Vnitr Lek 2024, 70(5):E3-E8 | DOI: 10.36290/vnl.2024.065

Pilot analysis of insulin pump (CSII) utilization for the treatment of seniors with diabetes in the Czech Republic

Martina Nováková1, Klára Benešová2, 3, Jiří Jarkovský2, 3, Ladislav Dušek2, 3, Iva Holmerová4, Milan Kvapil1
1 Geriatrická interní klinika 2. LF UK a FN Motol, Praha
2 Ústav zdravotnických informací a statistiky ČR, Praha
3 Institut biostatistiky a analýz, Lékařská fakulta, Masarykova univerzita, Brno
4 Katedra psychologie a věd o životě, Fakulta humanitních studií UK, Praha

Introduction: Good glucose control is the optimal goal of antidiabetic therapy in most patients. CSII improves results and does not increase the risk of hypoglycemia in patients with type 1 and type 2 diabetes mellitus; it reduces cardiovascular mortality in type 1 diabetics.

Objectives: evaluation of the use of CSII in the therapy of elderly treated with insulin in the Czech Republic.

Methodology: An anonymized set of patients with DM from the data of the National Register of Paid Health Services (NRHZS) in the years 2010-2021 (patients for whom an insulin pump, accessories or consumables were reported in the given year) was used for the analysis.

Results: In 2021, 84,345 patients were treated with insulin alone (ATC A10), of which 55.7% (46,969) were older than 65 years. The prevalence of CSII therapy is gradually increasing, from 5067 patients in 2010 to 7285 in 2021. In 2021, CSII therapy was reported in 685 patients over 65 years of age (9.4% of all treated with CSII; 1.5% of all treated only insulin). 6597 patients under the age of 65 are treated with CSII (17.7% of all treated with insulin).

Conclusion: In patients over 65 years of age, the prevalence of CSII use is significantly lower compared to younger patients. The results can help guide the efforts of professional societies, state administrations and management of health insurance companies to improve the conditions for the provision of CSII therapy and to strengthen the professional training of medical personnel outside diabetes centers.

Keywords: CSII; treatment of CSII patients over 65 years of age.

Accepted: August 28, 2024; Published: September 4, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Nováková M, Benešová K, Jarkovský J, Dušek L, Holmerová I, Kvapil M. Pilot analysis of insulin pump (CSII) utilization for the treatment of seniors with diabetes in the Czech Republic. Vnitr Lek. 2024;70(5):E3-8. doi: 10.36290/vnl.2024.065.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Amiel SA. The consequences of hypoglycaemia. Diabetologia. 2021 May;64(5):963-970. Go to original source... Go to PubMed...
    2. Schütt M, Fach EM, Seufert J, et al. Multiple complications and frequent severe hypoglycaemia in 'elderly' and 'old' patients with type 1 diabetes: age group-dependent characterization of patiens with type 1 diabetes. Diabet Med. 2012;29:e176-9. Go to original source... Go to PubMed...
    3. Weinstock RS, DuBose SN, Bergenstal RM, et al. Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes. Diabetes Care. 2016;39:603-10. Go to original source... Go to PubMed...
    4. Weinstock RS, Xing D, Maahs DM, et al. Severe hypoglycemia and diabetic ketoacidosis in adults with type 1 diabetes: results from the T1D exchange clinic registry. J Clin Endocrinol Metab. 2013;98:3411-9. Go to original source... Go to PubMed...
    5. Kvapil M, ed. Diabetologie 2023. Triton, Praha.
    6. Pala L, Dicembrini I, Mannucci E. Continuous subcutaneous insulin infusion vs modern multiple injection regimens in type 1 diabetes: an updated meta-analysis of randomized clinical trials. Acta Diabetol. 2019 Sep;56(9):973-980. Go to original source... Go to PubMed...
    7. Lucidi P, Porcellati F, Bolli GB, Fanelli CG. Prevention and Management of Severe Hypoglycemia and Hypoglycemia Unawareness: Incorporating Sensor Technology. Curr Diab Rep. 2018 Aug 18;18(10):83. Go to original source... Go to PubMed...
    8. https://www.uzis.cz/index.php?pg=registry-sber-dat--narodni-registr-hrazenych-zdravotnich-sluzeb (23. 12. 2023)
    9. Freeman NLB, Muthukkumar R, Weinstock RS, Wickerhauser MV, Kahkoska AR. Use of machine learning to identify characteristics associated with severe hypoglycemia in older adults with type 1 diabetes: a post-hoc analysis of a case-control study. BMJ Open Diabetes Res Care. 2024 Feb 27;12(1):e003748. Go to original source... Go to PubMed...
    10. Steineck I, Cederholm J, Eliasson B, et al. Swedish National Diabetes Register. Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18,168 people with type 1 diabetes: observational study. BMJ. 2015 Jun 22;350:h3234. Go to original source... Go to PubMed...
    11. Amiel SA. The consequences of hypoglycaemia. Diabetologia. 2021 May;64(5):963-970. Go to original source... Go to PubMed...
    12. Madsen KP, Olsen KR, Rytter K, et al. Effects of initiating insulin pump therapy in the real world: A nationwide, register-based study of adults with type 1 diabetes. Diabetes Res Clin Pract. 2023 Feb;196:110225. Go to original source... Go to PubMed...
    13. Daly A, Hovorka R. Technology in the management of type 2 diabetes: Present status and future prospects. Diabetes Obes Metab. 2021 Aug;23(8):1722-1732. Go to original source... Go to PubMed...
    14. Chatziravdeli V, Lambrou GI, Samartzi A, et al. A Systematic Review and Meta-Analysis of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Injections in Type-2 Diabetes. Medicina (Kaunas). 2023 Jan 10;59(1):141. Go to original source... Go to PubMed...
    15. Jankovec Z, Hahn M, Grunder S, et al. Analysis of continuous patient data from the Czech National Register of patients with type 1 and type 2 diabetes using insulin pump therapy. Diabetes Res Clin Pract. 2010 Feb;87(2):219-23. Go to original source... Go to PubMed...
    16. Rušavý Z, Honěk P, Dušek L, et al. Monitorování kompenzace diabetu u pacientů léčených inzulinovou pumpou v České republice [Monitoring of diabetes compensation in patients treated with an insulin pump in the Czech Republic]. Vnitr Lek. 2015 Nov;61(11 Suppl 3):3S39-43.

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.