Endocrine Abstracts

Introduction: Scientific progress allowed an evolution on the therapeutic of diabetes mellitus. Continuous subcutaneous insulin infusion therapy (CSII) is one good example, but, beside patients motivation little is known about other psychological factors of success in this therapeutic and how they contribute to quality of life (QoL).

Objectives: Determining some psychopathological predictors of CSII satisfaction and QoL improvement in patients on CSII therapy.

Patients and methods: We gather a sample of 49 diabetic patients in CSII therapy, 59.2% female, with a mean age of 37.9±11.4 years, disease duration of 21.4±8.5 years and a mean CSII usage time of 5.7±2.1 years. We applied the following questionnaires: the insulin delivery system rating questionnaire, the audit of diabetes-dependent quality of life and the brief symptom inventory (BSI). Spearman correlations were used for statistical analysis. A two-tailed value of P<0.05 was considered statistically significant.

Results: First of all we noticed that psychopathological symptomatology was inversely correlated with CSII satisfaction (r=−0.44; P=0.004) and overall QoL (r=−0.43; P=0.003). The perception that CSII is helpful concerning glicemic variability is the most important contributor to QoL (r=0.34; P=0.02). Results point out that patients who check their blood glucose more often tend to report less worries about diabetes complications, glicemic variability and daily self-security (r=−0.35; P=0.01). Nevertheless, 48.9% of patients reported that checking their blood glucose more than four times daily is more than they would like and this fact alone decreases significantly their QoL (r=−0.47; P=0.001). Regarding the BSI we noticed that patients with low interpersonal sensitivity tended to report less embarrassment in using CSII therapy (r=0.45; P=0.001). We also found that patients with higher obsessive compulsive symptomatology stated more daily activity interference in CSII therapy, namely, wearing desired clothes (r=0.42; P=0.003), sleep patterns (r=0.53; P≤0.001), eating habits (r=0.30; P=0.04) and exercising (r=0.35; P=0.01). Lastly, family support, reflected in the form of not arguing attitude, seems to be a psychopathological protector (r=0.36; P=0.01).

Conclusions: In our sample is clear that CSII therapy contributes positively to QoL. However, in order to maximize its impact, it seems relevant to monitor patient’s psychopathological register. Addressing these issues previously will probably provide patients and their families with more adaptative strategies in order to enhance better glicemic control.