This article is more than 5 years old. Information may no longer be current.
Insulin pump treatment reduces CV mortality by nearly half
Click Here to Manage Email Alerts
Adults with type 1 diabetes using insulin pump therapy reduce their cardiovascular mortality risk by nearly 50% and all-cause mortality risk by nearly 30% when compared with adults using multiple daily insulin injections, according to research in the BMJ.
In a population-based analysis of health records from adults with type 1 diabetes in Sweden, researchers found that insulin pump users had a substantially lower risk for dying from CVD when compared with those using daily injections, but they said mechanisms behind the findings still must be determined.
Isabelle Steineck
“There is a rationale for insulin pump treatment resulting in more stable blood glucose concentrations than multiple daily injections,” Isabelle Steineck, MD, of Aarhus University Hospital in Denmark, said in a press release. “Previous studies have shown that (an) insulin pump can reduce the frequencies of severe hypoglycemic episodes. Severe hypoglycemia can be a risk factor for [CV] events, particularly among high-risk individuals.”
Steineck and colleagues analyzed electronic health records from 18,168 adults from Sweden with type 1 diabetes entered into the Swedish National Diabetes Register from 2005 to 2012. Within the cohort, 2,441 were using insulin pump therapy; 15,727 were using multiple daily insulin injections. Researchers followed participants for an average of 6.8 years and used Cox regression analysis to estimate HRs for outcomes, including fatal and nonfatal coronary heart disease, fatal and nonfatal CVD and all-cause mortality.
Researchers found 1,423 cases of fatal or nonfatal CVD during the study period.
Insulin pump use was associated with a 45% reduction in fatal CHD, a 42% reduction in fatal CVD and a 27% reduction in all-cause mortality compared with multiple injection insulin therapy. The adjusted HRs for insulin pump use were 0.55 for fatal CHD (95% CI, 0.36-0.83), 0.58 for fatal CVD (95% CI, 0.4-0.85) and 0.73 for all-cause mortality (95% CI, 0.58-0.92). HRs were lower, but not significantly so, for fatal or nonfatal CHD and fatal or nonfatal CVD, according to researchers.
Researchers noted that the observed effect in patients could be attributable to a continuous infusion of insulin or to intensified glucose monitoring, increased motivation to control blood glucose or a better knowledge about type 1 diabetes. Data on patient education and frequency of blood glucose monitoring were unavailable.
“Persons with type 1 diabetes should definitely consider the pros and cons in changing from insulin pen treatment to insulin pump treatment,” Steineck told Endocrine Today. “More persons with type 1 diabetes could benefit from using insulin pump, as long as they get all the right education about the pump and are able to understand how to use it.”
Steineck said mechanisms that may have caused the study’s results, including episodes of severe hypoglycemia, should be explored in further studies. – by Regina Schaffer
Disclosure: Steineck reports no relevant financial disclosures. One study researcher reports receiving lecture fees from Novo Nordisk and Sanofi; another reports receiving lecture fees from various pharmaceutical companies.
Click Here to Manage Email Alerts