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Evaluation of Pump Discontinuation and Associated Factors in the T1D Exchange Clinic Registry

Wong, Jenise C., Boyle, Claire, DiMeglio, Linda A., Mastrandrea, Lucy D., Abel, Kimber-Lee, Cengiz, Eda, Cemeroglu, Pinar A., Aleppo, Grazia +5 more·2017·Journal of Diabetes Science and Technology
DOI 10.1177/1932296816663963
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Abstract

Background: The objectives of this study were to examine factors associated with insulin pump discontinuation among children and adults followed longitudinally for 1 year in the multicenter T1D Exchange clinic registry, and to provide participant-reported reasons for stopping pump therapy. Methods: We longitudinally followed 8935 participants of all ages using an insulin pump at the time of registry enrollment. Logistic regressions were used to identify demographic and clinical factors associated with pump discontinuation. Pump discontinuation was self-reported by participants on a first annual follow-up survey. Results: The overall frequency of pump discontinuation was 3%. Discontinuation was higher in adolescents (4%) and young adults (4%) than in younger children (3%) or older adults (1%). In multivariate analysis of children between 6 and <13 and 13 and <18 years, participants who discontinued pump use were more likely to have higher HbA1c levels at baseline (adjusted P < .001 for both). The top participant-reported reasons for discontinuing the pump included problems with wearability (57%), disliking the pump or feeling anxious (44%), and problems with glycemic control (30%). Conclusions: In T1D Exchange registry participants, insulin pump discontinuation is uncommon, but more prevalent among adolescents and young adults, and youth with poor glycemic control. Given the known benefits of pump therapy, these populations should be targeted for support and education on troubleshooting pump use. Common reasons for discontinuation should also be considered in future device design and technological improvement.

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  1. [2]2. Ahern JA, Boland EA, Doane R, et al. Insulin pump therapy in pediatrics: a therapeutic alternative to safely lower HbA1c levels across all age groups. Pediatr Diabetes . 2002;3(1):10-15.
  2. [4]4. Barnard KD, Lloyd CE, Skinner TC. Systematic literature review: quality of life associated with insulin pump use in Type 1 diabetes. Diabet Med . 2007;24(6):607-617.
  3. [5]5. Churchill JN, Ruppe RL, Smaldone A. Use of continuous insulin infusion pumps in young children with type 1 diabetes: a systematic review. J Pediatr Health Care . 2009;23(3): 173-179.
  4. [6]6. Eugster EA, Francis G. Position statement: continuous subcutaneous insulin infusion in very young children with type 1 diabetes. Pediatrics . 2006;118(4):e1244-e1249.
  5. [8]8. Phillip M, Battelino T, Rodriguez H, Danne T, Kaufman F. Use of insulin pump therapy in the pediatric age-group: consensus statement from the European Society for Paediatric Endocrinology, the Lawson Wilkins Pediatric Endocrine Society, and the International Society for Pediatric and Adolescent Diabetes, endorsed by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care . 2007;30(6):1653-1662.
  6. [9]9. Pickup JC, Sutton AJ. Severe hypoglycaemia and glycaemic control in type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabet Med . 2008;25(7):765-774.
  7. [11]11. Scrimgeour L, Cobry E, McFann K, et al. Improved glycemic control after long-term insulin pump use in pediatric patients with type 1 diabetes. Diabetes Technol Ther . 2007;9(5): 421-428.
  8. [12]12. Weissberg-Benchell J, Antisdel-Lomaglio J, Seshadri R. Insulin pump therapy: a meta-analysis. Diabetes Care . 2003;26(4):1079-1087.
  9. [13]13. Willi SM, Planton J, Egede L, Schwarz S. Benefits of continuous subcutaneous insulin infusion in children with type 1 diabetes. J Pediatr . 2003;143(6):796-801.
  10. [16]16. de Vries L, Grushka Y, Lebenthal Y, Shalitin S, Phillip M. Factors associated with increased risk of insulin pump discontinuation in pediatric patients with type 1 diabetes. Pediatr Diabetes . 2011;12(5):506-512.
  11. [17]17. Hofer SE, Heidtmann B, Raile K, et al. Discontinuation of insulin pump treatment in children, adolescents, and young adults. A multicenter analysis based on the DPV database in Germany and Austria. Pediatr Diabetes . 2010;11(2): 116-121.
  12. [18]18. Schifferdecker E, Schmidt K, Boehm BO, Schatz H. Longterm compliance of intensified insulin therapy. Diabetes Res Clin Pract . 1994;23(1):17-23.
  13. [19]19. Shulman R, Stukel TA, Miller FA, Newman A, Daneman D, Guttmann A. Insulin pump use and discontinuation in children and teens: a population-based cohort study in Ontario, Canada. Pediatr Diabetes . 2016. doi:10.1111/pedi.12353 · DOI
  14. [7]7. predictors of change in method of insulin delivery across two years. Pediatr Diabetes . 2015;16(8):592-599.
  15. [23]23. Seereiner S, Neeser K, Weber C, et al. Attitudes towards insulin pump therapy among adolescents and young people. Diabetes Technol Ther . 2010;12(1):89-94.
  16. [25]25. Sherr JL, Hermann JM, Campbell F, et al. Use of insulin pump therapy in children and adolescents with type 1 diabetes and its impact on metabolic control: comparison of results from three large, transatlantic paediatric registries. Diabetologia . 2016;59(1):87-91.
  17. [26]26. Beck RW, Tamborlane WV, Bergenstal RM, Miller KM, Dubose SN, Hall CA. The T1D Exchange Clinic Registry. J Clin Endocrinol Metab . 2012;97(12):4383-4389.
  18. [27]27. Brorsson AL, Viklund G, Ortqvist E, Lindholm Olinder A. Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? A retrospective case-control study. Pediatr Diabetes . 2015;16(7):546-553.

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Authors
Wong, J. C., Boyle, C., DiMeglio, L. A., Mastrandrea, L. D., Abel, K.-L., Cengiz, E., Cemeroglu, P. A., Aleppo, G., Largay, J. F., Foster, N. C., Beck, R. W., Adi, S., & for the T1D Exchange Clinic Network
Affiliations
  • University of California, San Francisco, San Francisco, CA, USA
  • Jaeb Center for Health Research, Tampa, FL, USA
  • Indiana University School of Medicine, Indianapolis, IN, USA
  • University at Buffalo, School of Medicine, Buffalo, NY, USA
  • Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • Yale School of Medicine, New Haven, CT, USA
  • Helon DeVos Children’s Hospital, Grand Rapids, MI, USA
  • Northwestern University, Chicago, IL, USA
  • University of North Carolina, Chapel Hill, NC, USA
Venue
Journal of Diabetes Science and Technology
Publisher
SAGE Publications
Published
2016-09-25
Volume
11
Issue
2
Pages
224-232
ISSN
1932-2968
DOI
10.1177/1932296816663963
Cited by
63
References
6
Language
en
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)

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