Effects of initiating insulin pump therapy in the real world: A nationwide, register-based study of adults with type 1 diabetes
Authors' conclusion
IPT significantly reduced HbA1c level and variability, compared with MDI. However, it also marginally increased the risk of hospitalised DKA.
Study context
- Population
- All adults with T1D in Denmark, national registry data, 2010–2020
- Participants
- 26,687 adults243,601 person-years
- Exposure
- Insulin pump therapy vs MDI
- Outcome
- HbA1c level
Methodological detailstreatment-staggered difference-in-differences, average treatment effects on the treated (ATT)
- Treatment-staggered difference-in-differences
- Average treatment effects on the treated (ATT)
Main finding
As reported in the abstract
HbA1c
ATT for HbA1c (treatment-staggered difference-in-differences)
−0.33 % (95 % CI −0.39 to −0.27); −3.6 mmol/mol (95 % CI −4.2 to −2.9)
Observational data: associations, not effects.
Further findings
HbA1c variability
- ATT for HbA1c variability
- −0.016 % [−0.028 to −0.0041); −0.17 mmol/mol (95 % CI −0.30 to −0.045)
- Corresponding decrease in SD of HbA1c
- 6.5 %
HbA1c by subgroup
- ATTs larger among women and individuals who were older, had highest baseline HbA1c, and used CGM
Safety
Hospitalised diabetic ketoacidosis (DKA)
- Additional hospitalisations per 1,000 person-years with insulin pump therapy (IPT) (ATT)
- 0.52
Severe hypoglycaemia hospitalisations
- Fewer hospitalisations per 1,000 person-years with IPT (ATT)
- 0.11
Original publication
Effects of initiating insulin pump therapy in the real world: A nationwide, register-based study of adults with type 1 diabetes. Diabetes Res Clin Pract. Published 17 December 2022. doi:10.
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