Enhancing Diabetes Management in Remote Regions: Insulin Pump Adaption and Safety in the Faroe Islands.

Background/Objective: Insulin pump therapy (IPT) is increasingly used in the management of type 1 diabetes, including in remote areas such as the Faroe Islands, where access to diabetes technology is universally reimbursed. However, evidence on its effectiveness in such settings remains limited. This study compared glycated hemoglobin (HbA1c), complications, and renal outcomes between users of IPT and multiple daily injections (MDI). Case Report: We conducted a nationwide, cross-sectional, registry-based study in the Faroe Islands, linking electronic medical records, prescription data, and laboratory results. Discussion: Continuous glucose monitoring was used by 92% of participants, and IPT by 50%, primarily hybrid closed-loop systems. Despite higher IPT use among younger individuals, longer diabetes duration was also associated with increased IPT use, suggesting it is often initiated in those with established T1D following challenges with MDI. HbA1c levels did not differ significantly between groups, but severely increased albuminuria was more common in MDI users, while IPT users had better-preserved renal function. Overall, 42% of participants achieved an HbA1c below 53 mmol/mol (7%). Conclusion: In this setting with broad access to diabetes technology, both IPT and MDI supported effective glycemic control, with possible renal benefits observed among insulin pump therapy users.