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Insulin pumps ‘no more effective’ than daily injections

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Insulin pumps are no more effective at improving quality of life for patients with type 1 diabetes than daily injection shots, according to UK researchers.

They said such technology did not take away the need for education on diabetes self-management and was no more effective than injections in helping adults control their blood glucose levels.

“Pumps may be useful in patients who are highly engaged in their own management”

Simon Heller

Extra training and support in how to flexibly manage lifestyle alongside the onerous tasks of measuring blood glucose, carbohydrate counting and monitoring exercise remain key, they said.

Findings from the REPOSE trial, involving Sheffield Teaching Hospitals NHS Foundation Trust and Sheffield University, have just been published in the British Medical Journal.

The researchers noted that around 6% of adults with type 1 diabetes were estimated to use insulin pumps, rising to 40% in the US.

Use of pumps was expensive, but could provide patients with a more flexible way of delivering their insulin, they noted.

However, until now, little research has been done to see how effective the pump is compared with injections, they said.

The Sheffield team allocated 267 participants – at eight centres across England and Scotland – onto a week-long educational course to learn about flexible insulin therapy, and split them into two groups.

One group also received training on how to use a pump to deliver their insulin while the second group used multiple insulin injections for two years.

“The findings of this research will be of real value to patients and clinicians in the NHS”

Martin Ashton-Key

Although, participants using the pumps were more satisfied with the treatment, there were no significant benefits in quality of life between those using insulin pumps and those taking daily shots of insulin.

Lead study author Professor Simon Heller said: “Offering pumps to adults whose blood glucose levels are high and who have not yet received training in insulin self-management doesn’t appear to offer additional benefit.

“What the results do suggest is that ensuring people receive training to enable them to better manage their diabetes is likely to be more beneficial,” he said.

“Pumps may be useful in patients who are highly engaged in their own management, but find that the limitations of insulin treatment prevent them achieving their glucose targets,” he noted.

Dr Martin Ashton-Key, scientific director at the National Institute for Health’s Research Evaluation Trials and Studies Co-ordinating Centre, added: “The findings of this NIHR-funded research will be of real value to patients with diabetes and clinicians in the NHS.”

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