Joanneum Research, A-8010Graz, Austria.
Diabetes Technol Ther. 2010 Jan;12(1):89-94. doi: 10.1089/dia.2009.0080.
This study investigated reasons for the rejection and discontinuation of insulin pump therapy and explored general attitudes towards this mode of therapy among young patients with type 1 diabetes.
A questionnaire was developed using a focus group of young people with diabetes. It was then used to survey a random sample of adolescents and young people identified by physicians specializing in diabetes care and participating in a voluntary quality improvement initiative in Germany. The physicians were also surveyed.
Eighty-eight patients participated in the survey (22 had never used the pump, 20 had formerly used the pump, and 46 were using the pump at that time, with an average age of between 20 and 22 years, depending on the group). Those who had never used the pump had had diabetes for a significantly shorter length of time and had undergone their first diabetes education more recently. Current pump users were significantly younger at the time of the first diabetes education. There were no significant differences between patients concerning where they obtained their information about the condition and treatment options. Although clinical factors were named, social and psychological factors were prominent as reasons both in reluctance to try the pump therapy and in discontinuing therapy. Technical problems as a disadvantage of the pump (aside from the catheter) were less likely to be named. Responses among physicians confirmed discipline and compliance were essential prerequisites for this therapy and supported findings that patients discontinuing pump therapy at their own request tend to do so for nonclinical reasons.
Although the technical reliability of the insulin pump was generally accepted by all patients regardless of current treatment, clinical disadvantages relating to the use of the pump but more commonly social/psychological factors were named, which resulted in patients being reluctant to try this therapy or discontinuing use of it.
本研究旨在探讨胰岛素泵治疗被拒绝和终止的原因，并探讨年轻 1 型糖尿病患者对这种治疗模式的总体态度。
使用糖尿病青年焦点小组开发了一份问卷。然后，它被用来调查德国参与自愿质量改进计划的专门从事糖尿病护理的医生确定的青少年和年轻人的随机样本。也对医生进行了调查。
88 名患者参与了调查（22 名从未使用过胰岛素泵，20 名曾使用过胰岛素泵，46 名当时正在使用胰岛素泵，平均年龄在 20 到 22 岁之间，具体取决于组）。从未使用过胰岛素泵的患者患糖尿病的时间明显较短，并且最近接受了首次糖尿病教育。目前使用胰岛素泵的患者在接受首次糖尿病教育时年龄明显较小。患者在获得有关病情和治疗选择的信息方面没有差异。尽管提到了临床因素，但社会和心理因素在不愿意尝试胰岛素泵治疗和停止治疗方面都是突出的原因。将技术问题作为胰岛素泵的缺点（除了导管）的情况较少。医生的回应证实，纪律和遵守是这种治疗的必要前提，并支持发现患者自行停止胰岛素泵治疗往往是出于非临床原因。
尽管所有患者，无论当前治疗如何，都普遍接受胰岛素泵的技术可靠性，但与使用泵相关的临床劣势，更常见的是社会/心理因素，导致患者不愿意尝试这种治疗或停止使用它。
