Colquitt, J. L. (Jill L.), Green, C., Sidhu, M. K., Hartwell, D. (Debbie L.) and Waugh, Norman. (2004) Clinical and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes. Health Technology Assessment, Vol.8 (No.43). ISSN 1366-5278

Preview	Text WRAP_Waugh_CSII TAR1.pdf - Published Version Download (885Kb) | Preview
Preview	Text (Cover sheet) WRAP_waugh2_Coversheet_FinalVersion.pdf Download (165Kb) | Preview

Abstract

Objectives: To assess the clinical and cost-effectiveness of continuous subcutaneous insulin infusion (CSII) compared with multiple daily injections (MDI) in the delivery of intensive insulin therapy for the treatment of diabetes mellitus. Data sources: Electronic databases, references of retrieved articles and manufacturer submissions. Experts in the field were consulted. Review methods: For the systematic review of clinical and cost-effectiveness, studies were assessed for inclusion according to predefined criteria by two reviewers. Data extraction and quality assessment were undertaken by one reviewer and checked by a second reviewer. Data on clinical effectiveness were synthesised through a narrative review with full tabulation of all eligible studies, with meta-analysis performed where appropriate. Results: Twenty studies comparing CSII with MDI were identified. Quality was generally poor. In adults with Type 1 diabetes, glycated haemoglobin improved by 0.61% (95% CI –1.29 to 0.07) in longer term studies, although this improvement was smaller when a study using bovine ultralente was excluded. A reduction in insulin dose with CSII of about 12 units per day (–11.90, 95% CI –18.16 to 5.63) was found in shortterm studies, with smaller differences in longer term studies. Body weight and cholesterol levels were similar between treatments. Hypoglycaemic events did not differ significantly between CSII and MDI in most trials, but some found fewer events with CSII and one found more hypoglycaemia and hypoglycaemic coma with CSII. There was no consistency between the studies in patient preference, but progress has been made both with insulin pumps and injector pens since the publication of many of the older studies. No difference in glycated haemoglobin between CSII and MDI was found in pregnancy; one study found less insulin was required by patients with CSII, but two other studies found no significant difference. One study of adolescents found lower glycated haemoglobin and insulin dose with CSII whereas a second study found no significant difference. In CSII analogue insulin was associated with lower glycated haemoglobin levels than soluble insulin. No economic evaluations comparing CSII with MDI were identified. The estimated additional cost of CSII compared to MDI varies from £1091 per annum to £1680 per annum, according to the make of the insulin pump and the estimated life of the device. These estimates include the costs for the insulin pump, the consumables associated with delivery of CSII, and an allowance for the initial education required when patients switch from MDI to CSII. The largest component of the annual cost for CSII is the cost of consumable items (e.g. infusion sets). Conclusions: When compared with optimised MDI, CSII results in a modest but worthwhile improvement in glycated haemoglobin in adults with Type 1 diabetes. It has not been possible to establish the longer term benefits of such a difference in glycated haemoglobin, although there is an expectation that it would be reflected in a reduction in long-term complications. More immediate primary benefits from CSII may be associated with an impact on the incidence of hypoglycaemic events and the dawn phenomenon, and greater flexibility of lifestyle. However, there is limited evidence on this, and information presented to offer context on quality-of-life is based on testimonies from those patients who have had a positive experience of CSII. The estimated cost to the NHS per year for CSII would be around £3.5 million in England and Wales if 1% of people with Type 1 diabetes used CSII, £10.5 million for 3%, and £17.5 million for 5%. Further research should focus on wider benefits of CSII, such as flexibility of lifestyle and quality of life, and on the psychological impact of wearing a device for 24 hours every day. Research into the use of CSII in children of different ages is also needed.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Warwick Evidence Faculty of Medicine > Warwick Medical School > Health Sciences
Library of Congress Subject Headings (LCSH):	Diabetes -- Treatment, Insulin -- Therapeutic use -- Administration
Journal or Publication Title:	Health Technology Assessment
Publisher:	NIHR Health Technology Assessment programme
ISSN:	1366-5278
Date:	2004
Volume:	Vol.8
Number:	No.43
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	NIHR Health Technology Assessment Programme (Great Britain)
References:	1. Rangasami JJ, Greenwood DC, McSporran B, Smail PJ, Patterson CC, Waugh NR. Rising incidence of type 1 diabetes in Scottish children, 1984–93. The Scottish Study Group for the Care of Young Diabetics. Arch Dis Child 1997;77:210–13. 2. Bingley PJ, Gale EA. Incidence of insulin dependent diabetes in England: a study in the Oxford region, 1985–6. BMJ 1989;298:558–60. 3. Zhao HX, Stenhouse E, Soper C, Hughes P, Sanderson E, Baumer JH, et al. Incidence of childhood-onset type 1 diabetes mellitus in Devon and Cornwall, England, 1975–1996. Diabet Med 1999;16:1030–5. 4. Burden AC, Hearnshaw JR, Swift PG. Childhood diabetes mellitus: an increasing incidence. Diabet Med 1989;6:334–6. 5. Patterson CC, Thorogood M, Smith PG, Heasman MA, Clarke JA, Mann JI. Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968–1976: evidence of an increasing incidence. Diabetologia 1983;24:238–43. 6. Patterson CC, Smith PG, Webb J, Heasman MA, Mann JI. Geographical variation in the incidence of diabetes mellitus in Scottish children during the period 1977–1983. Diabet Med 1988;5:160–5. 7. Staines A, Bodansky HJ, Lilley HE, Stephenson C, McNally RJ, Cartwright RA. The epidemiology of diabetes mellitus in the United Kingdom: the Yorkshire Regional Childhood Diabetes Register. Diabetologia 1993;36:1282–7. 8. Green A, Gale EA, Patterson CC. Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE Study. Lancet 1992;339:905–9. 9. UKPDS Study Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837–53. 10. Neil HA, Gatling W, Mather HM. The Oxford Community Diabetes Study: evidence for an increase in the prevalence of known diabetes in Great Britain. Diabet Med 1987;4:539–43. 11. Gatling W, Budd S, Walters D, Mulle MA, Goddard JR, Hill RD. Evidence of an increasing prevalence of diagnosed diabetes in the Poole area from 1983 to 1996. Diabet Med 1998;15:1015–21. 12. Mather HM, Keen H. The Southall Diabetes Survey: prevalence of known diabetes in Asians and Europeans. BMJ 1985;291:1081–4. 13. Newnham A, Ryan R, Khunti K, Majeed A. Prevalence of diagnosed diabetes mellitus in general practice in England and Wales, 1940 to 1998. Health Stat Q 2002;14:5–13. 14. Turner R, Cull C, Holman R, for the United Kingdom Prospective Diabetes Study. UKPDS 17: A 9-year update of a randomised controlled trial of the effect of improved metabolic control on complications in non-insulin-dependant diabetes mellitus. Ann Intern Med 1996;124:136–45. 15. Waugh NR, Jung RT, Newton RW. The Dundee prevalence study of insulin-treated diabetes; intervals between diagnosis and start of insulin therapy. Diabet Med 1989;6:346–50. 16. Humphrey ARG, McCarty DJ, Mackay IR, Rowley MJ, Dwyer T, Zimmet P. Autoantibodies to glutamic acid decarboxylase and phentotypic features associated with early insulin treatment in individuals with adult-onset diabetes. Diabet Med 1998;15:113–19. 17. Office for National Statistics. Key health statistics from general practice 1998. London: Office for National Statistics; 2000. 18. Wang PH, Lau J, Chalmers TC. Meta-analysis of effects of intensive blood-glucose control on late complications of type I diabetes. Lancet 1993;341:1306–9. 19. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977–86. 20. Reichard P, Nilsson B-Y, Rosenqvist U. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med 1993;329:304–9. 21. The Diabetes Control and Complications Trial. The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulindependent diabetes mellitus. Arch Ophthalmol 1995;113:36–51. 22. Egger M, Davey-Smith G, Stettler C, Diem P. Risk of adverse effects of intensified treatment in insulin-dependent diabetes mellitus: a metaanalysis. Diabet Med 1997;14:919–28. 23. Gold AE, Frier BM. Hypoglycaemia: practical and clinical implications. In Kelnar CJH, editor. Childhood and adolescent diabetes, London: Chapman and Hall; 1995. pp. 351–66. 24. The Diabetes Control and Complications Trial Research Group. Hypoglycemia in the Diabetes Control and Complications Trial. Diabetes 1997;46:271–86. 25. Muhlhauser I, Berger M, Sonnenberg G, Koch J, Jorgens V, Schernthaner G, et al. Incidence and management of severe hypoglycemia in 434 adults with insulin-dependent diabetes mellitus. Diabetes Care 1985;8:268–73. 26. Rewers A, Chase HP, Mackenzie T, Walravens P, Roback M, Rewers M, et al. Predictors of acute complications in children with type 1 diabetes. JAMA 2002;287:2511–18. 27. Emilien G, Maloteaux JM, Ponchon M. Pharmacological management of diabetes: recent progress and future perspective in daily drug treatment. Pharmacol Ther 1999;81:37–51. 28. Swift PGF. Insulin: types and regimens. Childhood and adolescent diabetes. London: Chapman and Hall; 1995. pp. 253–66. 29. Morris AD, Boyle DIR, McMahon AD, for the DARTS/MEMO Collaboration. Adherence to insulin treatment, glycaemic control and ketoacidosis in IDDM. Lancet 1997;350:1505–10. 30. Scottish Study Group for the Care of the Young Diabetic. Factors influencing glycemic control in young people with type 1 diabetes in Scotland. A population-based study (DIABAUD2). Diabetes Care 2001;24:239–44. 31. Atkinson MA, Eisenbarth GS. Type 1 diabetes: new perspectives on disease pathogenesis and treatment. Lancet 2001;358:221–9. 32. Pickup JC, Keen H, Parsons JA, Alberti KGMM. Continuous subcutaneous insulin infusion: an approach to achieving normoglycaemia. BMJ 1978;i:204–7. 33. Tamborlane WV, Sherwin RS, Genel M, Felig P. Reduction to normal of plasma glucose in juvenile diabetes by subcutaneous administration of insulin with a portable infusion pump. N Engl J Med 1979;300:573–8. 34. Thorp FK. Insulin pump therapy reconsidered. JAMA 1986;255:645–6. 35. Davies AG, Baum JD. A decade of insulin infusion pumps. Arch Dis Child 1988;63:329–32. 36. Lenhard MJ, Reeves GD. Continuous subcutaneous insulin infusion: a comprehensive review of insulin pump therapy. Arch Intern Med 2001;161:2293–300. 37. American Diabetes Association. Continuous subcutaneous insulin infusion. Diabetes Care 2002;25:S116. 38. Pickup J, Keen H. Continuous subcutaneous insulin infusion in type 1 diabetes is beneficial in selected patients and should be more widely available. BMJ 2001;322:1263–4. 39. Pickup J, Keen H. Continuous subcutaneous insulin infusion at 25 years: Evidence base for the expanding use of insulin pump therapy in type 1 diabetes. Diabetes Care 2002;25:593–8. 40. Pickup J, Mattock M, Kerry S. Glycaemic control with continuous subcutaneous insulin infusion compared with intensive insulin injections in patients with type 1 diabetes: meta-analysis of randomised controlled trials. BMJ 2002;324:705–8. 41. Pons JMV. Continuous subcutaneous infusion of insulin with portable pump in diabetes type 1 patients. Barcelona: CAHTA; 2000. No. IN01/2000. 42. Munoz A, Saz Z, Amate JM. Efficacy of insulin infusion pumps. Impact on the quality of live of certain patients. Spain: AETS; 2000. 43. Hotta SS, Adams D. Reassessment of external insulin infusion pumps. Health Technol Assess Reports 1990;(9):1–9. 44. Graff MR, Rubin RR, Walker EA. How diabetes specialists treat their own diabetes: findings from a study of the AADE and ADA membership. Diabetes Educ 2000;26:460–7. 45. Wredling R, Lin PE, Adamson U. Pump ‘run-away’ causing severe hypoglycaemia. Lancet 1989;ii:273. 46. Tritos NA, Casper K, King G. Museum visit leading to insulin pump malfunction. Ann Intern Med 1997;126:746. 47. Darmon P, Guillaume V, Wiart J, Dutour A, Oliver C. Do mobile cellular phones interfere with portable insulin pumps? Diabetes Care 1998; 21:1775. 48. Prendergast JJ, Dorsey C, Elsea V. Over-delivery of insulin by insulin pumps. Diabetes Care 1995; 18:1201–2. 49. Mecklenburg RS, Benson EA, Benson JW, Fredlund PN, Guinn T, Metz RJ, et al. Acute complications associated with insulin infusion pump therapy. Report of experience with 161 patients. JAMA 1984;252:3265–9. 50. Teutsch SM, Herman WH, Dwyer DM, Lane JM. Mortality among diabetic patients using continuous subcutaneous insulin-infusion pumps. N Engl J Med 1984;310:361–8. 51. Knight G, Jennings AM, Boulton AJ, Tomlinson S, Ward JD. Severe hyperkalaemia and ketoacidosis during routine treatment with an insulin pump. BMJ 1985;291:371–2. 52. The Kroc Collaborative Study Group. Blood glucose control and the evolution of diabetic retinopathy and albuminuria. A preliminary multicenter trial. N Engl J Med 1984;311:365–72. 53. Steel JM, West CP. Intrauterine death during continuous subcutaneous infusion of insulin. BMJ 1985;290:1787. 54. Bradley C, Gamsu DS, Knight G, Boulton AJ, Ward JD. Predicting risk of diabetic ketoacidosis in patients using continuous subcutaneous insulin infusion. BMJ 1986;293:242–3. 55. Bending JJ, Pickup JC, Keen H. Frequency of diabetic ketoacidosis and hypoglycemic coma during treatment with continuous subcutaneous insulin infusion. Audit of medical care. Am J Med 1985;79:685–91. 56. Chantelau E, Spraul N, Mhuhlhauser I, Gause R, Beger M. Long-term safety, efficacy and sideeffects of continuous subcutaneous insulin infusion treatment for type 1 (insulin-dependent) diabetes mellitus: a one centre experience. Diabetologia 1989;32:421–6. 57. Raskin P. Treatment of type 1 diabetes with portable insulin pumps. Diabetes Care 1982;5 (Suppl 1):48–52. 58. Toth EL, Boychuk LR, Kirkland PA. Recurrent infection of continuous subcutaneous insulin infusion sites with Mycobacterium fortuitum. Diabetes Care 1995;18:1284–5. 59. Pagnoux C, Nassif X, Boitard C, Timsit J. Infection of continuous subcutaneous insulin infusion site with Mycobacterium peregrinum. Diabetes Care 1998;21:191–2. 60. New insulin pump forum launched in UK. Pract Diab Int 2000;17:278–9. 61. Brink SJ, Stewart C. Insulin pump treatment in insulin-dependent diabetes mellitus. Children, adolescents, and young adults. JAMA 1986; 255:617–21. 62. Levy-Marchal C, Czernichow P. Feasibility of continuous subcutaneous insulin infusion in young diabetic patients. Diabetes Metab 1988;14:108–13. 63. Knight G, Boulton AJ, Ward JD. Experience of continuous subcutaneous insulin infusion in the outpatient management of diabetic teenagers. Diabet Med 1986;3:82–4. 64. Bougneres PF, Landier F, Lemmel C, Mensire A, Chaussain JL. Insulin pump therapy in young children with type 1 diabetes. J Pediatr 1984; 105:212–7. 65. De Beaufort CE, Bruining GJ. Continuous subcutaneous insulin infusion in children. Diabet Med 1987;4:103–8. 66. Kaufman FR, Halvorson M, Kim C, Pitukcheewanont P. Use of insulin pump therapy at nighttime only for children 7–10 years of age with type 1 diabetes. Diabetes Care 2000;23:579–82. 67. Schiffrin A. Nighttime continuous subcutaneous insulin infusion revisited: a strategy for improving insulin delivery. Diabetes Care 2000;23:571–3. 68. Olsson P, Arnqvist H, Von Schenck H, Ottosson AM. Overnight metabolic control with bedtime injection of intermediate-acting insulin or continuous subcutaneous insulin fusion. Diabetes Care 1987;10:702–6. 69. Kanc K, Janssen MM, Keulen ET, Jacobs MA, Popp-Snijders C, Snoek FJ, et al. Substitution of night-time continuous subcutaneous insulin infusion therapy for bedtime NPH insulin in a multiple injection regimen improves counterregulatory hormonal responses and warning symptoms of hypoglycaemia in IDDM. Diabetologia 1998;41:322–9. 70. Gabbe SG. New concepts and applications in the use of the insulin pump during pregnancy. J Matern Fetal Med 2000;9:42–5. 71. Aucott SW, Williams TG, Hertz RH, Kalhan SC. Rigorous management of insulin-dependent diabetes mellitus during pregnancy. Acta Diabetol 1994;31:126–9. 72. Caruso A, Lanzone A, Bianchi V, Massidda M, Castelli MP, Fulghesu AM, et al. Continuous subcutaneous insulin infusion (CSII) in pregnant diabetic patients. Prenat Diagn 1987;7:41–50. 73. Jensen BM, Kuhl C, Molsted-Pedersen L, Saurbrey N, Fog-Pedersen J. Preconceptional treatment with insulin infusion pumps in insulindependent diabetic women with particular reference to prevention of congenital malformations. Acta Endocrinol Suppl (Copenh) 1986;277:81–5. 74. Rudolf MC, Coustan DR, Sherwin RS, Bates SE, Felig P, Genel M, et al. Efficacy of the insulin pump in the home treatment of pregnant diabetics. Diabetes 1981;30:891–5. 75. Simmons D, Thompson CF, Conroy C, Scott DJ. Use of insulin pumps in pregnancies complicated by Type 2 diabetes and gestational diabetes in a multiethnic community. Diabetes Care 2001;24:2078–82. 76. Brinchmann-Hansen O, Dahl-Jorgensen K, Hanssen KF, Sandvik L. The response of diabetic retinopathy to 41 months of multiple insulin injections, insulin pumps, and conventional insulin therapy. Arch Ophthalmol 1988;106:1242–6. 77. Dahl-Jorgensen K, Hanssen KF, Kierulf P, Bjoro T, Sandvik L, Aagenaes O. Reduction of urinary albumin excretion after 4 years of continuous subcutaneous insulin infusion in insulindependent diabetes mellitus. The Oslo Study. Acta Endocrinologica 1988;117:19–25. 78. Dahl-Jorgensen K, Brinchmann-Hansen O, Hanssen KF, Ganes T, Kierulf P, Smeland E, et al. Effect of near normoglycaemia for two years on progression of early diabetic retinopathy, nephropathy, and neuropathy: the Oslo study. BMJ 1986;293:1195–9. 79. Tsui E, Barnie A, Ross S, Parkes R, Zinman B. Intensive insulin therapy with insulin lispro: a randomized trial of continuous subcutaneous insulin infusion versus multiple daily insulin injection. Diabetes Care 2001;24:1722–7. 80. Hanaire-Broutin H, Melki V, Bessieres-Lacombe S, Tauber JP. Comparison of continuous subcutaneous insulin infusion and multiple daily injection regimens using insulin lispro in type 1 diabetic patients on intensified treatment: a randomized study. The Study Group for the Development of Pump Therapy in Diabetes. Diabetes Care 2000;23:1232–5. 81. Bode BW, Steed RD, Davidson PC. Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in type I diabetes. Diabetes Care 1996;19:324–7. 82. Chiasson JL, Ducros F, Poliquin HM, Lopez D, Lecavalier L, Hamet P. Continuous subcutaneous insulin infusion (Mill-Hill Infuser) versus multiple injections (Medi-Jector) in the treatment of insulin-dependent diabetes mellitus and the effect of metabolic control on microangiopathy. Diabetes Care 1984;7:331–7. 83. Haakens K, Hanssen KF, Dahl-Jorgensen K, Vaaler S, Aagenaes O, Mosand R. Continuous subcutaneous insulin infusion (CSII), multiple injections (MI) and conventional insulin therapy (CT) in self-selecting insulin-dependent diabetic patients. A comparison of metabolic control, acute complications and patient preferences. J Intern Med 1990;228:457–64. 84. Ziegler D, Dannehl K, Koschinsky T, Toeller M, Gries FA. Comparison of continuous subcutaneous insulin infusion and intensified conventional therapy in the treatment of type I diabetes: a twoyear randomized study. Diabetes Nutr Metab Clin Exp 1990;3:203–13. 85. Nosadini R, Velussi M, Fioretto P, Doria A, Avogaro A, Trevisan R, et al. Frequency of hypoglycaemic and hyperglycaemic–ketotic episodes during conventional and subcutaneous continuous insulin infusion therapy in IDDM. Diabetes Nutr Metab 1988;1:289–96. 86. Schmitz A, Christiansen JS, Christensen CK, Hermansen K, Mogensen CE. Effect of pump versus pen treatment on glycaemic control and kidney function in long-term uncomplicated insulin-dependent diabetes mellitus (IDDM). Dan Med Bull 1989;36:176–8. 87. Bak JF, Nielsen OH, Pedersen O, Beck-Nielsen H. Multiple insulin injections using a pen injector versus insulin pump treatment in young diabetic patients. Diabetes Res 1987;6:155–8. 88. Home PD, Capaldo B, Burrin JM, Worth R, Alberti KG. A crossover comparison of continuous subcutaneous insulin infusion (CSII) against multiple insulin injections in insulin-dependent diabetic subjects: improved control with CSII. Diabetes Care 1982;5:466–71. 89. Nathan DM, Lou PAJ. Intensive conventional and insulin pump therapy in adult type 1 diabetes. A crossover study. Ann Intern Med 1982;97:31–6. 90. Saurbrey N, Arnold-Larsen S, Moller-Jensen B, Kuhl C. Comparison of continuous subcutaneous insulin infusion with multiple insulin injections using the NovoPen. Diabet Med 1988;5:150–3. 91. Schiffrin A, Belmonte MM. Comparison between continuous subcutaneous insulin infusion and multiple injection of insulin. A one-year prospective study. Diabetes 1982;31:255–64. 92. Nosari I, Maglio ML, Lepore G. Is continuous subcutaneous insulin infusion more effective than intensive conventional insulin therapy in the treatment of pregnant diabetic women? Diabetes Nutr Metab 1993;6:33–7. 93. Coustan DR, Reece EA, Sherwin RS, Rudolf MC, Bates SE, Sockin SM, et al. A randomized clinical trial of the insulin pump vs intensive conventional therapy in diabetic pregnancies. JAMA 1986;255:631–6. 94. Carta Q, Meriggi E, Trossarelli GF, Catella G, Dal Molin V, Menato G, et al. Continuous subcutaneous insulin infusion versus intensive conventional insulin therapy in type I and type II diabetic pregnancy. Diabetes Metab 1986;12:121–9. 95. Burkart W, Hanker JP, Schneider HP. Complications and fetal outcome in diabetic pregnancy. Intensified conventional versus insulin pump therapy. Gynecol Obstet Invest 1988; 26:104–12. 96. Tamborlane WV, Batas SE, Rudolf MC. Comparison of continuous subcutaneous insulin infusion versus multiple daily injections in adolescents with insulin-dependent diabetes. Adv Diabetol 1989;2 (Suppl 1):24–7. 97. Schiffrin AD, Desrosiers M, Aleyassine H, Belmonte MM. Intensified insulin therapy in the type 1 diabetic adolescent: a controlled trial. Diabetes Care 1984;7:107–13. 98. Boland EA, Grey M, Oesterle A, Fredrickson L, Tamborlane WV. Continuous subcutaneous insulin infusion. A new way to lower risk of severe hypoglycemia, improve metabolic control, and enhance coping in adolescents with type 1 diabetes. Diabetes Care 1999;22:1779–84. 99. Mack-Fogg J, Bates S, Faro B, Sciera M, Ippolito K, Orlowski CC, et al. Safe and effective use of continuous subcutaneous insulin infusion in young children with type 1 diabetes mellitus. Diabetes 2002;51 (Suppl 1, poster 712):122A. 100. Rudolf JW, Hirsch IB. An assessment of continuous subcutaneous insulin infusion therapy in an academic diabetes clinic. Diabetes 2000; 49 (Suppl 1, poster 501-P):A124. 101. Haardt MJ, Berne C, Dorange C, Slama G, Selam JL. Efficacy and indications of CSII revisited: the Hotel-Dieu cohort. Diabet Med 1997;14:407–8. 102. Tamborlane WV, Bonfig W, Boland E. Recent advances in treatment of youth with type 1 diabetes: better care through technology. Diabet Med 2001;18:864–70. 103. Kaufman FR, Halvorson M, Miller D, Mackenzie M, Fisher LK, Pitukcheewanont P. Insulin pump therapy in type 1 pediatric patients: now and into the year 2000. Diabetes Metab Res Rev 1999;15:338–52. 104. Plotnick L, Clark L. Insulin pumps in children and adolescents. Endocrinologist 2001;11:112–17. 105. Steindel BS, Roe TR, Costin G, Carlson M, Kaufman FR. Continuous subcutaneous insulin infusion (CSII) in children and adolescents with chronic poorly controlled type 1 diabetes mellitus. Diabetes Res Clin Pract 1995;27:199–204. 106. Maniatis AK, Klingensmith GJ, Slover RH, Mowry CJ, Chase HP. Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care. Pediatrics 2001;107:351–6. 107. Conrad SC, McGrath MT, Gitelman SE. Transition from multiple daily injections to continuous subcutaneous insulin infusion in type 1 diabetes mellitus. J Pediatr 2002;140:235–40. 108. Ahern JA, Boland E, Doane R, Ahern JJ, Rose P, Vincent M, et al. Insulin pump therapy in pediatrics: a therapeutic alternative to safely lower HbA1c levels across all age groups. Pediatr Diabetes 2002;3:10–15. 109. Fox LA, Wilkinson K, Buckloh L, Wysocki T, Mauras N. A randomized trial of insulin pump therapy in preschool age children with type 1 diabetes mellitus: preliminary results. Diabetes 2002;51 (Suppl 2, poster 1751):426A. 110. Weintrob N, Benzaquen H, Galatzer A, Shalitin S, Lazar L, Fayman G, et al. Comparison of continuous subcutaneous insulin infusion and multiple daily injection regimens in children with type 1 diabetes: a randomised controlled trial. Diabetes 2002;51 (Suppl 2, poster 1969). 111. Valensi P, Moura I, Le Magoarou M, Paries J, Perret G, Attali JR. Short-term effects of continuous subcutaneous insulin infusion treatment on insulin secretion in non-insulindependent overweight patients with poor glycaemic control despite maximal oral antidiabetic treatment. Diabetes Metab 1997;23:51–7. 112. Dupuy O, Mayaudon H, Palou M, Sarret D, Bordier L, Bauduceau B. Optimized transient insulin infusion in uncontrolled type 2 diabetes: evaluation of a pragmatic attitude. Diabetes Metab 2000;26:371–5. 113. Bode B, Weinstein R, Bell D, McGill J, Nadeau D, Raskin P, et al. Comparison of insulin aspart with buffered regular insulin and insulin lispro in continuous subcutaneous insulin infusion: a randomized study in type 1 diabetes. Diabetes Care 2002;25:439–44. 114. Renner R, Pfutzner A, Trautmann M, Harzer O, Sauter K, Landgraf R. Use of insulin lispro in continuous subcutaneous insulin infusion treatment. Results of a multicenter trial. German Humalog-CSII Study Group. Diabetes Care 1999; 22:784–8. 115. Schmauss S, Konig A, Landgraf R. Human insulin analogue [LYS(B28), PRO(B29)]: the ideal pump insulin? Diabet Med 1998;15:247–9. 116. Melki V, Renard E, Lassmann-Vague V, Boivin S, Guerci B, Hanaire-Broutin H, et al. Improvement of HbA1c and blood glucose stability in IDDM patients treated with lispro insulin analog in external pumps. Diabetes Care 1998;21:977–82. 117. Raskin P, Holcombe JH, Tamborlane WV, Malone JI, Strowig S, Ahern JA, et al. A comparison of insulin lispro and buffered regular human insulin administered via continuous subcutaneous insulin infusion pump. J Diabetes Complications 2001; 15:295–300. 118. Zinman B, Tildesley H, Chiasson JL, Tsui E, Strack T. Insulin lispro in CSII: results of a doubleblind crossover study. Diabetes 1997;46:440–3. 119. Green S, Deeks J, Savio F. The ends and the means: continuous data in Cochrane reviews. Poster presentation at Cochrane Colloquium, 2001. 120. Schifferdecker E, Schmidt K, Boehm BO, Schatz H. Long-term compliance of intensified insulin therapy. Diabetes Res Clin Pract 1994;23:17–23. 121. Wredling R, Lins PE, Adamson U. Factors influencing the clinical outcome of continuous subcutaneous insulin infusion in routine practice. Diabetes Res Clin Pract 1993;19:59–67. 122. Knight G, Boulton AJ, Drury J, Gamsu DS, Moses JL, Bradley C, et al. A feasibility study of the use of continuous subcutaneous insulin infusion in a diabetic clinic: patients’ choice of treatment. Diabet Med 1984;1:267–72. 123. Floyd JC, Cornell RG, Jacober SJ, Griffith LE, Funnell MM, Wolf LL, et al. A prospective study identifying risk factors for discontinuance of insulin pump therapy. Diabetes Care 1993; 16:1470–8. 124. Bell DS, Ackerson C, Cutter G, Clements RS. Factors associated with discontinuation of continuous subcutaneous insulin infusion. Am J Med Sci 1988;295:23–8. 125. Bell DSH, Cutter G, Clements J. The feasibility of long-term treatment of diabetes with continuous subcutaneous insulin infusion. Diabetes Nutr Metab Clin Exp 1993;6:57–60. 126. British National Formulary. London: British National Formulary; 2002. 127. Herman WH, Eastman RC. The effects of treatment on the direct costs of diabetes. Diabetes Care 1998;21:C19–24. 128. American Diabetes Association. Economic consequences of diabetes mellitus in the U.S. in 1997. Diabetes Care 1998;21:296–309. 129. Lifetime benefits and costs of intensive therapy as practiced in the diabetes control and complications trial. The Diabetes Control and Complications Trial Research Group. JAMA 1996;276:1409–15. 130. Gray A, Raikou M, McGuire A, Fenn P, Stevens R, Cull C, et al. Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41). United Kingdom Prospective Diabetes Study Group. BMJ 2000;320:1373–8. 131. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405–12. 132. Klein R, Klein BE, Moss SE, Cruickshanks KJ. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology 1998;105:1801–15. 133. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352:854–65. 134. Clark P, Gray A, Adler A, Stevens R, Raikou M, Cull C, et al. Cost-effective analysis of intensive blood glucose control with metformin in overweight patients with type 2 diabetes (UKPDS 51). Diabetologia 2001;44:298–304. 135. Palmer AJ, Weiss C, Sendi PP, Neeser K, Brandt A, Singh G, et al. The cost-effectiveness of different management strategies for type I diabetes: a Swiss perspective. Diabetologia 2000;43:13–26. 136. INPUT. INsulin PUmp Therapy. 2001. 137. Directory of diabetes care. Cambridge: CMA Medical Data; 2001. 138. Netten A, Rees T, Harrison G. Unit costs of health and social care, 2001. Canterbury: Personal Social Services Research Unit, University of Kent at Canterbury; 2002. 139. NHS. NHS reference costs. London: Department of Health; 2000. 140. Nordfeldt S, Jonsson D. Short-term effects of severe hypoglycaemia in children and adolescents with type 1 diabetes. A cost-of-illness study. Acta Paediatr 2001;90:137–42. 141. Leese GP, Wang J, Broomhall J, Kelly P, Marsden A, Morrison W, et al. Incidence of severe hypoglycaemia requiring emergency treatment in type 1 and type 2 diabetes: a population-based study of health service resource use. Diabet Med 2002;19 (Suppl 2):12–3. 142. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev 1999;15:205–18. 143. The Diabetes Control and Complications Trial Research Group. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995;44:968–83. 144. Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA 1988;260:2864–71. 145. Klein R, Klein BE. Relation of glycemic control to diabetic complications and health outcomes. Diabetes Care 1998;21 (Suppl 3):C39–43. 146. Epidemiology of severe hypoglycemia in the diabetes control and complications trial. The DCCT Research Group. Am J Med 1991;90:450–9. 147. Microvascular and acute complications in IDDM patients: the EURODIAB IDDM Complications Study. Diabetologia 1994;37:278–85. 148. Influence of intensive diabetes treatment on quality-of-life outcomes in the diabetes control and complications trial. Diabetes Care 1996;19:195–203. 149. Ferguson SC, Strachan MW, Janes JM, Frier BM. Severe hypoglycaemia in patients with type 1 diabetes and impaired awareness of hypoglycaemia: a comparative study of insulin lispro and regular human insulin. Diabetes Metab Res Rev 2001;17:285–91. 150. Marrero DG, Guare JC, Vandagriff JL, Fineberg NS. Fear of hypoglycemia in the parents of children and adolescents with diabetes: maladaptive or healthy response? Diabetes Educ 1997;23:281–6. 151. Cox DJ, Irvine A, Gonder-Frederick L, Nowacek G, Butterfield J. Fear of hypoglycaemia: quantification, validation and utilisation. Diabetes Care 1987;10:6717–621. 152. Clarke WL, Cox DJ, Gonder-Frederick LA, Julian D, Schlundt D, Polonsky W. Reduced awareness of hypoglycemia in adults with IDDM. A prospective study of hypoglycemic frequency and associated symptoms. Diabetes Care 1995; 18:517–22. 153. Gold AE, MacLeod KM, Frier BM. Frequency of severe hypoglycaemia in patients with type 1 diabetes with impaired awareness of hypoglycaemia. Diabetes Care 1994;17:697–703. 154. Chantelau E, Schiffers T, Schutze J, Hansen B. Effect of patient-selected intensive insulin therapy on quality of life. Patient Educ Couns 1997;30:167–73. 155. Lewis KS, Bradley C, Knight G, Boulton AJM, Ward JD. A measure of treatment satisfaction designed specifically for people with insulindependent diabetes. Diabet Med 1988;5:235–42. 156. Johansson UB, Adamson UC, Lins PE, Wredling RA. Improved blood glucose variability, HbA1c insuman Infusat and less insulin requirement in IDDM patients using insulin lispro in CSII. The Swedish Multicenter Lispro Insulin Study. Diabetes Metab 2000;26:192–6. 157. Wu S, Sainfort F, Tomar R, Tollios JL, Fryback DG. Development and application of a model to estimate the impact of type 1 diabetes on healthrelated quality of life. Diabetes Care 1998;21:725–31. 158. Brown MM, Brown GC, Sharma S, Shah G. Utility values and diabetic retinopathy. Am J Ophthalmol 1999;128:324–30. 159. Kiberd BA, Jindal KK. Screening to prevent renal failure in insulin dependent diabetic patients: an economic evaluation. BMJ 1995;311:1595–9. 160. Tomar R, Lee S, Wu S, Klein R, Moss SE, Fryback DG, et al. Disease progression and cost of insulin dependent diabetes mellitus: development and application of simulation model. J Soc Health Syst 1998;5:24–37. 161. Dolan P. Modelling valuations for EuroQol health states. Med Care 1997;35:1095–108. 162. Gerich JE. Selection of patients for intensive insulin therapy. Arch Intern Med 1985;145:1383–4. 163. Hanas R. Selection for and initiation of continuous subcutaneous insulin infusion. Proceedings from a workshop. Horm Res 2002;57 (Suppl 1):101–4. 164. Marshall SM, Home PD, Taylor R, Alberti KG. Continuous subcutaneous insulin infusion versus injection therapy: a randomised cross-over trial under usual diabetic clinic conditions. Diabet Med 1987;4:521–5. 165. Helve E, Koivisto VA, Lehtonen A, Pelkonen R, Huttunen JK, Nikkila EA. A crossover comparison of continuous insulin infusion and conventional injection treatment of type I diabetes. Acta Med Scand 1987;221:385–93. 166. Scottish Study Group for the Care of the Young Diabetic. Factors influencing glycemic control in young people with type 1 diabetes in Scotland. Diabetes Care 2001;24:239–44. 167. Warren E, Weatherley-Jones E, Chilcott J, Beverley C. Systematic review and economic evaluation of a long-acting insulin analogue, insulin glargine. Health Technol Assess 2004;8 (in press). 168. Schober E, Schoenle E, van Dyk J, Wernike-Panten K. Comparative trial between insulin glargine and NPH insulin in children and adolescents with type 1 diabetes. Diabetes Care 2001;24:2005–6. 169. Armstrong DU, King AB. Basal insulin: continuous glucose monitoring reveals less overnight hypoglycaemia with continuous subcutaneous insulin infusion than with glargine. Diabetes 2002;51 (Suppl 2, poster 373):92A. 170. Elbourne DR, Altman DG, Higgins JPT, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol 2002;31:140–9. 171. Chilcott J, Wight J, Lloyd Jones M, Tappenden P. The clinical effectiveness and cost effectiveness of pioglitazone in Type 2 diabetes mellitus: a rapid and systematic review. Health Technol Assess 2001;5(19).
URI:	http://wrap.warwick.ac.uk/id/eprint/49877

Request changes to a record

Actions (login required)

View Item