Pumps outperformed multiple daily injections on several measures. The researchers found that people who used the pumps achieved an average HbA1C that was 0.7 percent lower than the multi-injection group.
Among the pump patients, 55 percent reached the target range of 8 percent or less compared to 28 percent of those in the injection group. Patients using the pump also spent an average of almost three hours less everyday in hyperglycaemia, when their blood sugar was too high. The results of the ongoing OpT2mise clinical trial were published online July 3 in The Lancet.
Among the pump patients, 55 percent reached the target range of 8 percent or less compared to 28 percent of those in the injection group. Patients using the pump also spent an average of almost three hours less everyday in hyperglycaemia, when their blood sugar was too high. The results of the ongoing OpT2mise clinical trial were published online July 3 in The Lancet.
An insulin pump is essentially a computerized syringe about the size of a deck of cards. It delivers insulin every few minutes in tiny amounts, 24 hours a day. The insulin flows through a tube, which sits just under the skin in the subcutaneous tissue where insulin injections are given.
Previous clinical trials that randomly compared people using insulin pumps with people using multiple injections to treat type 2 diabetes have failed to consistently show an advantage for either therapy approach. Consequently experts have not reached a consensus supporting pump therapy.
The OpT2mise trial, funded by pump-maker Medtronic, was designed to compare effectiveness and safety in patients who have had little success in controlling their blood sugar. The researchers enrolled 495 adults (aged 30-75 years) with poorly controlled type 2 diabetes at 36 centers around the world led by researchers in Israel, France, Spain and Canada (ClinicalTrials.gov identifier: NCT01182493).
Patients underwent a two-month run-in period, where their blood sugar levels were controlled with multiple daily injections. After this run-in phase, 331 participants whose HbA1c remained above the target range of 8.0 percent up to 12 percent were randomly assigned to pump therapy or to continue with multiple injections.
In addition to twice as many people in the pump group being able to maintain their target HbA1c as the multiple-injection group, at the end of the study, the total daily dose of insulin was 20 percent lower with pump therapy than with multiple injections and there was no weight difference between the groups.
The researchers concluded that pump therapy is safe and effective in patients who have trouble controlling their blood sugar.
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