Background: Type 1 diabetes (T1D) is associated with substantial morbidity including psychological sequelae that may impair work, social and cognitive functioning. Continuous subcutaneous insulin infusion (CSII) improves glycaemic control, but little is known about the psychological impact of this therapy.
Aim: To assess the effect of CSII on physical, psychological and cognitive functioning in T1D.
Method: Patients were recruited following assessment for CSII over a 15-month period. Outcomes were collected at baseline, three, and six months post commencement. Measures included anthropometric data, HbA1c, food diary, and questionnaires on quality of life (WHOQOL), Problem Areas in Diabetes (PAID), Treatment satisfaction, Beck Depression Inventory (BDI), Spielberger State Trait Anxiety Inventory, Hospital Anxiety and Depression scale and Montreal cognitive assessment (MOCA).
Results: A total of 21 participants were recruited, 12 female and nine males with a median age of 45 years. Baseline HbA1c was 7-8.5% in 75% of participants with 20% > 9.0%. Three-quarters of participants achieved an HbA1c reduction of 0.2% to 2.5% during the six months of CSII therapy. At six months two-thirds had lost weight, with waist circumference being reduced in 50% and increased in 20%. The majority (75%) described good social support and participants’ knowledge of CSII improved from baseline to six months. In terms of cognitive function and depressive symptoms, the MOCA and BDI scores showed improvement from baseline to six months.
Conclusion: This small study demonstrated improvements in physical and psychological health in the first six months of CSII therapy in patients with type 1 diabetes.