For patients with type 2 diabetes, managing the condition can involve multiple daily injections of insulin. But a new study published in The Lancet suggests that insulin pumps may be more effective for controlling blood sugar levels.
This is not the first time a study has protested the benefits of insulin pumps. Last year, Medical News Today reported on a study suggesting that insulin pumps are better than insulin injections for type 1 diabetes.
But the team involved in this latest study, led by Prof. Yves Reznik of the University of Caen Côte de Nacre Regional Hospital Center in France, claims theirs is the largest study to date that explores the effectiveness of insulin pumps for type 2 diabetes – the type that accounts for 90-95% of all diabetes cases.
Type 2 diabetes is a condition whereby the body is unable to produce or use the hormone insulin effectively, resulting in high blood sugar levels. Over time, high blood sugar levels can cause nerve damage, stroke, and kidney, eye or heart diseases.
In some cases, the condition can be managed through diet or blood sugar-lowering medication, such as metformin. But in many cases, a patient may require multiple daily doses of insulin delivered by injection into the abdomen, upper arms, thighs or buttocks.
However, Prof. Reznik and colleagues note that around a third of patients that manage their condition with insulin injections have problems achieving the optimal level of blood sugar.
With this in mind, the team decided to compare the effectiveness of insulin injections against insulin pumps – small portable, computerized devices that deliver continuous doses of insulin through a catheter places under the skin.
For their study, the researchers enrolled 495 adults ages 30-75 years with type 2 diabetes who had poor control of their blood sugar levels. Participants were monitored as they received increased multiple daily injections of insulin.
After 2 months, the team identified 331 participants whose glycated hemoglobin (HbA1c) levels – an indicator of a patient’s blood sugar levels over the past 2-3 months – were above the target range of 8% or less. Of these, 168 were randomly assigned to receive treatment with insulin pumps, while 163 continued with multiple daily insulin injections.
After 6 months of treatment, the researchers found that the blood sugar levels of participants who used insulin pumps were on average 0.7% lower than those of participants who used multiple insulin injections. Furthermore, 55% of participants who used insulin pumps reached the HbA1c target range of 8% or less, compared with only 28% of participants who used insulin injections. Those who used insulin pumps also spent 3 hours less a day experiencing hyperglycemia – high blood sugar levels.
The researchers note that the time spent in hypoglycemia – extremely low blood sugar levels – was similar between each group, and at the end of the study, patients who used insulin pumps required a 20% lower daily insulin dose than those who used multiple injections. No difference in weight was observed between the two groups.
Commenting on the team’s findings, Prof. Reznik says:
“Pumps enhance effective insulin absorption and increase insulin sensitivity thanks to the continuous daily subcutaneous insulin delivery.
Our findings open up a valuable new treatment option for those individuals failing on current injection regimens and may also provide improved convenience, reducing the burden of dose tracking and scheduling, and decreasing insulin injection omissions.”
In an editorial linked to the study, Dr. Pratik Choudhary of King’s College London in the UK says that these findings provide “compelling evidence” for the effectiveness of insulin pumps to treat type 2 diabetes patients who are unable to control blood sugar with insulin injections. “However,” he adds, “cost effectiveness of pumps in different health care systems will need to be evaluated.”
Medical News Today recently reported on a study published in JAMA Internal Medicine, which suggested that insulin therapy and blood sugar-lowering medications may “do more harm than good” for older patients with type 2 diabetes.