Insulin Pump Therapy Improves Quality of Life of Young Patients With Type 1 Diabetes Enrolled in a Government-Funded Insulin Pump Program: A Qualitative Study

The Evolution of Insulin Administration in Type 1 Diabetes

“…CSII may modestly reduce HbA1c without sufficient evidence to infer improvements in glycemic outcomes such as hypoglycemia when compared to MDI [87]. Several studies cite quality of life improvements on CSII therapy [88] [89] [90]. Additional benefits to CSII include the ability to use extended, dual, or square-wave boluses to more closely mimic absorption of mixed macronutrient content meals [91].…”

Comparison of Socioeconomic Disparities in Pump Uptake Among Children With Type 1 Diabetes in 2 Canadian Provinces With Different Payment Models

“…3 Despite complex technology requiring substantial self-management by the users, pumps are safe, enhance quality of life, and improve glycemic control in children with T1D. 2,[4][5][6][7][8][9] All Canadian provinces have implemented universal programs providing varying amounts of assistance to cover the cost of the pump (approximately CAD$7000) and supplies (eg, infusion sets, approximately CAD$4000 annually) for children with T1D younger than 18 years. To our knowledge, the pump program in Ontario is the only program that has been systematically evaluated.…”

“…Landmark studies, such as the Diabetes Control and Complications Trial/Epidemiology of Diabetes Investigations and Complications, demonstrated that intensive insulin therapy with either multiple daily injections or pumps improved glycemic control and delayed the development of complications . Despite complex technology requiring substantial self-management by the users, pumps are safe, enhance quality of life, and improve glycemic control in children with T1D . All Canadian provinces have implemented universal programs providing varying amounts of assistance to cover the cost of the pump (approximately CAD$7000) and supplies (eg, infusion sets, approximately CAD$4000 annually) for children with T1D younger than 18 years.…”

Mental Health Matters: Limited Support Remains a Barrier to Optimal Care for Youth With Diabetes

“…Anxiety is a prevalent mental health concern for children and youth with type 1 diabetes; 18% will be diagnosed with an anxiety disorder before adulthood and having an anxiety disorder is associated with higher glycated hemoglobin (A1C) levels ( 7 ). Vesco et al ( 8 ) report that diabetes distress mediates this association between anxiety and A1C, suggesting that targeted strategies addressing diabetes distress are needed ( 9 ). In addition to anxiety, decreased quality of life and stigma are also associated with suboptimal glycemic control.…”

“…The use of advanced diabetes care technology, particularly continuous glucose monitoring systems and insulin pumps, may ameliorate some psychosocial adversity. For instance, in the qualitative study by Haynes et al, parents of young children report improved quality of life and “peace of mind” in managing their young child’s diabetes with insulin pump therapy compared with injections ( 9 ). Across all age groups, including adolescents and youth, pump use was reported to help them feel more “normal” and reduce diabetes-associated feelings of shame or stigma.…”