CSII as an alternative therapeutic strategy for managing type 2 diabetes: Adding the Indian experience to a global perspective

摘要

Background: Alternative insulin therapy with continuous subcutaneous insulin infusion (CSII) is offered with an objective of achieving better glycemic control, minimising glucose variability and thereby, preventing or reducing the risk of microvascular and macrovascular complications in people with type 1 or type 2 diabetes. Trials conducted across the world have demonstrated that CSII is more beneficial in terms of achieving better metabolic control in type 2 diabetes. Unawareness about the multiple benefits of CSII is a major hurdle to its widespread use. In India, insulin pumps are more popular in type 2 diabetes and we have been deploying pumps since 2004. Previously, we have reported reduction in HbA1c, body weight and total daily dose of insulin in patients on insulin pump therapy (IPT). Objective: The objective of this study was to assess the attitude and behavior of type 2 diabetes patients on IPT. Methods: A cross sectional survey was conducted among selected type 2 diabetes patients who have been on IPT for more than 3 years. We administered questionnaires to assess level of satisfaction with pump, improvement in quality of life (QoL), use of the advanced functions and average cost incurred by being on pump. Difference in scores between males and females were assessed using chiquare test for proportions and t-test for differences in means. Results: Improvement in QoL after being on pump was appreciated by 92. The level of satisfaction was rated as ‘fully satisfied’ by 52 of respondents while 26 found being on pump, ‘satisfactory’. Ninety percent thought that the pump met their expectations. Conclusion: The attitude and behavior of type 2 diabetes patients on IPT is positive and promising.