TUESDAY, June 29 (HealthDay News) -- Type 1 diabetics who used
an insulin pump and a sensor that continuously monitored their
blood sugar levels had better control over their illness than
people taking insulin injections, a large clinical trial finds.
Researchers divided 485 people aged 7 to 70 into two groups. One
group performed multiple daily insulin injections and tested their
blood sugar throughout the day, the standard treatment for type 1
The other group was taught to use an insulin pump and a blood
glucose sensor from device maker Medtronic, which helped fund the
study. The pump, about the size of a pager, delivers small amounts
of insulin through a tiny tube inserted under the skin. Insulin is
delivered throughout the day and can be adjusted according to food
intake, while the sensor reads blood sugar levels every five
Even though the sensor can relay information to the pump, the
sensor does not control the amount of insulin being delivered --
that is still calibrated and adjusted by the patient, the
researchers explained. The sensor also has adjustable alarms for
high and low blood sugar.
After one year, the group using the pump and sensor had
significantly better blood sugar readings than those using
injections, the study found.
At the start of the study, A1C levels (a measure of long-term
blood sugar control) were 8.3 percent for both groups.
For those on the pump, A1C levels dropped to 7.5 percent
compared to 8.1 percent for those using injections.
The A1C target for adults with diabetes is under 7 percent,
while for teens the target is 7.5 percent and for children aged 6
to 12, it's 8 percent, explained study author Dr. Richard
Bergenstal, executive director of the International Diabetes Center
at Park Nicollet in Minneapolis and president of the American
Diabetes Association. Studies suggest those thresholds can prevent
many of the long-term complications of high blood sugar, while also
helping to prevent dangerously low blood sugar levels.
Importantly, there was no difference in the incidence of
hypoglycemia, or dangerously low blood sugar episodes, between the
two groups, the authors found.
"This is a really important study that shows that a sensor and pump together can help people with type 1 diabetes in all age groups," Bergenstal said. "That children, adolescents and adults can improve their blood sugars without causing an increase in hypoglycemia or weight gain is a dramatic finding."
The study was published online June 29 in the
New England Journal of Medicine and was to be presented at
the American Diabetes Association annual meeting in Orlando,
The findings are especially good news for children and teens
whose blood sugar can be more difficult to manage due to
physiological changes and behavioral issues, Bergenstal said. A lot
of teens don't want to be bothered with managing their diabetes,
nor are children and teens known for thinking about the long-term
implications of their behaviors.
In the study, nearly 44 percent of pediatric patients using the
sensor-augmented pump achieved glucose control targets, compared to
only 20 percent of pediatric patients in the injection group.
While the pump/sensor combination could improve the ability of
diabetics to manage their blood sugar, the key to making the
technology work are the patients who use it, said Dr. Howard
Wolpert, a senior physician at the Joslin Diabetes Center in
Diabetics have to be willing to wear the devices, change the
cannula (inserted tube) every few days, monitor what the sensor is
telling them about their blood sugar and adjust their food intake
and insulin levels accordingly, he said.
"These tools do take diabetes management to a higher level and can lower risk of long-term complications, but it's still just a tool," Wolpert said. "It's really the patient who is motivated and gets the proper guidance who can use this technology most effectively."
Short- and long-term blood sugar trends and patterns can also be
downloaded from the device for viewing by the patient and doctors,
Though often lumped together, type 1 and type 2 diabetes are in
many ways different diseases. In type 1 diabetes, formerly called
juvenile diabetes, the pancreas stops producing insulin, the
hormone that enables the body to convert sugar and starches found
in foods into energy.
About 5 percent to 10 percent of people with diabetes have type
1, according to the American Diabetes Association. Tight blood
sugar control can minimize the risk of long-term complications,
including kidney failure, blindness and nerve damage.
"It's important for people to realize there is a real change in the long-term outlook for the health of people with type 1 diabetes, and that's what this new technology represents," Wolpert said.
Joslin Diabetes Center has more on type 1
diabetes, and the pros and cons of using an insulin pump.