Availability of and Access to Continuous Subcutaneous Insulin Infusion Therapy for Adults with Type 1 Diabetes in Ireland

Overview

Journal Acta Diabetol

Specialty Endocrinology

Date 2020 Mar 4

PMID 32124077

Citations 2

Authors

Katarzyna Anna Gajewska

Regien Biesma

Kathleen Bennett

Seamus Sreenan

Affiliations

Soon will be listed here.

Abstract

Aims: The uptake of continuous subcutaneous insulin infusion (CSII) is low in adults with type 1 diabetes mellitus (T1DM) in Ireland, compared to other countries where CSII is reimbursed. To explore the reasons for the low uptake, this study aims to investigate the availability of CSII in adult diabetes clinics in Ireland.

Methods: A national survey of all adult diabetes clinics (public and private) in Ireland was conducted and completed anonymously by the lead physician/diabetes nurse specialist in each clinic. Descriptive statistics and comparisons between clinics offering different levels of care for CSII are presented.

Results: Of 50 diabetes clinics invited, 47 (94%) participated in the study. Fifteen clinics (32%) offered no support for CSII, while 21 (45%) reported offering both training to commence CSII and ongoing support. Based on the survey findings, access to CSII was unavailable for 2426 (11%) of those with T1DM. The majority (n = 15,831, 71% of 22,321 T1DM population) received diabetes care from clinics offering CSII training, but only 2165 were using CSII (10% of T1DM population). Uptake of CSII was higher in clinics offering training than in those offering follow-up care for CSII only (12% vs. 5%, p < 0.001). Clinics offering all CSII services had more specialists (p = 0.005 for endocrinologists and p < 0.001 for dietitians). Reasons for not offering CSII services included staff shortages and heavy workload.

Conclusions: This study highlights the low uptake of CSII in Ireland and demonstrates that, even when reimbursed, other barriers to uptake of CSII can limit its use.

Citing Articles

Barriers and facilitators to accessing insulin pump therapy by adults with type 1 diabetes mellitus: a qualitative study.

Gajewska K, Biesma R, Bennett K, Sreenan S Acta Diabetol. 2020; 58(1):93-105.

PMID: 32862261 DOI: 10.1007/s00592-020-01595-5.

Low uptake of continuous subcutaneous insulin infusion therapy in people with type 1 diabetes in Ireland: a retrospective cross-sectional study.

Anna Gajewska K, Bennett K, Biesma R, Sreenan S BMC Endocr Disord. 2020; 20(1):92.

PMID: 32576284 PMC: 7310521. DOI: 10.1186/s12902-020-00573-w.

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