Sustained benefit of continuous subcutaneous insulin infusion on glycaemic control and hypoglycaemia in adults with Type 1 diabetes

Beato-Víbora, Pilar Isabel; Yeoh, Ester; Rogers, Helen; Hopkins, David; Amiel, S. A.; Choudhary, Pratik

doi:10.1111/dme.12869

Cited by 49 publications

(37 citation statements)

References 29 publications

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“…Beato-Vibora et al, 56 from King's College Hospital, looked back over 12 years of pump therapy in 327 patients, with a mean duration of 4.3 years on the pump. An initial reduction in HbA 1c of 8 mmol/mol or 0.7% was partially maintained with reduction at year 5 of 0.4%.…”

Section: Observational Studiesmentioning

confidence: 99%

“…Two studies 124,125 were identified as being potentially relevant for MDI + DAFNE individuals. Five studies [56][57][58][59]63 were identified as being potentially relevant for insulin pump therapy individuals. Two studies 56,59 were excluded: Beato-Vibora et al 56 was not included because fewer than one-quarter of the individuals in the initial sample had follow-up data for any given year; Clements et al 59 was excluded because it was a subgroup analysis of the data presented by Carlsson et al 58 As such, if Carlsson et al 58 was included to estimate the long-term duration of treatment effect of pump therapy, the effect estimated from Clements et al 59 would be given double the weight of the other studies because of a published subgroup analysis being available.…”

Section: Duration Of Treatment Effectiveness Beyond the Trial Periodmentioning

confidence: 99%

“…For the five included studies [56][57][58][59]63 (two studies for adults receiving MDI + DAFNE and three studies for adults receiving pump + DAFNE), the average yearly increase in HbA 1c was estimated, pragmatically, using data from the point of largest reduction in HbA 1c and the last observation in which the sample size was greater than one-quarter of the initial sample size. A weighted average of these studies' evidence (using the initial sample size) calculated the mean yearly HbA 1c increase for both trial arms ( Table 9).…”

Section: Duration Of Treatment Effectiveness Beyond the Trial Periodmentioning

confidence: 99%

See 2 more Smart Citations

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

Heller

White

Lee

et al. 2017

Health Technol Assess

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This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/107/01. The contractual start date was in June 2011. The draft report began editorial review in March 2016 and was accepted for publication in July 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by the NIH...

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Section: Observational Studiesmentioning

confidence: 99%

Section: Duration Of Treatment Effectiveness Beyond the Trial Periodmentioning

confidence: 99%

Section: Duration Of Treatment Effectiveness Beyond the Trial Periodmentioning

confidence: 99%

See 1 more Smart Citation

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

Heller

White

Lee

et al. 2017

Health Technol Assess

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“…In the UK, the National Institute for Health and Care Excellence recommends insulin pump therapy in patients who have struggled to achieve optimal glucose control (HbA 1c >8.5% [69mmol/mol]) or those with ongoing problematic hypoglycaemia despite optimised multiple injection therapy. Observational data also confirm that the benefits seen in studies are realised in clinical practice . However, these data hide a proportion of patients who do not seem to receive benefit, or who fail to sustain it.…”

mentioning

confidence: 66%

To pump or not to pump

2019

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“…Data from these registries offer real-world insights into factors associated with greater achievement of glucose targets. Indeed, both CSII and CGM have a large body of randomized controlled trial (RCT) as well as real-world observational evidence demonstrating benefits to people with Type 1 diabetes in terms of improved HbA 1c , reduced hypoglycaemia and improved quality of life [8,[10][11][12][13][14][15]. Indeed, both CSII and CGM have a large body of randomized controlled trial (RCT) as well as real-world observational evidence demonstrating benefits to people with Type 1 diabetes in terms of improved HbA 1c , reduced hypoglycaemia and improved quality of life [8,[10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes

et al. 2019

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In both adults and children with diabetes, technologies such as continuous subcutaneous insulin infusion using insulin pumps and continuous glucose monitoring can help improve diabetes control, reduce hypoglycaemia and improve quality of life. Access to these technologies in the UK is very variable. Some technologies are recommended by the National Institute for Health and Care Excellence, while others have not been appraised, and new technologies are emerging all the time. Additionally, different guidelines for adults and children further complicate access to diabetes technology in the transition from paediatric to adult care. Against this background, Diabetes UK and NHS England have brought together a multidisciplinary group of experts, including clinicians and people with diabetes, to develop this consensus guideline, combining the different technologies into a common pathway to aid clinical and policy decisionmaking. We created a pathway that supports the incremental addition of technology as monotherapy and then dual therapy in the same way that we incrementally add in therapeutic agents to support people with Type 2 diabetes to achieve their personalized glycaemic targets. The pathway emphasizes the importance of structured education, specialist support and appropriate access to psychological therapies, as essential pillars for optimized use of diabetes-related technology, and recommends the re-evaluation of its use when the individual is unable either to use the technology appropriately or to achieve the intended outcomes. This pathway is endorsed by UK-wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes.

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Sustained benefit of continuous subcutaneous insulin infusion on glycaemic control and hypoglycaemia in adults with Type 1 diabetes

Abstract: The benefits of continuous subcutaneous insulin infusion with regard to improving glycaemic control and reducing hypoglycaemia frequency, along with improvement in hypoglycaemia awareness without deterioration in glycaemic control, can be sustained over several years in clinical practice.

Cited by 49 publications

References 29 publications

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

To pump or not to pump

A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes

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