Insulin Pump Better Than Multiple-Shot Regimen for Diabetics
WebMD News Archive
"This article confirms what others have confirmed: that with the pump,
we can lower HbA1C, which means improving [blood sugar]
control," says Bruce Bode, MD, who reviewed the study for WebMD. "That
translates into a reduction in complications." Bode is an endocrinologist
at Atlanta Diabetes Associates and medical director of the Diabetes Resource
Center at Piedmont Hospital, also in Atlanta. He is also a consultant for
Mini-Med, an insulin pump manufacturer, and for insulin makers Novo and Eli
While Paul Jellinger, MD, FACE, president of the American Academy of
Clinical Endocrinologists, says experts have known for a while that patients on
pumps require less insulin, study co-author Rita Odell, MEd, says "the
reduction of insulin overall and the matching of insulin to food was a very
Patients who are deciding whether to switch to a pump should think about why
they want one, Bode says. "The main reason to use a pump is that you want
to improve your blood sugar control and have more flexibility in your lifestyle
-- to be able to eat, sleep, and work when you want. But someone who's not
going to check their glucose shouldn't go on it."
The pump is not for everyone, Jellinger says. "Many patients prefer not
to be attached to things. There's no mandate to put a patient on the pump if
they're doing well on [shots]. The best candidates are patients that ask to go
on a pump."
A big advantage of the pump is that it uses only the shorter-acting insulin,
which gives a more predictable result than the longer-acting kind used by
patients on injections, says Bode. Using short-acting insulin lessens the
chance of making your blood sugar too low.
Irl Hirsch, MD, of the Diabetes Care Center at the University of Washington,
in Seattle, notes in an editorial accompanying the study that many physicians
still struggle to get reimbursed for services related to switching patients to
pumps, such as counseling by nutritionists and nurse-educators. "These
important and talented personnel are required for all patients with diabetes,
regardless of the type of diabetes and the type of medications used," he
He also questions the authors' assertion that all the study patients were
measuring their blood sugar six to seven times daily, and wonders whether the
frequency of home testing increased when the patients were using pumps.
"Obviously, an increase in self-monitoring of [blood sugar] could account
for some of the improved results," Hirsch writes.