Greater reduction in glycated hemoglobin with pump therapy versus multiple daily injections
THURSDAY, Feb. 11, 2016 (HealthDay News) — Insulin pump therapy is more effective than multiple daily injections (MDI) for glycemic control in patients with type 2 diabetes, according to a study published online Feb. 8 in Diabetes, Obesity and Metabolism.
Ronnie Aronson, M.D., from LMC Diabetes & Endocrinology in Toronto, and colleagues compared insulin pump therapy and MDI in 331 patients with type 2 diabetes. Participants with glycated hemoglobin ≥8.0 percent and ≤12 percent were randomly allocated to pump therapy or continued MDI in a six-month randomization phase (RP). During a six-month continuation phase (CP), the MDI group was switched to pump therapy.
The researchers found that the reduction in glycated hemoglobin was significantly greater with pump therapy versus MDI at the end of the RP (−1.1 ± 1.2 versus −0.4 ± 1.1 percent; P < 0.001). This improvement was maintained to 12 months. A 0.8 percent reduction in glycated hemoglobin was seen for the MDI patients who switched to pump therapy; the final glycated hemoglobin was identical between the groups. The total daily insulin dose (TDD) was 20.4 percent lower with pump therapy than MDI in the RP, and persisted in the CP. There was a 19 percent decline in TDD in the MDI group, so that by 12 months TDD was the same in both groups.
“Patients with refractory hyperglycemia on a current basal-prandial injection regimen should be considered appropriate candidates for pump therapy, and may obtain sustained glycemic control with a favorable safety profile and reduction of insulin dose,” the authors write.
Several authors disclosed financial ties to pharmaceutical and medical technology companies, including Medtronic, which funded the study; several authors disclosed full-time employment by Medtronic.
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