Treatment of type 1 diabetes with continuous subcutaneous insulin infusion (CSII) in adults in Iceland

Objective: The goal of the study was to evaluate the effect and safety of CSII treatment in individuals 18 years and older with type 1 diabetes mellitus in Iceland. Methods: The research is retrospective. We gathered information from patient data of 40 individuals, age 19-57 years who had been treated with CSII in Iceland for 6 months or longer during the period January 2004 until December 2007. We looked at the effect of the treatment on treatment complications, HbA1c, body mass index (BMI) and insulin requirements compared with multiple daily injections (MDI). Results: HbA1c was lower on CSII but the difference was not significant. Mean initial HbA1c was 7.23 (95% confidence limits 6.29-8.18) for men and 6.93 (95% confidence limits 6.57-7.28) for women. The change in BMI was not significant. Mean initial BMI for men was 25.5 (95% confidence limits 23.6-27.3) and 25.9 (95% confidence limits 23.8-27.9) for women. Insulin requirements were significantly lower at the end of the study for both men and women. Insulin requirements decreased by mean 11.3 units for men (P=0.04) and 12.8 units for women (P=0.0009). There where six episodes of ketoacidosis, four of skin infections and two hypoglycemias that needed doctors attention while using CSII treatment. Conclusion: The experience of CSII treatment in Iceland is good. These results confirm that this treatment is safe and as effective as other treatment forms. Even tough the difference in HbA1c was not significant the result showed that those who had the highest HbA1c at the beginning of CSII treatment did get the best result with the pump and the insulin dosage was lower with CSII than with MDI.