The Effect of Retraining on Treatment Success, Quality of Life, and Metabolic Parameters in Patients with Type 1 Diabetes Using an Insulin Pump

Abstract

Objective: To investigate the effect of insulin pump user retraining on treatment success, quality of life, and metabolic parameters of patients with type 1 diabetes using continuous subcutaneous insulin infusion. Subjects and Methods: A total of 35 subjects participated in this prospective study. All patients were given insulin pump user retraining. Their knowledge level and application skills, metabolic parameters, quality of life, and satisfaction from treatment were evaluated at baseline and after 6 months. Results: There wassignificant improvement in patients' knowledge and application skills after insulin pump user retraining (self-assessment of user skills: 69.7 ± 11.5 vs. 76.3 ± 11.3, p < 0.001; knowledge level on technical issues: 3.3 ± 1.1 vs. 4.1 ± 1.8, p = 0.003; glucose monitoring: 27.1 ± 5.8 vs. 29.2 ± 5.6, p = 0.006; management of hyperglycemia: 13.1 ± 3.2 vs. 15.7 ± 3.4, p < 0.001; management of pump and infusion site problems: 8.8 ± 2.6 vs. 10.6 ± 2.6, p = 0.001). Hemoglobin (Hb)A_1c levels of patients with poor glycemic control improved after retraining (8.61% ± 0.78 vs. 8.23% ± 0.79, p = 0.02). However, no significant improvement in quality of life and treatment satisfaction parameters were found. Conclusion: Management of type 1 diabetes in insulin pump users can be significantly improved by retraining. Even a basic short-term retraining program helps patients to increase their knowledge level and ability to more effectively use the insulin pump. The fact that retraining significantly improves glycemic parameters in patients with poor metabolic control indicates that priority should be given to this group of patients. Further studies with individualized training programs in larger sample sizes with long-term follow-up are needed to establish the importance of retraining and create re-education plans for patients with type 1 diabetes using an insulin pump.

Transition from pediatric to adult care in emerging adults with type 1 diabetes: a blueprint for effective receivership

“…Adult providers may choose to administer transition preparedness questionnaires during the first appointment with the patient, review transition preparedness materials from the pediatrics provider, or collaborate with diabetes educators to help identify and fill in these gaps. Assessment of diabetes-related skills may also provide an opportunity to re-educate patients based on identified deficits and allow providers to enact new treatment modalities at a time when young adults are highly engaged [24, 25].…”

Education programmes for persons with type 1 diabetes using an insulin pump: A systematic review

“…The search revealed two reviews ,18 among the 948 studies and, through the reviews, two additional studies were identified for full text assessment 19,20 . Nine quantitative studies fulfilled the inclusion criteria: two reporting on basic education 19,21 and seven on re‐education 6,22–27 …”

“…Only one randomised controlled study (RCT) was found 27 . The other studies' designs were not all clearly described—with one not specified at all 23 —but included a comparative effectiveness study 26 and two prospective studies 22,25 . A single study compared two different educational settings, 24 five studies compared participant outcomes before and after an added educational intervention, 6,22,25–27 while three studies evaluated only after the intervention 19,21,23 …”

“…CGM and isCGM use was reported in the three studies: Ehrmann et al 27 with 17.0% of participants using isCGM and 13.1% using CGM, Bergis et al 26 included 21.5% CGM users and Quiros et al, 21 who reported 9.2% of participants using a sensor‐augmented pump. Seven studies reported diabetes duration of the participants (mean from 16 to 28 years and standard deviation from 10 to 14 years) 6,21,22,24–27 . The age of participants was reported in all studies except one 23 and most studies considered middle‐aged pump users (mean age reported in seven studies from 34 to 47 years).…”

“…Five studies reported gender distribution. The majority were women, representing between 62.1% 21 and 74.3% 25 of study participants. Marital status and occupation were reported in one study 25 .…”