GLP-1 receptor agonists for diabetes: a review of the cardiovascular, kidney and mortality outcomes

Long term differences in blood glucose control between adults using multiple daily injections vs insulin pumps


Posted by Medivizor on Jan 26, 2020 in Diabetes mellitus |

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In a nutshell

This study wanted to find out if people with type 1 diabetes who use insulin pumps have fewer changes in their blood glucose control than those who use multiple daily injections. The study found that the patients who used insulin pumps had fewer changes in blood glucose control than those on multiple daily injections.

Some background

In type 1 diabetes, the control of blood glucose over time is measured by a blood test called an HbA1c. This gives an average of the blood sugars over the past three months. It is good to have a fairly steady HbA1c over time. Large fluctuations in the HbA1c results can increase the risk of long-term complications.

There are two common ways to manage type 1 diabetes. The first is multiple daily injections delivered through an insulin pen. The second is continuous subcutaneous infusion therapy (CSI), more commonly known as treatment with an insulin pump. It is not known which of these treatments keeps the HbA1c more steady over time.

Methods & findings

This study had 506 participants. All of the participants were adults with type 1 diabetes. The study looked back at records of patients. The patients had had diabetes for an average of 17 years. The HbA1c results of the patients were analyzed for an average of 4.1 years.

On average, the patients who were using insulin pumps had their HbA1c vary by 0.5% (or 6mmol/mol) over the time studied. On average, the patients who were using multiple daily injections had their HbA1c vary by 0.7% (or 9mmol/mol) over the time studied.

56 of the patients studied swapped from multiple daily injections to using an insulin pump during the time period analyzed. On average, their HbA1c fell by 0.4% (5mmol/mol). One year after these patients started using the pump, their HbA1c was changed significantly less than when they were on multiple daily injections.

The bottom line

The study concluded that patients with type 1 diabetes who use insulin pumps have fewer changes in their HbA1c compared to those who use multiple daily injections.

The fine print

This study was based on medical records. Information might have been missing. This might have affected the results.

Original Title :

HbA1c variability in adults with type 1 diabetes on continuous subcutaneous insulin infusion (CSII) therapy compared to multiple daily injection (MDI) treatment.

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