Abstract
Abstract: Rationale: (CSII) therapy is a highly effective tool in maintaining euglycemia. It functions by providing the patient with continuous subcutaneous infusion of rapid acting insulin. There is significant diminution of researches on the same topic in Libya and need more evidence to increase its implement Objectives : The aim of this study is to compare between: First group: T1DM patients using insulin pump therapy for ≥ 6 months. Second group: T1DM patients on MDI therapy. Compared on the basis of: HbA1c readings / Frequency of acute complications/ Treatment adherence. Regular follow up / Quality of life. First group compared on the basis of: Maintenance/replacements availability/ Ease of using the pump. Acquiring skills about the pump/ Awareness about the common pump problems. Common problems facing the pump users. Methods: Case control study using interviewer-led questionnaire and Google form questionnaire conducted between 12-23/Jun/2022. Data from 62 patients were collected. Analyses using SPSS20 and Excel2018. Chi-square /Spearman correlation tests applied. Level of significance: P value < (0.05), 95% confidence interval. Results: First group: male 43.8%, female 56.3% , Childhood 9.4% , adolescents 78.1%, adulthood 12.5%, BMI: healthy weight 78.1%, overweight 21.9%. HbA1c mean: 6.97 (Std.deviation:0.6142). second group: male 26.7%, female 73.3% , Adolescents 16.7%, adulthood 83.3%, BMI: underweight 3.3%, healthy weight 33.3%, overweight 36.7%, obese 26.7%. HbA1c mean: 9.8 (Std deviation:1.9895). HbA1c reduction related to the duration of pump usage. 6 months to 1 year pump users HbA1C mean 7.2±0.2 (CI 95%). Following patients who have been pump usage for 1 to 2 years a reduction to a mean of 7.06±0.126 (CI 95%). Lastly pump usage for more than 2 years showed a mean of 6.89±0.159 (CI 95%). ≥4 hypoglycemia episodes/month for first and second group respectively were 31.3% and 50%. ≥2 DKA episodes/6months for the first and second group respectively were 3.1% and 20%. 81.3% of first group showed commitment to treatment 7 days/week while only 43.3% of second group took MDI. Conclusion: Our study concluded that CSII an effective tool that help T1DM management. Switch to CSII optimize self-management favoring HbA1c target and avoiding life-threatening situations. Patient‘s satisfaction/quality of life have been improved dramatically. Libyan health authorities should implement CSII program on wider scale by providing the replacements.