ADA Abstract #2770-PO: Pediatric Patients Sustain Significant Improvement in A1C Levels
In the study, "Sustained Improvements in Hemoglobin A1C During Long-Term Treatment With Continuous Subcutaneous Insulin Infusion (CSII) in Pediatric Patients," 102 type 1 diabetes patients (mean age 12.4 years, range 2.8 to 21 years) using insulin pump therapy sustained significant improvements in A1C levels for up to three years, as compared to A1C levels prior to pump use. At the final study evaluation, 75 percent of patients had a lower A1C level than they had prior to beginning pump therapy. The mean duration of pump use was 2.3 years for patients in the study.
ADA Abstract #2764-PO: Insulin Pump Therapy is Safe and Effective
The study, "Insulin Pump Therapy in Young Children Ages 2-7 Years With Type 1 Diabetes," followed 27 patients (ages 2 to 7 years) over a two year period and found pump therapy to be a safe and effective alternative to twice a day insulin injections using NPH and Humalog insulins. When comparing pump therapy to twice a day injections, pump users experienced less sick days and reduced episodes of severe hypoglycemia (low blood sugar). In addition, A1C levels were significantly improved after patients switched to pump therapy.
ADA Abstract #1887-P: Multi-National Study Highlights Benefits of Pump Therapy
In the study of Medtronic insulin pump users entitled, "The PedPump Study: A Low Percentage of Basal Insulin and More Than Five Daily Boluses are Associated With Better Centralized A1C in 1041 Children on CSII in 17 Countries," 1041 children with type 1 diabetes (ages 11.8 4.2 years) were studied in 30 centers throughout 17 countries. A benefit of insulin pump therapy is that patients can deliver extra insulin (called a bolus dosage) at the touch of a few buttons to reduce excessive rises in glucose levels. In the study, children who delivered more than five bolus dosages per day using their insulin pump had significantly better A1C levels. Moreover, the A1C levels of 710 children with less than half of their total daily insulin delivered as a baseline rate of insulin (known as a basal rate) were significantly better than the 331 children with a higher daily basal rate. This indicates that by fine-tuning bolus and basal insulin delivery with an insulin pump, patients were able to achieve better blood sugar control. Additionally, study results indicate a low incidence of severe high and low blood sugar, as well as hospitalizations, for pump users.
Insulin Pump Therapy: Growing Body of Evidence
The three studies presented at the ADA follow on the heels of a larger randomized, prospective study conducted by investigators from Yale School of Medicine. In that study, pump therapy was directly compared to multiple daily injections with Lantus(r) insulin in pediatric patients. The Yale study confirmed that pediatric patients using Medtronic insulin pumps experienced a statistically significant reduction in A1C levels (from 8.1 percent to 7.2 percent), whereas no significant change was reported in patients using multiple daily injections with Lantus (from 8.2 percent to 8.1 percent).
How Pump Therapy Helps Improve A1C Control
Insulin pump therapy is the most advanced method for precise and adjustable insulin delivery, and has been proven to help patients lower their A1C levels. An insulin pump is a small pager-size device that delivers insulin around the clock, much like a healthy pancreas. Patients can also deliver insulin on demand at the touch of a few buttons. Unlike injection therapy, pump users can program their pump to deliver insulin at varying rates to meet their changing insulin needs throughout the day and overnight. Many patients experience improved quality of life with pump therapy, ridding themselves of multiple injections, strict meal schedules and rigid sleep patterns associated with injection therapy.