MDI versus CSII in Chinese adults with type 1 diabetes in a real-world situation: based on propensity score matching method.

IF 3.2 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES Health and Quality of Life Outcomes Pub Date : 2024-06-13 DOI:10.1186/s12955-024-02263-w

Jian Yu, Hong Wang, Min Zhu, Jingjing Xu

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Abstract

Background: Compared with multiple daily insulin injections (MDI), continuous subcutaneous insulin infusion (CSII) is significantly more expensive and has not been widely used in Chinese type 1 diabetes mellitus (T1DM) patients. So there are still significant knowledge gaps regarding clinical and patient-reported outcomes in China.

Aims: This study aims to compare the glycated hemoglobin (HbA_1C), insulin therapy related quality of life (ITR-QOL), fear of hypoglycemia (FOH) of adult T1DM patients treated with MDI and CSII based on propensity score matching in real-world conditions in China.

Methods: Four hundred twenty adult T1DM patients who were treated with MDI or CSII continuously for more than 12 months in a national metabolic center from June 2021 to June 2023 were selected as the study subjects. Their QOL and FOH were evaluated with Insulin Therapy Related Quality of Life Measure Questionnaire-Chinese version (ITR-QOL-CV) and the Chinese Version Hypoglycemia Fear Survey-Worry Scale (CHFSII-WS), and their HbA_1C were collected at the same time. Potential confounding variables between the two groups were matched using propensity score matching.

Results: Of the 420 patients included in the study, 315 were in MDI group and 105 were in CSII group. 102 pairs were successfully matched. After matching, the total score of ITR-QOL-CV scale in CSII group was significantly higher than that in MDI group (87.08 ± 13.53 vs. 80.66 ± 19.25, P = 0.006). Among them, the dimensions of daily life, social life, and psychological state were all statistically different (P < 0.05). The scores of CHFSII-WS (8.33 ± 3.49 vs. 11.77 ± 5.27, P = 0.003) and HbA_1C (7.19 ± 1.33% vs. 7.71 ± 1.93%, P = 0.045) in CSII group were lower than those in MDI group.

Conclusions: 25.0% of T1DM adults are treated with CSII. Compared with adult T1DM patients treated with MDI, those treated with CSII have higher ITR-QOL, less FoH, and better control of HbA_1C in real-world conditions in China. Therefore, regardless of economic factors, CSII is recommended for adult T1DM patients to optimize the therapeutic effect and outcomes.

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MDI 与 CSII 在中国 1 型糖尿病成人患者中的实际应用：基于倾向得分匹配法。

背景：与每日多次胰岛素注射（MDI）相比，持续皮下胰岛素输注（CSII）的费用要高得多，而且尚未在中国的1型糖尿病（T1DM）患者中广泛使用。目的：本研究旨在比较在中国真实世界条件下，基于倾向得分匹配，接受 MDI 和 CSII 治疗的成年 T1DM 患者的糖化血红蛋白（HbA1C）、胰岛素治疗相关生活质量（ITR-QOL）、对低血糖的恐惧（FOH）：选取2021年6月至2023年6月在国家代谢中心连续接受MDI或CSII治疗12个月以上的420名成年T1DM患者作为研究对象。用胰岛素治疗相关生活质量测量问卷-中文版（ITR-QOL-CV）和中文版低血糖恐惧调查-担忧量表（CHFSII-WS）评估他们的QOL和FOH，同时收集他们的HbA1C。两组患者之间的潜在混杂变量采用倾向得分匹配法进行匹配：在纳入研究的 420 名患者中，315 人属于 MDI 组，105 人属于 CSII 组。102 对患者成功配对。匹配后，CSII 组的 ITR-QOL-CV 量表总分明显高于 MDI 组（87.08 ± 13.53 vs. 80.66 ± 19.25，P = 0.006）。其中，CSII组的日常生活、社会生活和心理状态维度均低于MDI组，差异有统计学意义（P 1C（7.19 ± 1.33% vs. 7.71 ± 1.93%，P = 0.045）：25.0%的T1DM成人接受了CSII治疗。结论：在中国，25.0% 的成年 T1DM 患者接受了 CSII 治疗，与接受 MDI 治疗的成年 T1DM 患者相比，接受 CSII 治疗的患者 ITR-QOL 更高、FoH 更低、HbA1C 控制得更好。因此，无论经济因素如何，建议成年 T1DM 患者使用 CSII，以优化治疗效果和预后。

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来源期刊

Health and Quality of Life Outcomes 医学-卫生保健

CiteScore

7.30

自引率

2.80%

发文量

154

审稿时长

3-8 weeks

期刊介绍： Health and Quality of Life Outcomes is an open access, peer-reviewed, journal offering high quality articles, rapid publication and wide diffusion in the public domain. Health and Quality of Life Outcomes considers original manuscripts on the Health-Related Quality of Life (HRQOL) assessment for evaluation of medical and psychosocial interventions. It also considers approaches and studies on psychometric properties of HRQOL and patient reported outcome measures, including cultural validation of instruments if they provide information about the impact of interventions. The journal publishes study protocols and reviews summarising the present state of knowledge concerning a particular aspect of HRQOL and patient reported outcome measures. Reviews should generally follow systematic review methodology. Comments on articles and letters to the editor are welcome.