Analysis Of Glycemic Control And Its Influence Factors In Diabetic Patients With Insulin Pump Therapy

Objective To evaluate control of blood glucose in diabetes millitus patients treated with insulin pump, analyze risk factors affecting control condition.Methods Medtronic’s telephone follow up database conducted in 28 class 3-A comprehensive hospitals and 13 Children’s hospitals from February 2014 to April 2014 were analyzed with respect to demographics, insulin pump message, self-management, subjective satisfaction and laboratorial index. Inclusion criteria were that patient had full data and still used pump therapy. The glycemic control was assessed accoding to the goal of Chinese Diabetes Society(CDS).logistic regression analysis was made to reveal the characteristics associated with patients achiveving goal.Results The mean HbAlc at 3 to 6 months before pump usage and the latest follow-up was (8.5±2.2)% and (7.1 ±1.4)%, respectively. And HbAlc well-controlled rate was 20.2% and 47.9%. Both values were improved significantly (P<0.05). Between HbAlc well-controlled group and poorly controlled group, diffferences regarding fasting blood glucose(FBG)[(9.7±4.3)mmol/L vs (10.0±3.8)mmol/L,P< 0.05], postprandial plasma glucose(PBG)[(12.5±4.7)mmol/L vs (13.7±4.6)mmol/L,P<0.05], Hgycosylated Hermoglobin Alc(HbAlc)[(5.6±2.0)% vs (6.0±0.6)%,P<0.05] before using insulin pump and the latest FBG[(5.9±1.4)mmol/L vs (7.2±2.1),P<0.05]mmol/L], PBG[(8.6±2.0)mmol/L vs (9.9±3.0)mmol/L, P< 0.05], HbAlc[(6.0±0.6)% vs (8.0±1.2)%,P<0.05] and overall satisfaction[(8.7±1.2) vs (8.4±1.4),P< 0.05].The constituent proportions of region, insulin pump system, the frequency of blood gulcose monitoring and return visit, pump usage proficiency and subject feelings such as better controlling blood glucose, reducing the incidengce of complications and free diet were significantly different among different control level groups(P< 0.05). Logistic regression analysis showed that the initial age of pump usage (OR=1.019,P=0.000), FBG before pump therapy (OR=1.036,P=0.031), the latest FBG(OR=0.856,P=0.000), region (OR=0.433,P=0.001). subjective control quality (OR=0.058,P=0.000) and complications (OR=0.396,P=0.013) were all risk factors affecting control condition of blood glucose.Conclusion Blood glucose control condition has improved dramatically in diabetes millitus patients treated with insulin pump. We argue that medical developments among regions should be balanced, and more attention should be paid to patients’ education with regard to blood glucose monitoring, recogniton level and self-confidence for further improvement.