Using insulin pumps in patients with difficult-to-treat type 2 diabetes is safe and effective for up to 5 years, researchers including one of Indian-origin have found.
"Insulin pumps can act as a valuable new treatment option, especially for those individuals failing on current injection regimens," said Priyamvada Singh, from the St Vincent Hospital in US.
About 30 per cent of patients with type 2 diabetes are not well controlled despite multiple daily injections of basal and bolus insulins, the researchers said.
A previous six-month trial of 331 patients who had not responded to multiple daily basal-bolus injection regimens, showed a 0.7-percentage-point improvement in hemoglobin A1c (HbA1c) among those in the insulin-pump group, 'Medscape Medical News' reported.
The current study was a retrospective single-centre chart review of 13 adults (10 men, three women) with an average age 55 years and mean body mass index 34.5 kg per square metre.
Study subjects also had to have one or more of the following problems with insulin therapy - daily dose more than 200 units, more than four injections per day, wide glycemic excursions, and/or intractable hypoglycemia.
All were taught how to count carbohydrates and to use the "bolus wizard" feature of the Medtronic pump, which automatically calculates the premeal bolus dose of insulin based on insulin-to-carb ratios and "correction" adjustments for highs or lows manually entered into the pump's software.
At 5 years, the average HbA1c for the group had dropped to 7.7 per cent from an average 8.9 per cent at baseline.
In one notable case, a patient's HbA1c dropped from 10.5 per cent to 6.6 per cent. Another patient, the one with the highest HbA1c at 5 years, 9.0 per cent, had also started off with the highest value, 10.8 per cent.
