Insulin pump treatment (INPUT) education programme improves glycaemic control in CSII patients

Ehrmann D, Kulzer B, Schipfer M et al (2018) Efficacy of an education program for people with diabetes and insulin pump treatment (INPUT): results from a randomized controlled trial. Diabetes Care 41: 2453–62

• Continuous subcutaneous insulin infusion (CSII) use leads to significant reductions in HbA_1c levels compared to multiple daily injections and avoids the use of injections but costs considerably more and its effects on hypoglycaemia have been inconclusive.
• Structured education is needed to provide users with the knowledge and skills to successfully use CSII and keep them motivated. A specific CSII education Insulin Pump Therapy (INPUT) programme incorporating clinical, technological and psychosocial aspects of self-management was developed and its effect on glycaemic control compared to standard care studied in a randomised controlled trial.
• Researchers randomly allocated 268 CSII therapy users (mean duration of CSII use = 9.5 years) to the INPUT group or control group and measured participants’ HbA_1c at baseline and 6 months and the incidence of hypoglycaemia during that period.
• The average HbA_1c of the INPUT group had improved from 8.33% to 8.04% at 6 months (P<0.0001) whereas there was little change in the control group, which was 8.33% at the start of the study and 8.27% after 6 months (P=0.11). There was a significant between-group difference in favour of the INPUT group (P=0.0029).
• The incidence of severe hypoglycaemia was 3.55 times higher in the control group than the INPUT group.
• Participation in the INPUT education programme resulted in a significant reduction in HbA_1c level and the incidence of hypoglycaemia in patients using CSII.

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