Insulin Pumps Better Than Shots for Diabetes Control

Insulin pumps provide better blood sugar control for adults with diabetes than multiple daily insulin injections, a new study says.

Insulin pumps are small devices that are worn by patients and deliver constant amounts of insulin to the body through a catheter placed under the skin.

The multicenter, international study was funded by medical device maker Medtronic and included 331 people aged 30 to 75. All of the patients had poorly controlled type 2 diabetes and were using multiple daily injections of insulin to control their blood sugar levels.

The patients were randomly assigned to either continue using injections or to switch to an insulin pump.

After six months, patients who used the insulin pumps had a much greater reduction in average blood sugar levels than those who used injections, the study found. According to the researchers, twice as many patients in the pump group reached the blood sugar control target range (55 percent vs. 28 percent).

By the end of the study, patients in the pump group required a 20 percent lower daily dose of insulin than those in the injection group. Patients in the pump group also averaged nearly three hours less per day with high blood sugar than those in the injection group, the team reported July 2 in The Lancet.

Insulin Pump Therapy An insulin pump is a small mechanical device, a little larger than a pager that is worn outside the body, often on a belt or in a pocket. It delivers fast-acting insulin into the body via an infusion set - a thin plastic tube ending in a small, flexible plastic cannula or a very thin needle. You insert the cannula beneath the skin at the infusion site, usually in your abdomen or upper buttocks. You keep the infusion set in place for two to three days (sometimes more), and then move it to a new location. All insulin is delivered through the infusion set.

The insulin pump is not an artificial pancreas. Rather, it is computer-driven device that delivers fast-acting insulin (NovoLog, Humalog, or Apidra) in precise amounts at pre-programmed times. Wearing an insulin pump might require more work on your part than traditional injection therapy, especially if you are not used to checking your blood sugar several times a day. You must also learn to use the pump to deliver the extra insulin you require when you eat.

The following companies make or sell insulin pumps in the United States:

Animas
Medtronic MiniMed
OmniPod (Insulet)
Roche
Tandem

According to the study, the amount of time people spent with extremely low blood sugar remained similarly low in both the pump and injection groups.

"Our findings open up a valuable new treatment option for those individuals [who are] failing on current injection regimens," study author Yves Reznik, from the University of Caen Cote de Nacre Regional Hospital Center in France, said in a journal news release. He believes that the devices "may also provide improved convenience, reducing the burden of dose tracking and scheduling, and decreasing insulin injection omissions."