7. Structured Education Program Proven to Be Beneficial
for Insulin Pump Users

Insulin pump therapy or Continuous subcutaneous insulin infusion (CSII) is the most advanced form of insulin delivery. However, to achieve the real benefits, users would require a structured education that provides them with the necessary knowledge/skills and supports their motivation. A CSII specific, structured education program (Insulin Pump Treatment [INPUT]) was developed and evaluated to understand its impact on glycemic control, behavior, and psychosocial status.

INPUT is a self-management-based treatment and education program for CSII users. It is designed to empower patients to adequately perform their therapy in daily life and to integrate their diabetes and their insulin pump into their lives in order to enhance the quality of life. Psychological and motivational aspects of living with diabetes and living with a CSII are also addressed.

A multicentre, randomized, parallel clinical trial was carried out and the results are now published in the journal Diabetes Care with Dr. Ehrmann D as the lead author. The study included 268 people with diabetes (16-75 years of age). They had been on CSII for a mean duration of 9.5 years. They were randomly assigned to the INPUT or the control group. At 6 months of follow-up, significant improvement in HbA1c was seen in the INPUT group (8.33 ± 0.8 vs. 8.04 ± 0.9; P < 0.0001) but not in the control group (8.33 ± 1.0 vs. 8.27 ± 1.0; P = 0.11). The between-group difference in HbA1c reduction was significant, favouring INPUT (-0.28% vs. -0.06%, Δ -0.22%, 95% CI -0.38 to -0.06; P = 0.0029). The incidence rate ratio of severe hypoglycemia was 3.55 times higher for the control group participants than for those in the INPUT group (95% CI 1.50-8.43; P = 0.0041).

INPUT education program resulted in a significant improvement in glycemic control and the incidence of severe hypoglycemia in insulin pump users.

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