Disponible en ligne sur www.sciencedirect.com Diabetes & Metabolism 34 (2008) 132–139 Original article Insulin-pump use in everyday practice: Data from an exhaustive regional registry in France J.-P. Riveline a,∗ , F.-X. Jollois b , N. Messaoudi a , S. Franc a , F. Lagarde c , B. Lormeau d , D. Charitanski e , A. Benoit a , S. Pichard f , A. Deburge g , E. Dresco h , O. Dupuy i , G. Charpentier a , For Groupe Pompe Sud-Francilien 1 a Service de diabétologie, centre hospitalier sud-francilien, 59, boulevard Henri-Dunant, 91600 Corbeil-Essonnes, France b CRIP5, université Paris-Descartes, 12, rue École-de-Médecine, 75006 Paris, France c Service de diabétologie, hôpital de Montargis, 658, rue Bourgoins, 45207 Montargis cedex, France d Service de diabétologie, CHU de Bondy, avenue 14-Juillet, 93140 Bondy, France e Service de diabétologie, hôpital de Dreux, 44, avenue Prés-John-Kennedy, 28100 Dreux, France f Service de diabétologie, centre hospitalier d’Étampes, 26, avenue Charles de Gaulle, 91150 Etampes, France g Service de diabétologie, hôpital de Forcilles, lieu-dit-Forcilles, 77150 Ferolles Attilly, France h Service de diabétologie, hôpital de Dourdan, 2, rue Potelet, 91410 Dourdan, France i Service de diabétologie, centre d’instruction des armées, Begin, 69, avenue Paris, 94163 St-mande cedex, France Received 11 September 2007; received in revised form 22 October 2007; accepted 30 October 2007 Available online 5 March 2008 Abstract Aim. – The aim of this study is to evaluate the effectiveness and safety of continuous subcutaneous insulin infusion (CSII) under real-life conditions among all patients treated with CSII in the south of Paris. Methods. – The 42 diabetologists practising in the region enrolled all patients treated with CSII or admitted for CSII initiation. During the study visit, the data for pump use and clinical results were recorded. Results. – Data were obtained for 424 patients, mean age 44.2 ± 15.6 years, disease duration 18.7 ± 10.6 years, including 339 treated with CSII for longer than three months (mean duration: 3.5 ± 3.5 years; range: 3–258 months). Most of the patients (N = 285, 84.8%) had type 1 diabetes; 44 (13.1%) had type 2 diabetes. In patients treated for more than three months, HbA 1c decreased significantly between CSII initiation (9.1 ± 1.9%) and the study visit (7.8 ± 1.4%; P < 0.0001). Patients with HbA 1c > 9%, using the pump, experienced a significant 0.9% improvement in their HbA 1c levels with CSII versus multiple daily injections (P = 0.001). The number of episodes of moderate hypoglycaemia was 2.7 ± 2.5 per patient per week; of severe hypoglycaemia, 0.34 per patient per year and of ketoacidosis, 0.11 per patient per year. Factors significantly associated with HbA 1c levels included amount of physical activity, pregnancy, HbA 1c at CSII initiation and number of glucose self-determinations. Those associated with the number of moderate hypoglycaemia episodes were basal rate number, female gender and HbA 1c level. HbA 1c was negatively correlated with moderate hypoglycaemia (P < 0.001), but not with severe hypoglycaemia. Conclusion. – This ‘pump’ registry establishes the effectiveness of CSII in everyday practice, yet underscores the risks of severe hypoglycaemia and ketosis episodes. It could help diabetologists to improve patient training programmes and follow-up. © 2008 Elsevier Masson SAS. All rights reserved. Résumé Utilisation de la pompe à insuline dans la vie courante : données issues d’un registre régional franc ¸ais exhaustif. Objectif. – Le but de cette étude est d’évaluer l’efficacité et la tolérance du traitement par pompe à insuline dans des conditions réelles, chez la totalité des patients traités par pompe dans la région sud-francilienne. Méthodes. – Les 42 diabétologues de la région ont inclu tous les patients traités par pompe à insuline ou admis à l’hôpital pour instaurer ce traitement. Durant la visite d’inclusion, les données concernant l’utilisation de la pompe, les résultats cliniques ont été recueillis. ∗ Corresponding author. E-mail address: jeanpierre.riveline@ch-sud-francilien.fr (J.-P. Riveline). 1 See Appendix for group of authors. 1262-3636/$ – see front matter © 2008 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.diabet.2007.10.010 © 2021 Elsevier Masson SAS. Tous droits réservés. - Document téléchargé le 13/12/2021 Il est interdit et illégal de diffuser ce document.