Insulin pumps help teenagers to control blood sugar levels more successfully

by Barbara Hewitt on August 20, 2013

Insulin pumps help teenagers to control blood sugar levels more successfully

Insulin pumps help teenagers to control blood sugar levels more successfully

Using insulin pumps improves blood glucose control in teenagers with type 1 diabetes, according to a new study from Australia. Researchers at the Princess Margaret Hospital for Children in Perth looked at over 700 children with type 1 diabetes over a seven year period.

In the group some 355 patients were on insulin pumps and 355 patients on injections whose regime was split between multiple daily injections and twice daily injections. From the start of pump use up to seven years after, the pump group had better HbA1c levels than the group that stayed on injection therapy. The difference between the groups widened through adolescence as teenagers in the injections group saw their HbA1c rise significantly, the study found.

For the injections group, HbA1c values which started at 64 mmol/mol, or 8%, grew steadily to 73 mmol/mol or 8.8%, after seven years. The pump group also started with an HbA1c of 64 mmol/mol, or 8%, but this actually decreased to 61 mmol/mol or 7.7%. The study also found that in the injections group, HbA1c gradually grew throughout the teenage years, whereas within the insulin pumps group, HbA1c changed differently.

Pump users started off with a significant drop in HbA1c, down to 60 mmol/mol or 7.6%, three months after beginning pump therapy. This was then followed by a gradual increase up to 65 mmol/mol or 8.1% two years after commencing pump use. Following this peak at the 2 year mark, HbA1c started to gradually but steadily come back down, culminating with 61 mmol/mol or 7.7% after seven years of pump usage when the average of the group was 18.

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The researchers said that it is worth noting that whilst both groups started the study with the same average HbA1c, those in the insulin pump group had displayed a slightly better ability to control their blood glucose a year prior to the start of pump use. This could indicate that these patients were therefore slightly better equipped to manage their diabetes than those in the injections group.

Writing in the research journals Diebetologia, they also pointed out that it is very much up to interpretation of why HbA1c got worse during teenage years for those on injection and slightly better for insulin pump users. A significant factor may be that those on a pump are essentially tied to their therapy. It is well established that teenagers and young adults with type 1 diabetes have particular difficulty in controlling blood glucose levels and that missing out injections and blood glucose tests is relatively common among this age group.

With insulin pump usage missing doses is less of an issue, particularly as the pump delivers a steady basal rate. This also means that teenagers know it is also important to regularly carry out blood tests to prevent short term complications. Another strong benefit of insulin pump therapy highlighted by the study is that the rate of severe hypos was also significantly lower, 30% lower, over the course of the seven years follow up amongst the pump users. Those on injections had 10.2 episodes of severe hypoglycaemia per 100 patient years compared with 7.2 episodes of severe hypo per 100 patient years within the insulin pump group.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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