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Type 1 Kids Do Well on Pumps
In several studies presented at the ADA Scientific Sessions in San Diego, California, insulin pumping demonstrated beneficial effects on a pediatric type 1 population.
One study (2770-PO) showed that 75 percent of participants using a pump had lower A1C levels than they had prior to beginning pump therapy.
Another study (2764-PO) showed that insulin pump therapy was safe and effective in 27 participants between the ages of 2 and 7 years. Participants experienced fewer sick days and reduced episodes of severe hypoglycemia. In addition, A1C levels were significantly improved after patients switched to pump therapy.
In another study (1887-P), 1,041 Medtronic pump users with an average age of 11.4 years were studied in 30 centers throughout 17 countries. The study found that children who delivered more than five bolus dosages per day using their insulin pump had significantly better A1C levels.
“This indicates that by fine-tuning bolus and basal insulin delivery with an insulin pump, patients were able to achieve better blood sugar control,” write the researchers.
Pumping During Pregnancy and Labor Examined in Type 1 Woman
A 29-year-old woman with type 1 for 28 years was studied during her pregnancy (2798-PO). She had been on an insulin pump for five years. A1C levels prior to conception were 5.8% and were 5.1% to 5.6% during the pregnancy. The patient’s hourly self-monitored glucose levels during labor and delivery and self-adjusted insulin doses are shown in the table below.
|Cervical dilation (cm)||2||2||4||6||8||full|
|Mean glucose (mg/dl)||138||109||136||113||65||96|
|Basal insulin dose (units/hour)||0.8||2.0||2.0||3.5||0.5||0.1|
Researchers say that if these findings are confirmed in additional patients, “self-management of glucose monitoring and insulin dose adjustment should be considered as a treatment option during labor and delivery in patients with type 1 diabetes.”
Insulin-Using Type 2s as Controlled on a Pump as With Multiple Daily Injections
Another study (504-P) found that in older subjects with insulin-treated type 2, controlling blood glucose with both an insulin pump and multiple daily injections of Humalog at mealtimes and Lantus for basal insulin achieved average A1C levels of less than 7% with good safety and patient satisfaction. Rates of severe hypoglycemia were similar in both groups. Weight gain did not differ. Costs comparisons of the two approaches to insulin therapy were not reported.
Data on Continuous Glucose Monitoring System Help Patients With Treatment Decisions
Results of a pilot study (363-P) showed that participants successfully used Medtronic’s Guardian RT Continuous Glucose Monitoring System to better control glucose fluctuations.
Ninety-four percent of the study participants actively used the real-time glucose values and/or high or low glucose alerts to control glucose fluctuations; 75 percent adjusted their insulin delivery; 63 percent changed their diet; and 31 percent made lifestyle changes after gleaning insights from real-time continuous glucose monitoring.
The Guardian RT System uses a subcutaneous glucose sensor, which records as many as 288 glucose readings per day. According to Medtronic, the sensor measures glucose in the interstitial fluid found between the body’s cells and is typically discarded and replaced after three days of use.
Sep 1, 2005
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.