Sensor-augmented pump therapy at 36 months.

BACKGROUND

This follow-up study investigates the metabolic and psychosocial effects of sensor-augmented pump (SAP) therapy in adults with type 1 diabetes 36 months after therapy start.

SUBJECTS AND METHODS

We invited all 24 Danish adults with type 1 diabetes who had previously participated in the European multicenter randomized controlled Eurythmics Trial. Thirteen of the 24 patients started SAP therapy during the Eurythmics Trial; 11 patients were controls but started using SAP immediately after completion of the trial. In the current study, we estimated the effects of SAP 36 months after therapy start by change in glycated hemoglobin (HbA1c) and diabetes questionnaire scores (Diabetes Treatment Satisfactions Questionnaire [DTSQs], Problem Areas in Diabetes [PAID] questionnaire, and Hypoglycemia Fear Survey [HFS]).

RESULTS

At 36 months, 16 of the 24 patients were still using SAP, 14 of them > 70% of time. The HbA1c level decreased from 8.7% at therapy start to 7.3% at 36 months (P < 0.0001). Similar reductions in HbA1c were obtained regardless of whether SAP therapy was initiated during or after the Eurythmics Trial. DTSQs, PAID questionnaire, and HFS scores improved by 9.0 (P < 0.0001), -10.8 (P = 0.013), and -5.5 (P = 0.152), respectively, in the 16 SAP users.

CONCLUSIONS

This study documents persisting beneficial effects of SAP on HbA1c, treatment satisfaction, magnitude of diabetes-related problems, and fear of hypoglycemia 36 months after therapy start. The follow-up is considerably longer than in other published studies; still, the results are in line with the positive short-term outcomes of larger studies of SAP use.