The studies find that old-fashioned insulin injections control blood sugar just as well as insulin pumps. But most studies find that people get better results by combining the pumps with new blood sugar monitoring devices.
Patients who used continuous glucose monitors to automatically track blood sugar had better blood sugar levels than people who used finger stick testing alone. However, the two methods were equally effective at keeping blood sugar from dropping to dangerously low levels. Insulin pumps were no more effective for controlling blood sugar than self-injection in most studies, but people tended to prefer the pumps over giving themselves shots many times a day. Those who used insulin pumps with coordinated, real-time continuous monitoring devices achieved better blood sugar control than people who use finger-stick testing and shots alone.
"When we compare the new to the old, we saw a much greater improvement in glucose control when the newer devices were used together," said study author Sherita Hill Golden, MD, MHS of Baltimore's Johns Hopkins University School of Medicine.
About 26 million Americans have diabetes, and that number is growing each year. Those with Type 1 and Type 2 diabetes require treatment with insulin to control blood sugar levels and reduce the risk of complications, which include foot ailments, especially the risk of amputation.
New technologies have given people with diabetes who used insulin more options to manage their diabetes, but it is not clear whether these expensive new devices actually improve the patient's health. "Health professionals and their diabetic patients need objective information when making decisions about the use of technologies that may be expensive or heavily marketed," said Golden.
Their analysis included data from 33 trials comparing continuous glucose monitoring with insulin pumps to conventional ways of monitoring and controlling blood sugar levels in people of all ages.
Continuous monitoring devices give blood sugar readings as often as every five minutes, using a sensor attached to the body. The sensor sends results to a display, which is usually worn on a belt. The device doesn't replace home glucose monitoring but can more closely track minute-to-minute changes in blood glucose. Patient still need to prick their fingers up to four times a day, but those who rely on finger pricks alone may need to stick themselves as many as 10 times a day.
The benefit of the insulin pumps is that it offers continuous insulin through a catheter placed under the skin around the belly. The pump replaces daily injections, although patients still have to make decisions about how much insulin they need.
The analysis found that insulin pumps and daily injections are similarly effective for controlling blood sugar, leading the researchers to conclude that decisions about which method to choose should include consideration of patient preference, quality of life, and expense.
Diabetes specialist Stuart Weinerman, MD, says some of his patients love the new devices, while some do not. "Some people can't stand the idea of wearing a device all the time, whether it is a pump or a glucose monitor. Others love the high-tech nature of the new devices and the fact that they have a lot more flexibility," Weinerman said.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
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