Featured Research

from universities, journals, and other organizations

Insulin pumps result in better blood sugar control than multiple daily injections in people with type 2 diabetes

Date:
July 2, 2014
Source:
The Lancet
Summary:
Type 2 diabetes is usually controlled by diet and medication, but most people with advanced disease also end up needing insulin therapy to achieve control of their blood sugar. However, roughly a third of these patients struggle to achieve the right level of blood sugar control with insulin injections many times a day. The growing obesity epidemic is adding to the problem by leading to greater insulin resistance.

Type 2 diabetes is usually controlled by diet and medication, but most people with advanced disease also end up needing insulin therapy to achieve control of their blood sugar. However, roughly a third of these patients struggle to achieve the right level of blood sugar control with insulin injections many times a day. The growing obesity epidemic is adding to the problem by leading to greater insulin resistance.

Insulin pumps are portable devices attached to the body which deliver constant amounts of rapid or short acting insulin via a catheter placed under the skin. Previous randomised trials comparing the efficacy of insulin pump therapy and multiple injections in people with type 2 diabetes have not provided consistent evidence, and the benefits of pump therapy continue to be debated.

The OpT2mise trial enrolled 495 adults (aged 30-75 years) with poorly controlled type 2 diabetes to a 2 month run-in period, where their insulin multiple daily injection treatment was optimised. After the run-in phase, the 331 participants whose HbA1c (glycated haemoglobin; an indicator of blood sugar control over the past 2 or 3 months) remained above the target range (≥ 8·0% and ≤12%) were randomly assigned to pump therapy or to continue with multiple injections.

Pumps outperformed multiple daily injections on several measures. The researchers found that people who used the pumps achieved a significantly greater reduction in average blood sugar levels than those who used multiple daily injections at 6 months (HbA1C difference of -0.7%). Twice as many patients also reached the target range of 8% or less in the pump-therapy group compared with the injection group (55% vs 28%). Patients using the pump also spent on average almost 3 hours less every day in hyperglycaemia (when blood sugar becomes too high).

What is more, the time spent in hypoglycaemia -- when blood sugar becomes extremely low -- remained similarly low with pump and multiple daily injections. At the end of the study, the daily dose of insulin was 20% lower with pump therapy than with multiple injections and no weight difference was observed in patients from both groups.

According to lead author Professor Yves Reznik from the University of Caen Cτte de Nacre Regional Hospital Center, Caen, France, "Pumps enhance effective insulin absorption and increase insulin sensitivity thanks to the continuous daily subcutaneous insulin delivery. Our findings open up a valuable new treatment option for those individuals failing on current injection regimens and may also provide improved convenience, reducing the burden of dose tracking and scheduling, and decreasing insulin injection omissions."

Writing in a linked Comment, Dr Pratik Choudhary from King's College London, UK, says, " OpT2mise provides a compelling case for the clinical effectiveness of insulin pump treatment in type 2 diabetes, suggesting that it can help improve glycaemic control in this difficult to treat group of patients who are unable to achieve glucose control despite increasing doses of insulin. However, cost effectiveness of pumps in different health-care systems will need to be evaluated."


Story Source:

The above story is based on materials provided by The Lancet. Note: Materials may be edited for content and length.


Journal Reference:

  1. Yves Reznik, Ohad Cohen, Ronnie Aronson, Ignacio Conget, Sarah Runzis, Javier Castaneda, Scott W Lee. Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial. The Lancet, 2014; DOI: 10.1016/S0140-6736(14)61037-0

Cite This Page:

The Lancet. "Insulin pumps result in better blood sugar control than multiple daily injections in people with type 2 diabetes." ScienceDaily. ScienceDaily, 2 July 2014. <www.sciencedaily.com/releases/2014/07/140702203705.htm>.
The Lancet. (2014, July 2). Insulin pumps result in better blood sugar control than multiple daily injections in people with type 2 diabetes. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2014/07/140702203705.htm
The Lancet. "Insulin pumps result in better blood sugar control than multiple daily injections in people with type 2 diabetes." ScienceDaily. www.sciencedaily.com/releases/2014/07/140702203705.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) — Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) — Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) — At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) — The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:  

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile iPhone Android Web
      Follow Facebook Twitter Google+
      Subscribe RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins