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Insulin pump therapy improves glycemic control in adults with type 2 diabetes
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Adults with poorly controlled type 2 diabetes using insulin who were randomly assigned to 6 months of insulin pump therapy saw significant improvements in glycemic profile vs. those who continued with multiple daily insulin injections, according to recent findings.
Ignacio Conget, MD, of the endocrinology and nutrition department at University Hospital Clinic in Barcelona, Spain, and colleagues analyzed data from 331 adults with poorly controlled type 2 diabetes (HbA1c between 8% and 12%) participating in the OpT2mise trial, a randomized controlled parallel-group study evaluating the effectiveness of insulin pump therapy vs. multiple daily injections. All participants were taking multiple daily injections before being randomly assigned to either continuous subcutaneous insulin infusion therapy (n = 168; 94 men; mean age, 56 years; mean HbA1c, 9%) or continuing multiple daily injections (n = 163; 86 men; mean age, 56 years; mean HbA1c, 9%) for 6 months. Researchers used continuous glucose monitoring data (Medtronic iPro2 system) collected over 6-day periods before and 6 months after randomization to analyze changes in glucose profiles.
After 6 months, the mean HbA1c in the pump therapy group decreased to 7.9%; compared with a mean of 8.6% in the injection group. Participants assigned to insulin pump therapy saw significantly greater HbA1c reductions after 6 months when compared with those who continued multiple daily injections (-1.1% vs. -0.4%; P < .001). Participants in the pump therapy group also saw significant reductions in 24-hour mean sensor glucose, less exposure to sensor glucose, and more time in the sensor glucose range of 70 to 180 mg/dL.
Researchers also found that participants in the pump therapy group experienced greater changes in postprandial glucose area under the curve after breakfast (-775.9 mg/dL/min vs. -160.7 mg/dL/min) and after dinner (-731.4 mg/dL/min vs. -71.1 mg/dL/min) when compared with those who continued with injections.
“It is important that, in this study, the reduction in exposure to hyperglycemia in the [pump therapy] group was not associated with an increase in time spent in hypoglycemia,” the researchers wrote. “There was only one episode of hypoglycemia during the study, which occurred in the [multiple daily injection] group.” – by Regina Schaffer
Disclosure: Conget reports receiving lecture and consulting fees from Bayer AG, Eli Lilly & Co., GlaxoSmithKline, Medtronic, MSD, Novo-Nordisk and Sanofi-Aventis. Please see the full study for the other authors’ relevant financial disclosures.
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