Change in the usage of pump features predicts improvement of glycemic control

Insulin pumps offer a wide range of technical features designed to help patients with achieving optimal glycemic control. However, many patients do not achieve better glycemic control despite CSII therapy. In this study, we analyzed whether a change in using pump features was associated with an improvement in glycemic control. 197 patients with CSII treatment were analyzed at baseline and 12-weeks later (age 42.2 ± 14.3 yrs.; 59% female; diabetes duration 22.2 ± 11.9 yrs.; duration of CSII 9.4 ± 7.3 yrs.; baseline A1c 8.3 ± 0.9%). Change in using pump features (see table) were the independent variables of interest in a linear regression analysis on the difference in HbA1c (follow-up – baseline).
The analysis was controlled for demographic (age, gender, BMI, education) and medical variables (diabetes duration, duration of CSII, use of CGM/FGM, complications, SMBG).
Increased use of pump features standardized beta p
Temporary basal rates -0.16 .027
Different basal rate profiles -0.09 .219
Bolus options 0.16 .031
Bolus calculators 0.02 .790
Analysis software -0.16 .025
CGM pairing -0.23 .002
An increased use of temporary basal rates as well as using analysis software more often predicted an improvement in HbA1c (see table). Linking a CGM system to the insulin pump was the strongest predictor of better glycemic control. In clinical practice, patients with CSII therapy should be educated how to make use of their pump features and should be encouraged to do so.