Sensor-augmented insulin pump therapy may reduce urine albumin creatinine ratio in type 1 diabetes
In patients with type 1 diabetes and a history of albuminuria on stable renin-angiotensin system inhibition, sensor-augmented insulin pump treatment appears to decrease urine albumin creatinine ratio, according to recent findings.
Signe Rosenlund, MD, of the Steno Diabetes Center in Gentofte, Denmark, and colleagues evaluated 55 adults with type 1 diabetes and a history of albuminuria on stable renin-angiotensin system (RAS) inhibition randomly assigned to sensor-augmented insulin pump (n = 26) or multiple daily injection treatment (n = 29) to determine the effect of each treatment on albuminuria. Follow-up was conducted for 1 year.
The researchers found that after 1 year, the sensor-augmented pump group demonstrated a mean urine albumin creatinine ratio of –13% compared with 30% in the multiple daily injection group (unadjusted P = .051; adjusted for HbA1c at all visits, P = .04; adjusted for HbA1c, sex and BMI, P = .02).
HbA1c decreased by 1.3% in the sensor-augmented group vs. 0.6% in the multiple daily injection group (P = .01). The sensor-augmented group had decreases of 0.9 mmol/L for glucose variability in terms of standard deviation of glucose variables vs. 0.3 mmol/L in the multiple daily injection group (P = .049). No changes were found in either group for blood pressure.
According to the researchers, this study is the largest randomized controlled study comparing sensor-augmented insulin pump vs. multiple daily injection treatment on late diabetic complications.
“[Sensor-augmented insulin pump] treatment reduced [urine albumin creatinine ratio] in a [randomized controlled trial] in type 1 diabetes patients with a history of albuminuria on stable RAS inhibition,” the researchers wrote. “Significance was reached after adjustment for HbA1c. Treatment with [sensor-augmented insulin pump] reduced glucose variability and HbA1c and might have a beneficial effect on diabetic nephropathy.” – by Jennifer Byrne
Disclosure: Rosenlund reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.