Insulin Pumps in Type 1 Diabetes with Mental Disorders: Real-Life Clinical Data Indicate Discrepancies to Recommendations

Nicole Prinz*, Christina Bächle, Marianne Becker, Gabriele Berger, Angela Galler, Holger Haberland, Michael Meusers, Joaquina Mirza, Paul L. Plener, Simone Von Sengbusch, Michaela Thienelt, Reinhard W. Holl

*Corresponding author for this work
6 Citations (Scopus)


Background: The latest American Association of Clinical Endocrinologists/American College of Endocrinologists consensus statement published in 2014 does not recommend continuous subcutaneous insulin infusion (CSII) in patients with mental health problems. This study investigated the use and discontinuation of CSII in daily routine care of type 1 diabetes (T1D) patients with or without comorbid mental disorders. Materials and Methods: Insulin-treated T1D patients (n = 48,700) between 5 and 30 years of age (median [interquartile range], 15.6 [12.0-17.7] years) from the German/Austrian diabetes patient follow-up registry (DPV) were studied. A comorbid diagnosis and/or specific treatment of mental disorder was documented in 3,158 (6.5%) patients: attention-deficit hyperactivity disorder (ADHD), n = 1,352; depression, n = 692; eating disorders, n = 395; needle phobia, n = 319; anxiety/obsessive compulsive disorder (OCD), n = 231; and psychosis and/or neuroleptic medication, n = 169. Multivariable logistic regression with age, sex, diabetes duration, and migration background as independent variables was used to compare groups. Results: After adjustment for confounders, use of CSII was more common in patients with depression (41.5%), anxiety/OCD (41.4%), or needle phobia (75.8%) compared with patients without mental disorders (34.6%) (each P < 0.05). By contrast, psychotic patients (26.2%, P < 0.05) used CSII less often, and patients with ADHD (36.3%) or eating disorders (33.9%) used it with a similar frequency. Compared with patients without mental disorders (5.1%), the rate of CSII discontinuation was higher in patients with ADHD (9.7%), depression (8.2%), or eating disorders (10.0%) (P < 0.05, respectively) but similar in patients with anxiety/OCD (6.0%), psychosis (4.2%), or needle phobia (5.3%). Conclusions: In routine diabetes care, CSII use and discontinuation vary widely among T1D patients with mental disorders and indicate clear differences from the latest recommendations.

Original languageEnglish
JournalDiabetes Technology and Therapeutics
Issue number1
Pages (from-to)34-38
Number of pages5
Publication statusPublished - 01.01.2016

DFG Research Classification Scheme

  • 205-17 Endocrinology, Diabetology, Metabolism


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