Availability of insulin pump therapy in clinical practice

Britt Carlsson, Patiyan Andersson, J Alnervik, John Carstensen, Marcus Lind

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Aim: To examine the availabilityof insulin pump therapy in patients with Type 1 diabetes.

     

    Methods: Patients using insulinpumps among a cohort of 7224 patients with Type 1 diabetes were studied.

     

    Results: In logistic regression,used to evaluate variables not changing over time among the total cohort, useof insulin pumps varied by outpatient clinic (P < 0.001) and sex (P < 0.001).Cox regression analysis in 5854 patients with detailed patient data prior touse of an insulin pump showed higher HbA1c (P < 0.0001),lower creatinine (P = 0.002), high and low insulin doses (P < 0.0001),younger age (P < 0.0001) and female sex (P < 0.0001)to be associated with use of an insulin pump. Women were 1.5-fold more likelyto start using an insulin pump (hazard ratio 1.52, 95% confidence interval1.29–1.79) and patients in the 20- to 30-years age range were more than twiceas likely to begin use of an insulin pump than patients aged 40–50 years(hazard ratio 8.63, 95% confidence interval 5.91–12.59 and hazardratio 3.98, 95% confidence interval 2.80–5.64, respectively). A 10-μmol/lhigher level of creatinine was associated with a hazard ratio of 0.56 (95%confidence interval 0.39–0.81) of starting use of an insulin pump.

     

    Conclusions: At 10 hospitaloutpatient clinics in Sweden, use of insulin pumps therapy varied by clinic. Ahigher proportion of women began using insulin pumps. Younger patients andpatients with fewer complications were also more likely to start using aninsulin pump. Further research is needed to confirm these findings in othergeographical regions and to understand whether the availability of insulinpumps today is optimized.

    Original languageEnglish
    Pages (from-to)1055-1059
    Number of pages5
    JournalDiabetic Medicine
    Volume29
    Issue number8
    DOIs
    Publication statusPublished - Aug 2012

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    Insulin
    Therapeutics
    Confidence Intervals
    Creatinine
    Ambulatory Care Facilities
    Sweden
    Logistic Models
    Regression Analysis
    Research

    Cite this

    Carlsson, B., Andersson, P., Alnervik, J., Carstensen, J., & Lind, M. (2012). Availability of insulin pump therapy in clinical practice. Diabetic Medicine, 29(8), 1055-1059. https://doi.org/10.1111/j.1464-5491.2011.03517.x
    Carlsson, Britt ; Andersson, Patiyan ; Alnervik, J ; Carstensen, John ; Lind, Marcus. / Availability of insulin pump therapy in clinical practice. In: Diabetic Medicine. 2012 ; Vol. 29, No. 8. pp. 1055-1059.
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    title = "Availability of insulin pump therapy in clinical practice",
    abstract = "Aim: To examine the availabilityof insulin pump therapy in patients with Type 1 diabetes. Methods: Patients using insulinpumps among a cohort of 7224 patients with Type 1 diabetes were studied. Results: In logistic regression,used to evaluate variables not changing over time among the total cohort, useof insulin pumps varied by outpatient clinic (P < 0.001) and sex (P < 0.001).Cox regression analysis in 5854 patients with detailed patient data prior touse of an insulin pump showed higher HbA1c (P < 0.0001),lower creatinine (P = 0.002), high and low insulin doses (P < 0.0001),younger age (P < 0.0001) and female sex (P < 0.0001)to be associated with use of an insulin pump. Women were 1.5-fold more likelyto start using an insulin pump (hazard ratio 1.52, 95{\%} confidence interval1.29–1.79) and patients in the 20- to 30-years age range were more than twiceas likely to begin use of an insulin pump than patients aged 40–50 years(hazard ratio 8.63, 95{\%} confidence interval 5.91–12.59 and hazardratio 3.98, 95{\%} confidence interval 2.80–5.64, respectively). A 10-μmol/lhigher level of creatinine was associated with a hazard ratio of 0.56 (95{\%}confidence interval 0.39–0.81) of starting use of an insulin pump. Conclusions: At 10 hospitaloutpatient clinics in Sweden, use of insulin pumps therapy varied by clinic. Ahigher proportion of women began using insulin pumps. Younger patients andpatients with fewer complications were also more likely to start using aninsulin pump. Further research is needed to confirm these findings in othergeographical regions and to understand whether the availability of insulinpumps today is optimized.",
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    Carlsson, B, Andersson, P, Alnervik, J, Carstensen, J & Lind, M 2012, 'Availability of insulin pump therapy in clinical practice', Diabetic Medicine, vol. 29, no. 8, pp. 1055-1059. https://doi.org/10.1111/j.1464-5491.2011.03517.x

    Availability of insulin pump therapy in clinical practice. / Carlsson, Britt; Andersson, Patiyan; Alnervik, J; Carstensen, John; Lind, Marcus.

    In: Diabetic Medicine, Vol. 29, No. 8, 08.2012, p. 1055-1059.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Carlsson, Britt

    AU - Andersson, Patiyan

    AU - Alnervik, J

    AU - Carstensen, John

    AU - Lind, Marcus

    PY - 2012/8

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    N2 - Aim: To examine the availabilityof insulin pump therapy in patients with Type 1 diabetes. Methods: Patients using insulinpumps among a cohort of 7224 patients with Type 1 diabetes were studied. Results: In logistic regression,used to evaluate variables not changing over time among the total cohort, useof insulin pumps varied by outpatient clinic (P < 0.001) and sex (P < 0.001).Cox regression analysis in 5854 patients with detailed patient data prior touse of an insulin pump showed higher HbA1c (P < 0.0001),lower creatinine (P = 0.002), high and low insulin doses (P < 0.0001),younger age (P < 0.0001) and female sex (P < 0.0001)to be associated with use of an insulin pump. Women were 1.5-fold more likelyto start using an insulin pump (hazard ratio 1.52, 95% confidence interval1.29–1.79) and patients in the 20- to 30-years age range were more than twiceas likely to begin use of an insulin pump than patients aged 40–50 years(hazard ratio 8.63, 95% confidence interval 5.91–12.59 and hazardratio 3.98, 95% confidence interval 2.80–5.64, respectively). A 10-μmol/lhigher level of creatinine was associated with a hazard ratio of 0.56 (95%confidence interval 0.39–0.81) of starting use of an insulin pump. Conclusions: At 10 hospitaloutpatient clinics in Sweden, use of insulin pumps therapy varied by clinic. Ahigher proportion of women began using insulin pumps. Younger patients andpatients with fewer complications were also more likely to start using aninsulin pump. Further research is needed to confirm these findings in othergeographical regions and to understand whether the availability of insulinpumps today is optimized.

    AB - Aim: To examine the availabilityof insulin pump therapy in patients with Type 1 diabetes. Methods: Patients using insulinpumps among a cohort of 7224 patients with Type 1 diabetes were studied. Results: In logistic regression,used to evaluate variables not changing over time among the total cohort, useof insulin pumps varied by outpatient clinic (P < 0.001) and sex (P < 0.001).Cox regression analysis in 5854 patients with detailed patient data prior touse of an insulin pump showed higher HbA1c (P < 0.0001),lower creatinine (P = 0.002), high and low insulin doses (P < 0.0001),younger age (P < 0.0001) and female sex (P < 0.0001)to be associated with use of an insulin pump. Women were 1.5-fold more likelyto start using an insulin pump (hazard ratio 1.52, 95% confidence interval1.29–1.79) and patients in the 20- to 30-years age range were more than twiceas likely to begin use of an insulin pump than patients aged 40–50 years(hazard ratio 8.63, 95% confidence interval 5.91–12.59 and hazardratio 3.98, 95% confidence interval 2.80–5.64, respectively). A 10-μmol/lhigher level of creatinine was associated with a hazard ratio of 0.56 (95%confidence interval 0.39–0.81) of starting use of an insulin pump. Conclusions: At 10 hospitaloutpatient clinics in Sweden, use of insulin pumps therapy varied by clinic. Ahigher proportion of women began using insulin pumps. Younger patients andpatients with fewer complications were also more likely to start using aninsulin pump. Further research is needed to confirm these findings in othergeographical regions and to understand whether the availability of insulinpumps today is optimized.

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    JO - Diabetic Medicine

    JF - Diabetic Medicine

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    Carlsson B, Andersson P, Alnervik J, Carstensen J, Lind M. Availability of insulin pump therapy in clinical practice. Diabetic Medicine. 2012 Aug;29(8):1055-1059. https://doi.org/10.1111/j.1464-5491.2011.03517.x