Beltrand Jacques, Benhamou Pierre-Yves, Choleau Carine, Braithwaite Ben, Bonin Alice, Riveline Jean-Pierre
Service d'Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker Enfants Malades, APHP Centre, Université de Paris-Cité, Paris, France.
Inserm U1016, UMR Institut Cochin, Paris, France.
Diabetes Ther. 2025 Feb;16(2):289-306. doi: 10.1007/s13300-024-01682-8. Epub 2024 Dec 24.
While people with diabetes (PWD)'s experiences with their insulin delivery systems (IDS) are frequently reported in clinical trials, few real-world data exist on the subject. This study aimed to assess the real-world experience and satisfaction with IDS in PWD.
This cross-sectional survey of PWD treated with tubed or tubeless insulin pumps, hybrid closed loop (HCL) systems, or multiple daily injections (MDI) for at least 3 months ran from 4 to 16 May 2023. The questionnaire containing bespoke questions and the Insulin Delivery System Rating Questionnaire (IDSRQ) satisfaction and interference subscales was answered by subscribers of the Aide aux Jeunes Diabétiques patient association and users of the MyDiabby Healthcare web platform.
Of 896 analysable respondents (552 children [age 10.7 ± 3.8 years, 46.9% female, all type 1] and 344 adults [age 43.1 ± 19.3 years, 61.9% female, 87.2% type 1]), HCL and pump users reported greater satisfaction with their IDS on the IDSRQ satisfaction subscale (HCL, 70.9 ± 17.7 [n = 208]; tubeless, 66.6 ± 19.1 [n = 272]; tubed, 64.1 ± 21.6 [n = 215]) than MDI users (53.1 ± 23.0 [n = 201]; all p < 0.001). Regarding the interference subscale, tubeless pumps (31.1 ± 24.8) performed similarly to HCLs (37.0 ± 25.5; p = 0.07) and significantly better than tubed pumps (38.6 ± 26.0; p < 0.001) and MDI (42.2 ± 24.3; p < 0.001). Furthermore, 84.6% of tubeless pump users would retain their style of pump for their ideal HCL, almost twice as often as tubed pump users.
These results demonstrate a more positive person-reported experience with HCLs or tubeless pumps than with tubed pumps or MDI, primarily due to less interference with daily life, which most tubeless pump users would like to retain when transitioning to a HCL system. Overall, this pioneering study underscores the importance of patient preferences, providing valuable information for physicians prescribing IDS, and facilitating discussions about treatment options.
虽然糖尿病患者（PWD）在胰岛素给药系统（IDS）方面的体验在临床试验中经常被报道，但关于这一主题的真实世界数据却很少。本研究旨在评估PWD在IDS方面的真实世界体验和满意度。
这项横断面调查于2023年5月4日至16日进行，调查对象为使用管内或无管胰岛素泵、混合闭环（HCL）系统或多次皮下注射（MDI）治疗至少3个月的PWD。由青少年糖尿病患者援助协会的订阅者和MyDiabby Healthcare网络平台的用户回答包含定制问题以及胰岛素给药系统评分问卷（IDSRQ）满意度和干扰分量表的问卷。
在896名可分析的受访者中（552名儿童[年龄10.7±3.8岁，46.9%为女性，均为1型糖尿病]和344名成年人[年龄43.1±19.3岁，61.9%为女性，87.2%为1型糖尿病]），HCL和泵使用者在IDSRQ满意度分量表上对其IDS的满意度更高（HCL，70.9±17.7[n = 208]；无管，66.6±19.1[n = 272]；有管，64.1±21.6[n = 215]），高于MDI使用者（53.1±23.0[n = 201]；所有p<0.001）。关于干扰分量表，无管泵（31.1±24.8）的表现与HCL（37.0±25.5；p = 0.07）相似，且明显优于有管泵（38.6±26.0；p<0.001）和MDI（42.2±24.3；p<0.001）。此外，84.6%的无管泵使用者会在理想的HCL中保留他们的泵型，这一比例几乎是有管泵使用者的两倍。
这些结果表明，与有管泵或MDI相比，HCL或无管泵在患者报告方面的体验更积极，主要是因为对日常生活的干扰较少，大多数无管泵使用者在过渡到HCL系统时希望保留这种体验。总体而言，这项开创性研究强调了患者偏好的重要性，为开具IDS处方的医生提供了有价值的信息，并促进了关于治疗选择的讨论。
