Insulin Pump Produces Better Results in Young Patients


Young people with diabetes may do better with insulin pumps than they do with injections.

A new study has shown that insulin pump therapy may be superior to injection therapy for young patients with type 1 diabetes.

According to the results of the study, which were published in JAMA, patients on insulin pump therapy had a lower risk of diabetic ketoacidosis and severe hypoglycemia compared with patients on insulin injections.

"In a large group of patients, we compared both strategies, and our results indicate advantages for pump therapy," Reinhard W. Holl, MD, one of the study's authors, told Drug Topics. "For children, adolescents and young adults, pump therapy may be superior to MDI [multiple daily injections] as a treatment strategy for type-1 diabetes."

The population-based cohort study-led by Beate Karges, MD, of RWTH Aachen University in Germany-compared the two types of therapy using data from 446 diabetes centers in Germany, Austria, and Luxembourg gathered between January 2011 and December 2015. They found that patients on pump therapy had a rate of hypoglycemia of 9.55 per 100 patient-years compared with a rate of 13.97 per 100 patient years for those on injection therapy with at least four daily injections. The pump therapy group also had a lower rate of diabetic ketoacidosis at 3.64 per 100-patient years compared to 4.26 per 100 patient years.

Control was also improved in the insulin pump therapy group. Researchers noted lower glycated hemoglobin levels and lower total daily insulin doses for those using a pump.

To participate in the study, patients were required to be younger than 20 years old and to have had diabetes for a year or more. The average age of the 30,579 patients who participated in the study was 14 years old.

Holl said the researchers wanted to conduct the study to assess the safety of insulin pump therapy.  Previously, he said, some physicians in the field had indicated that diabetic ketoacidosis (DKA) may occur more frequently in those on insulin pump therapy.

"Our data are reassuring, as we demonstrated a lower rate of DKA in patients on pump therapy," Holl said.

He hopes data from this latest study will help inform patients, families, and medical providers as they are making treatment decisions.

While insulin pump therapy appeared superior to injection therapy, Holl said additional research is still needed to assess more long-term impacts of pump therapy, including psychosocial adjustment.

According to the JDRF, there are an estimated 200,000 people under the age of 20 living with type 1 diabetes in the United States. More than a million adults, over the age of 20, are also said to be living with the disease.

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