Insulin Pump Use Linked to High Rates of Uncontrolled Glycemic Levels: Study

Diabetics using an insulin pump may experience some health improvements, but a new British study suggests the devices are linked to poor control of blood sugar levels among patients with Type I diabetes.

In a study presented at an American Diabetes Association meeting on June 7, researchers indicate that nearly 40% of patients with Type I diabetes still had a blood sugar level over 8.5 percent while using an insulin pump.

Researchers from the University of Manchester, England, conducted a retrospective study of nearly 450 patients who were on an insulin pump for at least 12 months with glycated hemoglobin averaged over a 30 month period through November 2014.

Patients A1c, blood glucose level, was measured to identify which patients had high concentrations over prolonged periods of time.

Overall, more than one-third of patients maintained high blood glucose levels above 8.5%, while another 11%of patients using an insulin pump were above a 10% A1c level.

These proportions were seen despite an average 0.6% blood glucose improvement after starting insulin pump therapy. Researchers noted there were greater declines in patients starting at higher A1c levels..

The study is one of the largest conducted on the effectiveness of insulin pumps. Approximately 42% of patients who were studied used a Medtronic pump, 30% used Omnipod, 14% used Animas and 13% used Accu-Chek.

There was no difference in blood glucose levels when comparing different types of pumps among users. Researchers did see a negative correlation between blood glucose levels and age, but not with duration of pump use.

Less than one-third of patients achieved a good control of their blood glucose levels when using an insulin pump. That rate did improve from 19% who had their blood glucose levels under control before receiving the pump to 32% who had the levels under control after receiving the pump.

The proportion of patients above an 8.5% blood glucose levels declined from 52% to 40% overall.

Researchers say the reason for the poor outcomes may have to do with a person’s adherence to proper use guidelines or limited use with continued glucose monitoring.

Doctors hope placing a patient on an insulin pump may improve blood glucose levels, but that depends on whether the patient does the necessary things to control their blood glucose.

“Our data highlight the challenges of managing T1DM [Type 1 diabetes] in real-life conditions,” researchers concluded.