Retrospective Analysis and Patient Satisfaction Assessment of Insulin Pump Therapy in Patients with Type 2 Diabetes

Gentry, Chad; Cross, L. Brian; Gross, Benjamin; McFarland, M. Shawn; Bestermann, William H.

doi:10.1097/smj.0b013e3181fa7230

Cited by 18 publications

(19 citation statements)

References 15 publications

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“…This finding was consistent with other studies comparing baseline HbA1c to 12 months post-CSII initiation4,5,7. Of note, our baseline mean HbA1c pre-CSII was lower (8.69%) compared to other baseline HbA1c values from transitional studies3,5,7, thus the absolute mean HbA1c reduction of −1.17% was impressive. We also stratified HbA1c across 3-month intervals post-CSII over 12 months to assess the sustainability of glycemic control following conversion.…”

Section: Discussionsupporting

confidence: 92%

“…Assessing patient satisfaction with the clinical pharmacist is a qualitative outcome unique to our study. Previous studies have assessed patient satisfaction with CSII compared to MDI, with results showing that patients not only prefer CSII, but there is an improvement in patient quality-of-life3,9. Consistent with results from Gentry et al 3,.…”

Section: Discussionsupporting

confidence: 77%

“…Previous studies have assessed patient satisfaction with CSII compared to MDI, with results showing that patients not only prefer CSII, but there is an improvement in patient quality-of-life3,9. Consistent with results from Gentry et al 3,. patients felt that they were more in control of hyperglycemia and hypoglycemia with CSII.…”

Section: Discussionsupporting

confidence: 77%

“…Results from previous CSII-based trials have exhibited varying effects on weight or BMI3,6–8. Improved diabetes control using insulin intensification typically results in weight gain.…”

Section: Discussionmentioning

confidence: 99%

“…Physician–Pharmacist collaboration efforts centered on insulin initiation in veterans with uncontrolled type 2 diabetes has been previously described19 and intensification of anti-diabetes therapies, including insulin, has demonstrated a reduction in HbA1c20,21. Only one CSII-based study to date included clinical pharmacists working in collaboration with a multidisciplinary team with access to endocrinologists3. The current study involved pharmacists operating under collaboration with PCPs only, which more accurately represents the majority of primary care practice settings today.…”

Section: Introductionmentioning

confidence: 99%

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Impact of clinical pharmacist collaboration in patients beginning insulin pump therapy: a retrospective and cross-sectional analysis

Ledford

Hess

Johnson³

2013

Journal of Drug Assessment

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ObjectiveTo measure clinical and qualitative outcomes in patients with diabetes mellitus transitioning from intensive insulin therapy using multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII) initiated and managed by clinical pharmacists under a collaborative practice agreement in a primary care setting without an endocrinologist.Research design and methodsThis study was a retrospective and cross-sectional analysis of data from an electronic medical record (EMR) and patient survey at a large primary care private practice. Patients with type 1 or type 2 diabetes who were ≥18 years old, started on CSII between 2007 and 2010, and had at least one follow-up visit post-CSII were analyzed. Mean HbA1c results were stratified across 3-month intervals post-CSII initiation and compared to pre-CSII levels. Body mass index (BMI), the number of diabetes-related clinic visits with the primary care physician (PCP), and non-insulin diabetes medication use was compared pre- and post-CSII initiation. Paper-based questionnaires were used to assess patient satisfaction with CSII vs MDI and pharmacist-led services.ResultsTwenty-five patients were included in the analysis. HbA1c decreased from 8.69 to 7.52% pre and post-CSII, respectively (p < 0.001). HbA1c also decreased across all 3-month intervals post-CSII. BMI decreased from 33.0 to 32.3 kg/m2 pre- and post-CSII, respectively (p = 0.085). Fewer diabetes-related PCP visits were completed post-CSII (5.09 vs 3.78 visits/year, p = 0.009), and less non-insulin diabetes medications were prescribed post-CSII (p < 0.001). Patients felt more comfortable controlling glycemic excursions and resultant insulin adjustments with CSII compared to MDI (p < 0.001).ConclusionsPharmacist-led CSII services appear to improve diabetes control in patients requiring intensive insulin therapy. Patients report greater comfort using CSII and strong confidence in the abilities of the pharmacist. Physician–pharmacist collaboration in the management of intensive insulin therapy in the primary care setting should be further explored.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 77%

“…Results from previous CSII-based trials have exhibited varying effects on weight or BMI3,6–8. Improved diabetes control using insulin intensification typically results in weight gain.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of clinical pharmacist collaboration in patients beginning insulin pump therapy: a retrospective and cross-sectional analysis

Ledford

Hess

Johnson³

2013

Journal of Drug Assessment

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The role of insulin pump therapy for type 2 diabetes mellitus

Landau

Wainstein

Bar‐Dayan

2016

Diabetes Metabolism Res

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Many patients with type 2 diabetes fail to achieve adequate glucose control despite escalation of treatment and combinations of multiple therapies including insulin. Patients with long-standing type 2 diabetes often suffer from the combination of severe insulin deficiency in addition to insulin resistance, thereby requiring high doses of insulin delivered in multiple injections to attain adequate glycemic control. Insulin-pump therapy was first introduced in the 1970s as an approach to mimic physiological insulin delivery and attain normal glucose in patients with type 1 diabetes. The recent years have seen an increase in the use of this technology for patients with type 2 diabetes. This article summarizes the clinical studies evaluating insulin pump use in patients with type 2 diabetes and discusses the benefits and shortcomings of pump therapy in this population.

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Diabetes technology: A primer highlighting the role of the pharmacist

Hess

Schumacher

Whitley

et al. 2022

J Am Coll Clin Pharm

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The rapid advancement of technology has ushered in a new era of diabetes management, especially with regard to continuous glucose monitoring (CGM) and insulin delivery systems. Technology is changing at a fast pace and these tools can be unknown or confusing to people with diabetes. Pharmacists can play a major role in reducing barriers and facilitating shared decision‐making regarding the individualization of technology in diabetes care. The Endocrine and Metabolism PRN Research Committee solicited the PRN membership to draft an opinion paper on diabetes technology using the Identify‐Configure‐Collaborate (ICC) framework from the Association of Diabetes Care and Education Specialists. The primary goal of the opinion paper is to provide an educational primer to health care professionals interested in learning more about the emerging diabetes technology landscape and highlight the role of the pharmacist within the ICC framework.

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Retrospective Analysis and Patient Satisfaction Assessment of Insulin Pump Therapy in Patients with Type 2 Diabetes

Cited by 18 publications

References 15 publications

Impact of clinical pharmacist collaboration in patients beginning insulin pump therapy: a retrospective and cross-sectional analysis

Impact of clinical pharmacist collaboration in patients beginning insulin pump therapy: a retrospective and cross-sectional analysis

The role of insulin pump therapy for type 2 diabetes mellitus

Diabetes technology: A primer highlighting the role of the pharmacist

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