Insulin Pump Therapy Improves QoL for Adolescents With T2DM
Insulin requirements decreased by 30%.
Adolescents with type 2 diabetes with poor glycemic control decreased hemoglobin A1c (HbA1c) levels by 1.3% after using insulin pump therapy for a 3-month period, according to study results presented at ENDO 2017: the 99th Annual Meeting & Expo, April 1-4, in Orlando, Florida.
Insulin pumps are considered safe and appropriate by the American Diabetes Association for children with type 1 diabetes, although data is lacking in children with type 2 diabetes. Therefore, Preneet Cheema Brar, MD, from the New York University School of Medicine in New York City, and colleagues conducted a pilot study to determine whether insulin pump therapy is a feasible treatment modality to improve quality of life (QoL) in adolescents with type 2 diabetes over a 3-month period.
Adolescents with poor glycemic control (HbA1c ≥8%) were placed on a continuous glucose monitoring system before they initiated insulin pump therapy. A total of 5 female adolescents (mean age, 16.3±1.9; duration of diabetes, 5.4±3; body mass index [BMI], 30±3) completed the study.
At 1, 2, and 3 months, the pumps were downloaded and the settings were titrated accordingly. QoL questionnaires, including the Pediatric Quality of Life Inventory, diabetes empowerment and treatment satisfaction scales, were administered at the beginning and end of the study.
The total daily dose of insulin at the start of the study was 53.3±3 units. At the end of the study, the average basal rate was 1.4±0.4 U/hr, the average insulin carbohydrate level was 7±1, and the average insulin sensitivity factor was 23±7.
The average blood sugar at the start of the pilot was 205±91 mg/dL and the average at the end of the study was 161±70 mg/dL. In addition, the average HbA1c level at the start of the study was 11.7±1.4%, which decreased to 10.3±1.8% by the end of the study.
Two of the participants decided to continue using insulin pumps for their ongoing diabetes management, insulin requirements decreased by 30%, and the QoL parameters showed a trend towards improvement.
“Teaching pump therapy to these technologically savvy adolescents was easy and adherence was fair,” the researchers noted. “Until more prescription options get approval, insulin pumps may be an option to consider as more adolescents fail metformin and insulin injections and face enormous physical and psychological challenges of their poorly controlled [type 2 diabetes].”
Brar PC, Dingle E, Ovadia D. A clinical pilot to assess improvement in health related quality of life (QOL), treatment satisfaction, and glycemic control in adolescents with type 2 diabetes using continuous subcutaneous insulin injection therapy. Abstract 619. Presented at: ENDO 2017; April 1-4, 2017; Orlando, Florida.