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Background: The use of continuous subcutaneous insulin infusion (CSII), or insulin pump therapy, has been shown to improve glycemic control in patients with type 1 diabetes (T1D), however, there is limited real-world evidence on the rates of insulin pump use and impact on glycemic control across age groups in the U.S. This study aims to examine A1c trends among insulin pump users in one of the largest U.S. based population-based cohorts of people with type 1 diabetes.
Methods: The analysis included 15,113 patients in the T1D Exchange Quality Improvement (T1DX-QI) database for whom electronic medical record data was available from eight endocrinology clinics participating in the T1DX-QI collaborative. Patients with at least one completed clinic encounter from 2017-2020 were included in this analysis.
Results: In this population, 73% (N=11,046) of T1D patients were insulin pump users, whereas 27% (N=4,067) were non-users. Insulin pump use during the years of 2017 through 2020 remained constant in the range of 74%-76%. Mean Hba1c among insulin pump users was lower than for non-users (Mean [SD]: 8.0 [1.7] vs. 8.6 [1.8] (p<0.001). This difference persisted when compared across all age groups.
Conclusions: This study highlights the benefit of uptake of insulin pump therapy to achieve better glycemic control across all groups using one the largest real-world databases for people with T1D.
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