Insulin Pump Better Than Multiple-Shot Regimen for Diabetics
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.
- A new study shows that an insulin pump may be a better way for people with
type 1 diabetes to control their blood sugar than daily injections of
- Using the insulin pump requires careful monitoring of blood sugar levels,
so diabetics should switch to an insulin pump only if they are willing to do
- Another advantage to the insulin pump is more lifestyle flexibility.