Background: Technology applied to type 2 diabetes (T2D) is an area of investigation with important clinical applications.
Objective and hypotheses: There are three issues which should be considered: is continuous subcutaneous insulin infusions (CSII) effective for treatment of T2D? What is the level of satisfaction and quality of life in T2D patients using CSII? Are CSII and glucose monitoring in T2D relevant from an economic perspective?
Method: We conducted a comprehensive literature search on this topic.
Results: Larger longitudinal trials showed a durable efficacy of CSII on glucose control accompanied by moderate weight gain. Diabetes satisfaction scores improved over time with both CSII and MDI treatments. A insurer cost-of-care study performed among T2D patients analyzed diabetes treatment costs from T2D patients on MDI or CSII therapy found a cost-saving reduction in insulin dose. To improve adherence to CSII therapy, it is recommended the use of a behavioural contract providing specific metabolic goals to patients; SMBG frequency and commitment by the patient to go to the diabetes centre for follow-up visits and fulfill a detailed list of responsibilities.
Conclusion: Diabetes technology in T2D is an example of personalized therapy, where evaluation and use should be both appropriate and targeted. Without a structured approach the new technologies are often started and maintained improperly with poor cost-effective results.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology