Health related quality of life, treatment satisfaction and costs associated with intraperitoneal versus subcutaneous insulin administration in type 1 diabetes. A randomized controlled trial

Susan J. Logtenberg; Nanne Kleefstra; Sebastiaan T. Houweling; Klaas H. Groenier; Reinold O. Gans; Henk J. Bilo

doi:10.2337/dc09-1758

Health related quality of life, treatment satisfaction and costs associated with intraperitoneal versus subcutaneous insulin administration in type 1 diabetes. A randomized controlled trial

Susan J. Logtenberg, MD (s.j.j.logtenberg{at}isala.nl)¹,
Nanne Kleefstra, MD¹,²,
Sebastiaan T. Houweling, MD, PhD¹,²,³,
Klaas H. Groenier, PhD⁴,⁵,
Reinold O. Gans, MD, PhD⁵,⁶ and
Henk J. Bilo, MD, PhD, FRCP¹,⁵,⁶

1. Diabetes Centre, Isala Clinics, Zwolle, The Netherlands
2. Langerhans Medical Research Group, The Netherlands
3. General Practice Sleeuwijk, the Netherlands
4. Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands
5. University of Groningen, Groningen, The Netherlands
6. Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands

Abstract

Objective- To investigate the effects of continuous intraperitoneal insulin infusion (CIPII) compared to subcutaneous insulin on health related quality of life (HRQOL) and treatment satisfaction, and to perform a cost analysis in type 1 diabetes.

Research Design and Methods- Open-label, prospective, crossover, randomized, 16-month study (n=24). HRQOL and patient satisfaction were assessed with questionnaires (SF-36, WHO-5 and DTSQ, respectively). Direct costs of CIPII and continuous subcutaneous insulin infusion (CSII) were compared.

Results- Questionnaires scores were higher with CIPII compared to subcutaneous therapy. Yearly direct pump- and procedures associated costs for CIPII were estimated at €10,910 compared to €4,810 for CSII.

Conclusions- Apart from improving glycemic control, CIPII improved HRQOL and treatment satisfaction as compared to subcutaneous insulin. Direct pump- and procedures associated costs are considerably higher, however.