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Use of advanced functions on insulin pumps improves HbA1c in diabetes
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HbA1c levels were lower in adults and children with diabetes who use advanced pump functions, have a higher rate of sensor use and who have a longer duration of diabetes compared with their counterparts, according to findings published in Nutrition, Metabolism and Cardiovascular Diseases.
Daniela Bruttomesso , MD, PhD, of the department of medicine at the University Hospital of Padova in Italy, and colleagues evaluated data on 6,623 children and adults with diabetes treated with continuous subcutaneous insulin infusion for at least 1 year from 93 diabetes care centers in Italy between September 2015 and October 2016. Researchers sought to determine the degree of glycemic control and frequency of diabetes complications in people treated with continuous subcutaneous insulin infusion.
Children (n = 1,025) had a mean age of 14 years, all had type 1 diabetes, 48.5% were boys and the mean duration of diabetes was 5 years. Adults (n = 5,598) had a mean age of 41 years, 98.6% had type 1 diabetes, 41.1% were men and the mean duration of diabetes was 19 years.
More than half of the participants, regardless of age, used a conventional pump (64.3%), and the remaining 35.7% used a sensor-augmented pump.
In the year before study enrollment, median HbA1c was 7.6% in all participants and tended to be lower in those aged 6 to 12 years. Compared with women and girls, men and boys had lower HbA1c (7.5% vs. 7.6%; P < .05). Twenty-three percent of participants had median HbA1c less than 7%, and 42% had median HbA1c less than 42%. HbA1c was lower in participants who used a sensor-augmented pump compared with those who used a conventional pump (7.5% vs. 7.6%; P < .0001).
Lower HbA1c levels were associated with a longer duration of diabetes, sensor-augmented pump use, sensor use, bolus option and carbohydrate counting.
In the year before the study, 5% of participants reported at least one episode of severe hypoglycemia, 2.6% reported an episode of ketoacidosis and 3.5% reported a visit to the emergency room for either reason. – by Amber Cox
Disclosures: Bruttomesso reports she has served as an advisory board member for Abbott and Novo Nordisk and received speaker honoraria from Eli Lilly, Lifescan, Roche Diagnostics and Sanofi Aventis. Please see the study for all other authors’ relevant financial disclosures.
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