI and an established patch pump. EASD, Abstract # 708. https://www.easd.org/virtualmeeting/home.html#!resources/first-results-from-pro-solo-patient-reported-outcomes-from-a-clinical-trial-comparing-a-new-patch-pump-with-mdi-and-an-established-patch-pump-bd91cbf2-e1ff-42c0-99c3-4fa16eed5120 (Bergh). 2020. Accessed May 9, 2021.
Sakane N, Murata T, Tone A, et al. Development and Validation of the Continuous Subcutaneous Insulin Infusion-Related Quality-of-Life (CSII-QOL) Scale. Diabetes Technol Ther. 2020;22(3):216-221. CrossRef Medline. https://doi.org/10.1089/dia.2019.0216 PMID:31638420
SID. Indagine della società italiana di diabetologia (SID) sulle differenze regionali nell’accesso a farmaci, presidi e servizi per la persona con diabete. https://www.siditalia.it/clinica/linee-guida-societari/send/80-linee-guida-documenti-societari/4717-indagine-sid-differenze-regionali (Bergh). 2019. Accessed March 17, 2021.
Roze S, Duteil E, De Brouwer BF, de Portu S. Health-economic analysis of the use of Sensor-Augmented Pump (Sap) Therapy In The Netherlands Compared to Insulin Pump Therapy Alone (CSII), In Type 1 Diabetic Patients. Value Health. 2015;18(7):A360-A361. CrossRef. https://doi.org/10.1016/j.jval.2015.09.695
Ziegler R, Oliver N, Waldenmaier D, Mende J, Haug C, Freckmann G. Evaluation of the accuracy of current tubeless pumps for continuous subcutaneous insulin infusion. Diabetes Technol Ther. 2020;dia.2020.0525. https://doi.org/10.1089/dia.2020.0525 PMID: 33210949
Winkelkötter J, Reitz T. Analysis of the Waste Volume and CO2-Equivalent Caused by the Use of Selected Patch Pumps. J Diabetes Sci Technol. 2021;1932296821991523. PMID:33576259 https://doi.org/10.1177/1932296821991523
Downloads
Published
How to Cite
License
Copyright (c) 2021 The Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2021-05-20
Published 2021-07-02
10.2337/cd22-0034
