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.