Insulin Pump Therapy in Libya: A Comparative Study on Glycemic Control and Patient Outcomes in Type 1 Diabetes

This study evaluated the clinical effectiveness of continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) in managing type 1 diabetes mellitus (T1DM) among Libyan patients. Conducted in June 2022, the comparative cross-sectional study compared 32 CSII users (≥6 months of therapy) with 30 MDI controls through structured questionnaires. The CSII group demonstrated significantly better outcomes, including superior glycemic control (mean HbA1c 6.97±0.61 vs 9.8±1.99), reduced acute complications (hypoglycemia: 31.3% vs 50%; DKA: 3.1% vs 20%), and higher treatment adherence (81.3% vs 43.3%). Glycemic improvement correlated strongly with pump duration, showing progressive HbA1c reduction from 7.2±0.2 at 6-12 months to 6.89±0.16 after >2 years of use. The CSII cohort also exhibited more favorable BMI distributions (78.1% healthy weight vs 33.3%) and reported enhanced quality of life. Despite these benefits, challenges in maintenance supply availability were reported. These findings provide compelling evidence for CSII's clinical superiority in Libya's context and support its wider implementation through national programs that address current supply chain limitations while ensuring proper patient training and follow-up support. The results highlight CSII as a valuable therapeutic advancement for T1DM management in resource-constrained settings