By Kelly Young
Edited by Susan Sadoughi, MD, and Jaye Elizabeth Hefner, MD
Insulin pumps are associated with better glycemic control than insulin injections in patients with type 2 diabetes and high insulin requirements, according to an industry-funded trial in the Lancet.
Roughly 330 patients who had type 2 diabetes with insufficient glycemic control despite high doses of insulin (>0.7 units/kg/day) had a 2-month run-in phase to optimize their doses. They were then randomized to receive either an insulin pump or multiple daily insulin injections.
At 6 months, the mean glycated hemoglobin level had decreased more the pump group than in the injection group (between-group difference, -0.7%). Severe side effects, like ketoacidosis and severe hypoglycemia and hyperglycemia, were rare and rates were not significantly different between groups.
A commentator concludes that the study "provides a compelling case for the clinical effectiveness of insulin pump treatment in type 2 diabetes, suggesting that it can help improve glycemic control in this difficult to treat group... However, cost effectiveness of pumps in different healthcare systems will need to be evaluated."