Insulin pumps are more effective at controlling blood sugar than insulin injections and cause fewer complications, according to new research by Associate Professor Elizabeth Davis and colleagues, Princess Margaret Hospital for Children, Perth, Australia.
Improvements in pump technology, the availability of insulin analogues, and the benefits offered by improved blood sugar control, have all contributed to an increase in the use of insulin pump therapy over the last 15 years, particularly in children. However, there has been relatively little research into the long-term effects in children, with many studies too short in duration or with too few patients.
How effective are insulin pumps?
This study followed 345 young people on pump therapy over the course of seven years, matching them to controls using insulin injections. As the longest and largest study of the effectiveness of pump therapy, the study found that episodes of severe hypoglycaemia (dangerously low blood glucose) more than halved, while events in the control group increased. Admissions for diabetic ketoacidosis for pump users were also less than half than for those using injections.
Why did some children stop using their pumps?
Despite the improved control provided by the pump therapy, 38 patients stopped using the pump during the course of the study; six of these were in the first year of treatment, seven in the second year and 10 in the third year of treatment, with the remainder stopping after having used a pump for at least three years. The researchers found that some children stopped because they became tired of the extra attention needed to manage their pump, or were concerned about how it looked. Other children took a temporary ‘pump holiday’, before going back to using a pump.
The need for specialist nursing support
Bridget Turner, Director of Policy and Care Improvement for Diabetes UK, said: “This provides further evidence that using insulin pumps can help children with Type 1 diabetes achieve good blood glucose control and, with the right education and specialist nursing support, in the long term this can help reduce risk of serious complications such as amputation, blindness and kidney failure.
“This is why it is a real concern that the UK is lagging behind comparable countries in terms of insulin pump usage. We want the NHS to do more to ensure there are enough healthcare professionals who are qualified to support children and adults with Type 1 diabetes to use a pump effectively, so that everyone who wants to use one is able to do so. This could make a real difference to ensuring that everyone with diabetes has the best possible chance of a long and healthy life.”
The study is published inDiabetologia, the Journal of the European Association for the Study of Diabetes.