Authors: Nicolucci, A.¹; Maione, A.¹; Franciosi, M.¹; Amoretti, R.²; Busetto, E.³; Capani, F.⁴; Bruttomesso, D.⁵; Di Bartolo, P.⁶; Girelli, A.⁷; Leonetti, F.⁸; Morviducci, L.⁹; Ponzi, P.³; Vitacolonna, E.⁴

Source: Diabetic Medicine, Volume 25, Number 2, February 2008 , pp. 213-220(8)

Publisher: Wiley-Blackwell

Abstract:

Aims 

The aim of this case-control study was to compare quality of life (QoL) and treatment satisfaction in adults with Type 1 diabetes (T1DM) treated with either continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). Methods 

Consecutive patients aged between 18 and 55 years, and attending diabetes clinics for a routine visit, completed the Diabetes-Specific Quality-of-Life Scale (DSQOLS), the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the SF-36 Health Survey (SF-36). Case (CSII) and control subjects (MDI) were recruited in a 1 : 2 ratio. Results 

Overall, 1341 individuals were enrolled by 62 diabetes clinics; 481 were cases and 860 control subjects. Cases had a longer diabetes duration and were more likely to have eye and renal complications. Age, school education, occupation and HbA_1c were similar. Of control subjects, 90% followed glargine-based MDI regimens and 10% used NPH-based MDI regimens. On multivariate analysis, after adjusting for socioeconomic and clinical characteristics, scores in the following areas of the DSQOLS were higher in cases than control subjects: diet restrictions (β = 5.96; P < 0.0001), daily hassles (β = 3.57; P = 0.01) and fears about hypoglycaemia (β = 3.88; P = 0.006). Treatment with CSII was also associated with a markedly higher DTSQ score (β = 4.13; P < 0.0001) compared with MDI. Results were similar when CSII was compared separately with glargine- or NPH-based MDI regimens. Conclusions 

This large, non-randomized, case-control study suggests quality of life gains deriving from greater lifestyle flexibility, less fear of hypoglycaemia, and higher treatment satisfaction, when CSII is compared with either glargine-based or NPH-based MDI regimens.

Diabet. Med. 25, 213-220 (2008)

Keywords: continuous subcutaneous insulin infusion; multiple daily injections; quality of life; questionnaires; Type 1 diabetes

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1464-5491.2007.02346.x

Affiliations: 1: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, (CH), 2: The Diabetes Unit, Azienda Ospedaliera S. Giovanni Addolorata, Rome, 3: Fondazione Medtronic Italia, Sesto San Giovanni (MI) , 4: Department of Medicine and Ageing, University `G. D'Annunzio', Chieti and Online University `Leonardo da Vinci', Torrevecchia Teatina (CH), 5: Department of Clinical and Experimental Medicine, University of Padova, Padova, 6: Diabetes Unit, AUSL Provincia di Ravenna, Ravenna, 7: Diabetes Unit, Spedali Civili di Brescia, Brescia, 8: Department of Clinical Sciences, La Sapienza University and 9: Diabetes Unit, San Camillo Hospital, Rome, Italy

Publication date: 2008-02-01

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• By this author: Nicolucci, A. ;  Maione, A. ;  Franciosi, M. ;  Amoretti, R. ;  Busetto, E. ;  Capani, F. ;  Bruttomesso, D. ;  Di Bartolo, P. ;  Girelli, A. ;  Leonetti, F. ;  Morviducci, L. ;  Ponzi, P. ;  Vitacolonna, E.

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