Insulin pumps for management of type 1 diabetes

January 01, 0001

Insulin pumps for management of type 1 diabetes

Recently developed technologies for the treatment of type 1 diabetes mellitus include a variety of pumps and pumps with glucose sensors. In this 1-year, multicenter, randomized, controlled trial, the US authors compared the efficacy of sensor-augmented pump therapy (pump therapy) with that of a regimen of multiple daily insulin injections (injection therapy) in 485 patients (329 adults and 156 children) with inadequately controlled type 1 diabetes. Patients received recombinant insulin analogues and were supervised by expert clinical teams.

They found: "At 1 year, the baseline mean glycated hemoglobin level (8.3% in the two study groups) had decreased to 7.5% in the pump-therapy group, as compared with 8.1% in the injection-therapy group. The proportion of patients who reached the glycated hemoglobin target (les than 7%) was greater in the pump-therapy group than in the injection-therapy group. The rate of severe hypoglycemia in the pump-therapy group (13.31 cases per 100 person- years) did not differ significantly from that in the injection-therapy group (13.48 per 100 person-years). There was no significant weight gain in either group."

The authors concluded: "In both adults and children with inadequately controlled type 1 diabetes, sensor-augmented pump therapy resulted in significant improvement in glycated hemoglobin levels, as compared with injection therapy. A significantly greater proportion of both adults and children in the pump-therapy group than in the injection-therapy group reached the target glycated hemoglobin level."

Insulin pumps for treatment of type 1 diabetes are coming of age.


For the full abstract, click here.

N Engl J Med 363(4):311-320, 22 July 2010 © 2010 to the Massachusetts Medical Society
Effectiveness of Sensor-Augmented Insulin-Pump Therapy in Type 1 Diabetes. Richard M. Bergenstal, William V. Tamborlane, Andrew Ahmann, et al. Correspondence to Dr. Bergenstal: [email protected]

Category: T. Endocrine/Metabolic/Nutritional. Keywords: type 1 diabetes, glucose control, insulin pump, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 10 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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