Continuous subcutaneous insulin infusion and quality of life in people with type 1 diabetes: A systematic review

Abstract

Type 1 diabetes (T1D) is associated with lower quality of life (QOL). Continuous Subcutaneous Insulin Infusion (CSII) is an effective and safe alternative to multiple daily injections (MDI) for T1D, with the potential to improve both glycemic control and QOL. Literature offers limited information regarding the QOL in people using CSII. The aim of the study was to comprehensively review the published literature about QOL in people with type 1 diabetes. The electronic databases (Pubmed) were searched for peer-reviewed articles published between January 2010 and July 2021 by using the keywords "type 1 diabetes, CSII, AND QOL" in English. QOL measured using general (SF-36 and EQ-5D), diabetes-specific (DQOL, KINDL-DM, and PedsQL), and CSII specific scale (CSII-QOL). Two RCT, 11 observational (longitudinal and cross-sectional), and 2 qualitive studies were identified. Meta-analysis of three studies involving 1,007 people with T1D and CSII/MDI demonstrated that CSII was associated with significant increase in QOL score by PedsQL (MD = 6.33, 95% CI = 0.91 to 11.76, P =0.022) compared to MDI. CSII could improve QOL in people with T1D and CSII. More RCTs with larger samples and CSII-specific QOL scale are needed to confirm these issues.