Type 1 Diabetes Patients Using Continuous Subcutaneous Insulin Infusion Therapy: Feeling Burdened Correlated with Factors.

Type 1 diabetes may be treated using either multiple daily injection (MDI) therapy, or continuous subcutaneous insulin infusion (CSII) therapy, which uses an insulin pump. Recent advances in insulin pump technology are associated with an increasing number of patients with type 1 diabetes adopting CSII. Meta-analyses comparing CSII with MDI have reported that CSII is associated with reduced blood glucose level fluctuation, improved HbA1c levels, and less frequent hypoglycemia and hyperglycemia.1–5 Partly in consequence, numerous studies have reported that CSII is associated with improved quality of life and that CSII patient satisfaction levels are high. A Japanese study of satisfaction in type 1 diabetes patients using CSII obtained similar results;6 however, Shetty (2010)7 and Saarinen (2014)8 have reported that although patients tend to feel that CSII facilitates daily control of blood glucose, patients may also feel inconvenienced, as the pump’s needle must be kept in place, the pump is heavy and conspicuous if worn outside clothing, and the equipment can be cumbersome to operate. Previous studies in other countries have examined CSII’s effectiveness, operability, and effect on patients’ daily lives; however, Japanese research addressing CSII has been limited to case studies. There is no apparent extant Japanese research examining the psychological aspects of CSII’s use—in particular, how patients may feel burdened by using CSII. We therefore examined patients’ feelings of being burdened and potentially related underlying factors, to suggest means of improving nursing care for type 1 diabetes patients using CSII.