Marked improvements in glycaemic outcomes following insulin pump therapy initiation in people with type 1 diabetes: a nationwide observational study in Scotland – published online 08/03/2021

Anita Jeyam, Fraser W. Gibb, John A. McKnight, Brian Kennon, Joseph E. O’Reilly, Thomas M. Caparrotta, Andreas Höhn, Stuart J. McGurnaghan, Luke A. K. Blackbourn, Sara Hatam, Rory J. McCrimmon, Graham Leese, Robert S. Lindsay, John Petrie, John Chalmers, Sam Philip, Sarah H. Wild, Naveed Sattar, Paul M. McKeigue, Helen M. Colhoun, On behalf of the Scottish Diabetes Research Network (SDRN) Epidemiology Group

As the use of continuous subcutaneous insulin infusion (CSII) to aid diabetes management becomes more widespread, there is still uncertainty regarding its effectiveness and safety. In this issue, Jeyam et al (https://doi.org/10.1007/s00125-021-05413-7) report that, among the Scottish population with type 1 diabetes, CSII initiation is associated with reductions in HbA_1c in both adults and children, with the largest improvements being observed in those with the highest starting HbA_1c levels. They also report CSII initiation to be associated with an overall reduction in the incidence of severe hospitalised hypoglycaemia and diabetic ketoacidosis, though directions of associations varied across age groups for the latter. Finally, they highlight the existing socioeconomic disparities in CSII usage between least and most deprived areas. The authors conclude that CSII is a promising option for improving glycaemic control, especially for those with high HbA_1c levels.

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