PURPOSE Insulin pump therapy has become the preferential treatment for type 1 diabetes (T1D) as it mimics the physiological secretion of insulin better than multiple daily injections. However, not all patients improve with insulin pump therapy. This study aims to determine the predictors of the effectiveness of insulin pumps in T1D. METHODS We conducted a retrospective observational study of patients who started insulin pumps. Data from four timepoints (before, at 6, 12, and 36 months) were evaluated for outcomes of glycemic control and safety. The association of baseline predictors with outcomes was analyzed using linear and logistic regression models. RESULTS We evaluated 136 patients (57.4% females, age 36 ± 12 years, duration of T1D 14 ± 9 years). During the follow-up, there was a mean decrease of HbA1c of 0.9 ± 1.2%. The improvement in HbA1c was independent of sex, age, and duration of T1D. Higher baseline HbA1c, family history of diabetes, and not being treated with statins were predictors of improvement in HbA1c. Not being treated with statins and higher baseline HbA1c predicted improvement in HbA1c without worsening hypoglycemia. History of hypoglycemia was a predictor of severe hypoglycemia. Family history, higher baseline HbA1c, and psychological/psychiatric disorders were predictors of ketoacidosis. CONCLUSION Benefits of insulin pump were independent of sex, age, and duration of T1D. Baseline HbA1c, family history of diabetes, treatment with statins, history of hypoglycemia, and psychological/psychiatric disorders were predictors of outcomes, and may allow the identification of patients who benefit most from insulin pump therapy or who are at increased risk of complications.

中文翻译：

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胰岛素泵对 1 型糖尿病患者有效性的预测因子。

目的 胰岛素泵治疗已成为 1 型糖尿病 (T1D) 的首选治疗方法，因为它比每日多次注射更能模拟胰岛素的生理分泌。然而，并非所有患者都能通过胰岛素泵治疗得到改善。本研究旨在确定 T1D 中胰岛素泵有效性的预测因子。方法 我们对开始使用胰岛素泵的患者进行了一项回顾性观察研究。评估了四个时间点（之前、6、12 和 36 个月）的血糖控制结果和安全性。使用线性和逻辑回归模型分析基线预测因子与结果的关联。结果 我们评估了 136 名患者（57.4% 的女性，年龄 36 ± 12 岁，T1D 病程 14 ± 9 年）。在随访期间，HbA1c 平均下降 0.9 ± 1.2%。HbA1c 的改善与性别、年龄和 T1D 持续时间无关。较高的基线 HbA1c、糖尿病家族史和未接受他汀类药物治疗是 HbA1c 改善的预测因素。未接受他汀类药物治疗和较高的基线 HbA1c 可预测 HbA1c 的改善，而不会恶化低血糖。低血糖病史是严重低血糖的预测因素。家族史、较高的基线 HbA1c 和心理/精神疾病是酮症酸中毒的预测因素。结论 胰岛素泵的益处与性别、年龄和 T1D 持续时间无关。基线 HbA1c、糖尿病家族史、他汀类药物治疗、低血糖病史和心理/精神疾病是预后的预测因素，