Pump Therapy Superior to Injections For Children With Type 1

Insulin pump therapy was associated with improved glycemic control and reduced risk for short-term diabetes-related complications compared with insulin injection therapy in children with type 1 diabetes, according to the findings of a recent study.

The population-based cohort study included 30,579 patients with type 1 diabetes younger than 20 years of age who were involved in the Diabetes Prospective Follow-up Initiative (mean age 14.1 years). Pump therapy was utilized by 14,119 patients and 16,460 patients received 4 or more insulin injections a day.
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In analysis, the researchers matched 9814 patients using pump therapy and 9814 patients using insulin injections, and assessed the rates of severe hypoglycemia and diabetic ketoacidosis during the most recent treatment year, as well as glycated hemoglobin levels, insulin dose, and body mass index.

Compared with injection therapy, pump therapy was associated with lower rates of severe hypoglycemia (13.97 vs 9.55 per 100 patient-years, respectively), diabetic ketoacidosis (4.26 vs 3.64 per 100 patient-years), and lower glycated hemoglobin levels (8.22% vs 8.04%).

In addition, the total daily insulin doses were lower for those who used pump therapy compared with those who used injection therapy. However, there were no significant differences in body mass index between treatment groups.

“Among young patients with type 1 diabetes, insulin pump therapy, compared with insulin injection therapy, was associated with lower risks of severe hypoglycemia and diabetic ketoacidosis and with better glycemic control during the most recent year of therapy,” the researchers concluded. “These findings provide evidence for improved clinical outcomes associated with insulin pump therapy compared with injection therapy in children, adolescents, and young adults with type 1 diabetes.”

—Melissa Weiss

Reference:

Karges B, Schwandt A, Heidtmann B, et al. Association of insulin pump therapy vs insulin injection therapy with severe hypoglycemia, ketoacidosis, and glycemic control among children, adolescents, and young adults with type 1 diabetes. JAMA. 2017;318(14):1358–1366. doi:10.1001/jama.2017.13994.