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Insulin Pumps Linked to Improved Glycemic Control in Patients with Hard-to-Treat Type 2 Diabetes — Physician’s First Watch

Medical News |
July 7, 2014

Insulin Pumps Linked to Improved Glycemic Control in Patients with Hard-to-Treat Type 2 Diabetes

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."

Reader Comments (2)

THOMAS KLINE Physician, Geriatrics

Need to keep an eye on the death rates. Continuous monitoring
of glucose levels might prevent death from
hypoglycemia. Also total "under the curve" insulin should be
monitored as exogenous supraphysiological insulin dosing
can accelerate arteriosclerosis.

Thomas Kline MD PhD

PAUL HELMAN Physician, Internal Medicine, Nort shore university health systems

Is any mention of lipid control as that is a major function of insulin in addition to glucose homeostasis and to focuse only on glucose evidences a fairly profound conceptual limitatio.

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