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Insulin Pump Beats Shots
for Young Diabetics
posted 07/21/04
Insulin pumps found to be more
effective than multiple daily injections in controlling blood sugar levels in
young people with Type 1 diabetes.
Moreover, most patients chose to continue with or switch to insulin pumps after
the study was over, Elizabeth A. Doyle and colleagues from the Yale University
School of Medicine in New Haven report in the medical journal Diabetes Care.
The researchers randomly assigned 32 patients aged 8 to 21 to treatment with
pump-delivered continuous subcutaneous insulin infusion (CSII) or to once-daily
long-acting insulin (glargine) plus fast-acting insulin injections before meals
and snacks, for 16 weeks.
Blood levels of hemoglobin A1c -- an indicator of long-term blood glucose
control -- did not change in the multi-injection group, but dropped to target
levels in the insulin pump patients.
The researchers point out that glargine cannot be mixed with rapid-acting
insulin, so therapy with this insulin analog requires patients to give
themselves injections with fast-acting insulin before meals and large snacks.
The need for multiple daily injections can make compliance difficult, they add.
In fact, at the close of the study, 14 of the 16 patients on CSII chose to
continue using the infusion pumps, while 12 of the 16 patients on multiple daily
injections switched to CSII.
The team calls for further studies but concludes that "in the context of a
short-term randomized clinical trial, we observed a considerably greater
improvement in hemoglobin A1c levels with CSII than with glargine. It should be
noted, however, that no single approach to treatment is ideal for every
patient."
Source: Diabetes In Control.com: Diabetes Care, July 2004.
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