CSII in Type 1 Diabetes: Diet, Quality of Life & Cardiometabolic Risks - A Cross-Sectional Study
CSII in Type 1 Diabetes: Diet, Quality of Life & Cardiometabolic Risks - A Cross-Sectional Study
Glycaemic control is an important aspect of Type 1 diabetes (T1D) management for
 diabetologists and patients alike. Evidence suggests continuous subcutaneous insulin infusion
 (CSII) is an effective method of achieving this. Among the advantages of CSII is the
 opportunity for patients to potentially discard relatively inflexible mealtimes and
 carbohydrate requirements imposed by other regimes such as multiple daily injections (MDI).
 There are also reported improvements in quality of life. Furthermore, in patients with good
 glycaemic control, such as those often assisted by CSII, various qualitative atherogenic
 lipid abnormalities may exist, despite the presence of a normal quantitative lipid profile;
 potentially leading to increased cardiometabolic risks. Literature examining the eating
 behaviours, quality of life and cardiometabolic risks of CSII patients over time after
 commencement of the therapy is sparse, frequently dated and worthy of further research.
Continuous subcutaneous insulin infusion (CSII) is a therapy for patients with Type-1
 diabetes mellitus involving insulin administration via electronic pump. CSII has been shown
 to reduce HbA1c levels and improve blood sugar control and the continuous, unobtrusive
 insulin delivery may potentially allow patients increased dietary flexibility and quality of
 life. However, despite these claims investigatory literature is sparse. This study will
 clarify whether adult CSII patients experience eating behaviour and quality of life
 alterations compared to patients using multiple daily injection (MDI) therapy. This is
 important as differences may be associated with cardiometabolic risk variations; which will
 also be investigated.

 Participants will be a combination of adults with Type-1 diabetes invited from diabetes
 clinics at the Royal Liverpool University Hospital who are a) have been using CSII for over 1
 year or b) have Type 1 diabetes but have never used CSII, have no current plans to use CSII
 and are presently using MDI therapy.

 Following ethical consent participants will be asked to complete one food frequency
 questionnaire (FFQ) and one quality of life (QOL) questionnaire. A subgroup of these
 participants (approximately 10 CSII users and 10 MDI users) will then be asked to take part
 in one interview to investigate quality of life and complete a food diary to explore eating
 behaviours. All participants consenting to the cross-sectional arm of the study will also be
 asked to provide an extra volume of blood for analysis. This will be taken at the same time
 and in addition to their regular diagnostic sample, however where this is unfeasible extra
 occasional appointments may be needed. (Please be aware that the interview, food diary and
 blood sample are all optional and that the minimum requirement for participation in the study
 is the completion of the FFQ and the QOL questionnaires). Results will be compared with
 existing patient medical records, which will also be analysed during the study.
Inclusion Criteria:

 -  Patients must reside in Liverpool or the surrounding areas.

 -  Patients must be ages over 18

 -  Patients must have Type 1 diabetes

 -  Patients must be using or pending the supply of an insulin pump.

 -  Patients who have been using either continuous subcutaneous insulin infusion or
 multiple daily injections for over a year.

 Exclusion Criteria:

 -  Patients must not live outside of Liverpool and the surrounding areas.

 -  Patients must not be aged under 18