Researchers in Chico, California, conducted a Web-based survey based on the Diabetes Control and Complications Trial quality-of-life questionnaire. The survey asked subjects to compare their previous injection therapy with pump therapy.
Among the findings from the 561 respondents (92 percent of whom were from the United States):
- A1C levels decreased in 77 percent of the respondents, regardless of how long they'd been pumping.
- Satisfaction with diabetes care and management was significantly greater.
- Respondents were nearly always, "almost always" or "considerably satisfied" with their diabetes treatment since the initiation of pump therapy.
- Personal satisfaction was significantly improved.
- For 81 percent of the respondents, their diet had become more flexible.
- Hypoglycemic episodes were experienced only occasionally or seldom.
- Respondents reported that diabetes had less negative impact on their lives.
- Respondents felt less concern about becoming unconscious.
The researchers speculate that the short-term enhancement in quality of life might result from the effectiveness of insulin pump therapy, whereas long-term enhanced quality of life could stem from a decreased risk of complications because of the lower A1Cs.
Family Support Important to Diabetes Control
Continued support from family members translates to better outcomes when it comes to pumping insulin.
Researchers from Boston, Massachusetts, studied the importance of family involvement in insulin pump therapy for children and adolescents. Data was collected from 109 subjects, ages 3 to 17, concerning frequency of blood-glucose monitoring, basal and bolus dosages, blood-glucose control and issues involving family support and conflict in relation to diabetes management.
Involvement from family members was significantly greater during the first six months of insulin therapy than it was in later months. Those subjects who had more support from their parents tested more frequently, remembered to give themselves their bolus insulin more regularly and had lower A1C levels.
Those who had less family support reported forgetting their bolus insulin 30 percent more often than those with more family involvement. Those who reported more family conflict also tested their blood-glucose levels less frequently.
The researchers advise that continued family support is critical for sustaining the benefits of insulin pump therapy.
Insulin Pump Therapy Superior to MDI for Type 2s
People with type 2 diabetes who are obese and are severely insulin-resistant do better on insulin pumps than on multiple daily injections (MDI) when it comes to glucose control, insulin requirements and weight gain, researchers in Israel say.
Thirty-nine obese people with type 2 diabetes whose A1Cs were greater than 8.5% and who required more than 1 unit of insulin per kilogram of body weight per day were studied. Subjects underwent 18 weeks of insulin pump therapy either preceded or followed by 18 weeks of multiple daily injections, with a washout period of 12 weeks between regimens during which all subjects were on MDI.
During insulin pump therapy, the average A1C was reduced from 10.2% to 7.9%. Those on MDI during the initial period went from an average A1C of 10.3% to 8.3%. Neither group experienced significant weight gain. Average daily insulin requirements were reduced from 99.3 units a day to 87.6 units a day in the group using insulin pumps, whereas those on MDI went from 113.4 units a day to 117.6 units a day.
After the washout period and the changeover, researchers found no further change or significant differences between the groups.
Overall results for pump therapy showed an average A1C of 8.6%, average weight of 97.4 kilograms and average insulin usage of 109.4 units per day. The results for MDI averaged an A1C level of 8.4%, weight of 93.7 kilograms and daily insulin dose of 110.5 units.
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