Associations between insulin pump self‐management and HbA1c in type 1 diabetes

Abstract

AbstractAimsInsulin pump self‐management is important for glycaemic outcomes. We aimed to investigate associations between self‐management factors and HbA1c.MethodsAdult insulin pump users with type 1 diabetes (n = 770) completed an online questionnaire. The latest HbA1c and demographics were extracted from national registries. Associations between HbA1c and self‐management (use of advanced features, timing of infusion set change, timing of meal bolus, data‐upload and pump settings adjustments) were investigated using backward selected linear regression models.ResultsOf the 699 responders eligible for this study, 60% were women; the median age and diabetes duration were 49 and 25 years, respectively. Significant associations with HbA1c were found for changing infusion set every 0–4 days relative to 5–10 days (−5 mmol/mol (−0.4%), p = 0.003), and for never/rarely missing a bolus (−6 mmol/mol (−0.5%), p < 0.001) relative to often missing a bolus. Timing insulin 10–15 min before meal relative to after meal start was also associated with lower HbA1c (−3 mmol/mol (−0.3%), p = 0.023). Self‐adjusting pump settings showed the strongest association with lower HbA1c (−6 mmol/mol (−0.6%), p < 0.001) relative to health care professionals doing all adjustments.ConclusionSelf‐adjusting insulin pump settings, optimal timing and few omissions of meal boluses, and timely change of infusion set are associated with lower HbA1c.