Insulin Pumps Cut Mortality Risk in Diabetes

In patients with type 1 diabetes, the use of insulin pumps, as compared with multiple daily injections, may decrease risk for all-cause mortality by 29% and risk for fatal cardiovascular disease by 43%, suggest data presented at the European Association for the Study of Diabetes Annual Meeting.

For this study, Soffia Gudbjörnsdottir, MD, PhD, of the University of Gothenburg, Sweden, and colleagues evaluated more than 18,000 patients with type 1 diabetes in the Swedish National Diabetes Register.

They compared data between 2,441 patients using insulin pump therapy, also known as continuous subcutaneous insulin infusion (CSII), and 15,727 patients receiving multiple daily insulin injections during a mean follow-up period of nearly 7 years.

Compared with patients using multiple daily insulin injections, patients using insulin pumps were 29% less likely to die from any cause. They were also 43% less likely to develop fatal cardiovascular disease (CVD), the researchers reported, noting that both findings reached statistical significance.

Additionally, data linked insulin pump use to an 18% reduction in risk for fatal or nonfatal coronary heart disease (CHD) specifically. Statistical significance was borderline.

Insulin pumps were also associated with decreases in risk for fatal and nonfatal CVD combined as well as for non-CVD mortality, but these findings were not statistically significant, according to results reported in a press release.

The researchers noted that unmeasured confounders, including personality, type of care, frequency of blood sugar control, diabetes education, continuous glucose monitoring (CGM) use and adherence, may affect results. Nevertheless, a sensitivity analysis indicated that they likely had little impact on the data, according to the researchers.

“The conclusion of this large observational study is that pump treatment may be associated with a lower risk of CVD and all-cause mortality than injections,” the researchers said in the release.

“This study showed that pump treatment of type 1 diabetes was beneficial with regard to long-term complications. However, it is important to note that the patients treated with pump therapy in this study were selected from the total patients with type 1 diabetes because they were able and willing to manage use of the pump,” they added.

Reference

1. Gudbjörnsdottir S et al. Oral Presentation 196. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 15-19, 2014; Vienna, Austria.