Insulin Pump Therapy Had Durable Effect in Type 2 Diabetes
Insulin pump therapy had a sustained effect in patients with uncontrolled type 2 diabetes.
(HealthDay News) — Insulin pump therapy is more effective than multiple daily injections for glycemic control in patients with type 2 diabetes, according to a study published in Diabetes, Obesity and Metabolism.
Ronnie Aronson, MD, from LMC Diabetes & Endocrinology in Toronto, and colleagues compared insulin pump therapy and multiple daily injections in 331 patients with type 2 diabetes. Participants with glycated hemoglobin of 8.0% or greater and 12% or lower were randomly allocated to pump therapy or continued multiple daily injections in a 6-month randomization phase. During a 6-month continuation phase, the multiple daily injections group was switched to pump therapy.
The researchers found that the reduction in glycated hemoglobin was significantly greater with pump therapy vs multiple daily injections at the end of the randomization phase (−1.1% vs −0.4%; P<.001). This improvement was maintained to 12 months.
A 0.8% reduction in glycated hemoglobin was seen for the multiple daily injections patients who switched to pump therapy; the final glycated hemoglobin was identical between the groups.
The total daily insulin dose was 20.4% lower with pump therapy than multiple daily injections in the randomization phase, and persisted in the continuation phase. There was a 19% decline in total daily insulin dose in the multiple daily injections group, so that by 12 months the total daily dose was the same in both groups.
"Patients with refractory hyperglycemia on a current basal-prandial injection regimen should be considered appropriate candidates for pump therapy, and may obtain sustained glycemic control with a favorable safety profile and reduction of insulin dose," the researchers wrote.
Several authors disclosed financial ties to pharmaceutical and medical technology companies, including Medtronic, which funded the study; several authors disclosed full-time employment by Medtronic.