Glucose control better with pumps than injections for type 2 diabetes
Insulin pump therapy helped patients with type 2 diabetes achieve better blood glucose control than with multiple daily injections, according to research published in The Lancet.
“Pump therapy is a valuable option for treating patients with type 2 diabetes with uncontrolled hyperglycemia despite a high dose regimen of insulin analogs,” Yves Reznik, MD, of the department of endocrinology, University of Caen Côte de Nacre Regional Hospital Center in Caen, France, told Endocrine Today. “Pumps may obviate several limitations such as the burden of dose tracking and scheduling or insulin injection omissions.”
The findings are from OpT2mise, the largest international study on insulin pump safety and efficacy to date, undertaken by Reznik and colleagues. The trial included 36 hospitals, tertiary care centers and referral centers in Canada, Europe, Israel, South Africa and the United States.
The researchers recruited 495 patients aged 30 to 75 years who had not achieved glycemic control through daily injections of insulin analogs to a 2-month dose-optimization run-in period. A computer-generated sequence randomly assigned 331 patients in the HbA1c target range of 8% to 12%, or 64 mmol/mol to 108 mmol/mol, to pump treatment (n=168) or to continue with multiple daily insulin injections (n=163). At baseline, mean HbA1c was 9% (75 mmol/mol) in both cohorts.
At 6 months, mean HbA1c had dropped by 1.1% with pump therapy vs. 0.4% with multiple daily injections; this represented a –0.7% difference between groups (95% CI, –0.9 to –0.4).
By the end of the 6-month continuation phase, mean total daily insulin dose was significantly lower with pump therapy compared with multiple daily injections (97 units vs. 122 units; P<.0001). Body weight change between cohorts showed no significant difference.
Two serious adverse events resulted in hospital admissions with pump therapy vs. one with multiple daily injections. One episode of severe hypoglycemia occurred in the multiple daily injection group.
“OpT2mise demonstrates that when patients with type 2 diabetes fail to respond to insulin intensification with complex multiple injection regimens, pump therapy will be effective for reaching glucose targets,” Reznik said. “The ability of pump therapy to reduce HbA1c by more than 1% carries potential benefit for long-term microvascular consequences of diabetes.” — by Allegra Tiver
For More Information:
Reznik can be reached at Department of Endocrinology, University of Caen Côte de Nacre Regional Hospital Center, Caen, France; email: reznik-y@chu-caen.fr.
Disclosure: Please see the study for full list of researchers’ financial disclosures.
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