Pump Beats Insulin Shots in Young T1D Patients

Pump therapy was tied to fewer complications and better glycemic control among young patients with type 1 diabetes compared with daily injections, a new study showed.

Insulin pump therapy was associated with lower rate of diabetic ketoacidosis compared with multiple daily injections over about 3.5 years in a matched cohort analysis (3.64 versus 4.26 per 100 patient-years; difference -0.63, 95% CI -1.24 to -0.02; P=0.04), according to Beate Karges, MD, of Aachen University in Germany, and colleagues. It also carried a lower risk for severe hypoglycemia (9.55 versus 13.97 per 100 patient-years; difference -4.42,-6.15 to -2.69; P<0.001), they wrote in JAMA.

Pump therapy was also tied to lower glycated hemoglobin levels (8.04% versus 8.22%; difference -0.18%, 95% CI -0.22 to -0.13; P<0.001) and lower doses of total daily insulin (0.84 U/kg versus 0.98 U/kg; difference -0.14, 95% CI -0.15 to -0.13; P<0.001).

A total of 30,579 young people, mean age 14, with type 1 diabetes from the Diabetes Prospective Follow-up Initiative database were included in the overall analysis, representing 446 diabetes centers in Europe. All had type 1 diabetes for at least one year, and patients using continuous glucose monitoring were excluded.

For their matched analysis, the researchers focused on 19,628 participants, matching those on pump therapy with those on insulin injection therapy. The total study population was involved in an exploratory analysis using propensity score inverse probability of treatment weighting.

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