Researchers studied the use of either multiple daily injections or insulin pumps to manage type 1 diabetes in young adults.
Insulin is made in the pancreas. In type 1 diabetes, the pancreas produces either little or no insulin. Multiple daily doses of insulin from an external source are required to maintain proper body function. Two common methods of providing this supplementation are by using either multiple daily injections or an insulin pump. An insulin pump is a medical device that continuously administers pre-set doses of insulin to the wearer of the device.
A research news article, recently published in the British Medical Journal, discusses an important clinical trial evaluating the safety and efficacy of insulin pumps for young adults. The population-based study was originally published in the Journal of the American Medical Association and involved 446 diabetes centres in Austria, Germany, and Luxembourg. There were 30,579 total participants, with an average age of 14 years. The 9,814 participants who used insulin pumps were matched with 9,814 participants who used insulin injections.
The outcomes measured show that incidences of severe hypoglycemia and diabetic ketoacidosis were lower in the participants who were using an insulin pump. A participant was identified as being severely hypoglycemic if they needed help from another person to administer medication to treat low blood sugar. Diabetic ketoacidosis was defined as pH less than 7.3 or bicarbonate concentration less than 15mmol/L. The insulin pump group also had better blood sugar control and required a smaller amount of insulin daily.
Overall, the insulin pump was associated with a lower risk of severe hypoglycemia and diabetic ketoacidosis, and with better glycemic control than multiple daily doses of insulin in young adults. These results indicate that when compared to using multiple daily injections, insulin pumps are associated with better outcomes in children and young adults with type 1 diabetes.
Written by Anuolu Bank-Oni, Pharm.D, CDE
Karges B, et al. “Association of Insulin Pump Therapy vs Insulin Injection Therapy with Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults with Type 1 Diabetes”. JAMA 2017. doi:10.1001/jama.2017.13994
Wise, J. “Insulin pumps are linked to lower risk of complications in young people”. BMJ 2017;359:j4665 doi: 10.1136/bmj.j4665