Associations between insulin pump self-management and HbA1c in type 1 diabetes
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Associations between insulin pump self-management and HbA1c in type 1 diabetes. / Rytter, Karen; Madsen, Kristoffer Panduro; Andersen, Henrik Ullits; Hommel, Eva; Pedersen-Bjergaard, Ulrik; Schmidt, Signe; Nørgaard, Kirsten.
In: Diabetic Medicine, Vol. 40, No. 6, e15068, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Associations between insulin pump self-management and HbA1c in type 1 diabetes
AU - Rytter, Karen
AU - Madsen, Kristoffer Panduro
AU - Andersen, Henrik Ullits
AU - Hommel, Eva
AU - Pedersen-Bjergaard, Ulrik
AU - Schmidt, Signe
AU - Nørgaard, Kirsten
N1 - Publisher Copyright: © 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
PY - 2023
Y1 - 2023
N2 - Aims: Insulin pump self-management is important for glycaemic outcomes. We aimed to investigate associations between self-management factors and HbA1c. Methods: Adult insulin pump users with type 1 diabetes (n = 770) completed an online questionnaire. The latest HbA1c and demographics were extracted from national registries. Associations between HbA1c and self-management (use of advanced features, timing of infusion set change, timing of meal bolus, data-upload and pump settings adjustments) were investigated using backward selected linear regression models. Results: Of the 699 responders eligible for this study, 60% were women; the median age and diabetes duration were 49 and 25 years, respectively. Significant associations with HbA1c were found for changing infusion set every 0–4 days relative to 5–10 days (−5 mmol/mol (−0.4%), p = 0.003), and for never/rarely missing a bolus (−6 mmol/mol (−0.5%), p < 0.001) relative to often missing a bolus. Timing insulin 10–15 min before meal relative to after meal start was also associated with lower HbA1c (−3 mmol/mol (−0.3%), p = 0.023). Self-adjusting pump settings showed the strongest association with lower HbA1c (−6 mmol/mol (−0.6%), p < 0.001) relative to health care professionals doing all adjustments. Conclusion: Self-adjusting insulin pump settings, optimal timing and few omissions of meal boluses, and timely change of infusion set are associated with lower HbA1c.
AB - Aims: Insulin pump self-management is important for glycaemic outcomes. We aimed to investigate associations between self-management factors and HbA1c. Methods: Adult insulin pump users with type 1 diabetes (n = 770) completed an online questionnaire. The latest HbA1c and demographics were extracted from national registries. Associations between HbA1c and self-management (use of advanced features, timing of infusion set change, timing of meal bolus, data-upload and pump settings adjustments) were investigated using backward selected linear regression models. Results: Of the 699 responders eligible for this study, 60% were women; the median age and diabetes duration were 49 and 25 years, respectively. Significant associations with HbA1c were found for changing infusion set every 0–4 days relative to 5–10 days (−5 mmol/mol (−0.4%), p = 0.003), and for never/rarely missing a bolus (−6 mmol/mol (−0.5%), p < 0.001) relative to often missing a bolus. Timing insulin 10–15 min before meal relative to after meal start was also associated with lower HbA1c (−3 mmol/mol (−0.3%), p = 0.023). Self-adjusting pump settings showed the strongest association with lower HbA1c (−6 mmol/mol (−0.6%), p < 0.001) relative to health care professionals doing all adjustments. Conclusion: Self-adjusting insulin pump settings, optimal timing and few omissions of meal boluses, and timely change of infusion set are associated with lower HbA1c.
KW - diabetes education
KW - empowerment
KW - HbA1c
KW - insulin pump
KW - self-management
KW - type 1 diabetes
U2 - 10.1111/dme.15068
DO - 10.1111/dme.15068
M3 - Journal article
C2 - 36786049
AN - SCOPUS:85149622664
VL - 40
JO - Diabetic Medicine Online
JF - Diabetic Medicine Online
SN - 1464-5491
IS - 6
M1 - e15068
ER -
ID: 365814790