Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr. Stewart Harris and Dr. Jeffrey Mahon

Abstract

Background: Limited “real-world” evidence exists supporting insulin pump therapy (IPT) benefits in adults with type 1 diabetes mellitus (T1DM).

Methods: A retrospective matched cohort study compared the change in glycated hemoglobin (A1C) and incidence of adverse events before and after IPT start in adults with T1DM at St. Joseph’s Healthcare in London, Ontario started on IPT between September 2008 – August 2011 to those of a matched control cohort. Paired t-tests, McNemar’s test and negative binomial regression were used.

Results: 174 matched pairs were included. At 1 year, glycaemic control significantly improved in IPT users but not in controls—the mean paired difference in A1C change was -0.3% (p=0.041, n=133 pairs)—and severe hypoglycaemia was lower in IPT than controls (p=0.016).

Conclusions: Provincially-funded IPT in adults with T1DM was associated with clinically significant improvement in glycaemic control and severe hypoglycaemia, providing “real-world” evidence supporting continued IPT funding in adults with T1DM.


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