The crude DKA event-rate was significantly lower in post-CSII person-time compared with pre-CSII person-time: 49.6 events (95% CI 46.3, 53.1) per 1000 person-years vs 67.9 (64.1, 71.9) rate ratio from Bayesian mixed models adjusting for pre-exposure trend: 0.61 (95% credible interval 0.47, 0.77 posterior probability of reduction pp = 1.00). Statistical significance and magnitude of change were supported by the mixed models results. Within-person changes were most substantial in those with the highest baseline HbA 1c, with median −21.0 mmol/mol (−30.0, −11.0) (−1.9% ) change in those with a baseline >84 mmol/mol (9.8%) within a year of exposure, that was sustained: −19.0 mmol/mol (−27.6, −6.5) (−1.7% ) at ≥5 years. HbA 1c decreased after CSII initiation, with a median within-person change of −5.5 mmol/mol (IQR −12.0, 0.0) (−0.5% ). structured education often precedes initiation) (2) repeated within-person measurements and (3) background time-trends occurring pre-intervention.
We then used mixed models to assess the significance of CSII exposure, taking into account: (1) the diffuse nature of the intervention (i.e. We presented crude within-person differences from baseline HbA 1c over time since initiation, crude DKA and SHH event-rates pre-/post-CSII exposure. We included 4684 individuals with type 1 diabetes from the national Scottish register, who commenced CSII between 20. Our aim was to assess the use of continuous subcutaneous insulin infusion (CSII) in people with type 1 diabetes in Scotland and its association with glycaemic control, as measured by HbA 1c levels, frequency of diabetic ketoacidosis (DKA) and severe hospitalised hypoglycaemia (SHH), overall and stratified by baseline HbA 1c.
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