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Study: Insulin Pump Better Than Injections

Researchers Say 'Artificial Pancreas' for Type 1 Diabetes May Be Reality in Several Years
By
WebMD Health News
Reviewed by Laura J. Martin, MD

insulin_pump_type_1_diabetes_1.jpg

July 21, 2010 -- Encouraging research raises new hopes that a long awaited "artificial pancreas" to treat patients with type 1 diabetes could be available in the U.S. within the next few years, experts say.

In the largest and longest study ever of an insulin pump with a continuous glucose sensor, patients who used the device achieved better control of their blood sugar than patients taking insulin injections.

Those in the study who used the insulin pump marketed by medical device maker Medtronic Inc., had to adjust their insulin levels manually, just as patients who give themselves insulin injections do.

But Medtronic and other companies are working on a closed-loop system -- often referred to as an artificial pancreas -- which will continuously monitor blood sugar levels and adjust insulin delivery automatically.

Study researcher Richard M. Bergenstal, MD, says the new study proves that combining an insulin pump and sensor can help patients achieve optimal blood sugar control even without the automatic insulin delivery.

Bergenstal is executive director of the International Diabetes Center at Park Nicollet as well as president for medicine and science with the American Diabetes Association.

"We were able to get blood sugar down into the range where we can prevent long-term complications and we did it without causing it to drop too low," he tells WebMD. "These are probably the best results in terms of balancing the two of any study done to date."

Insulin Pump-Sensor Improved Diabetes Control

In healthy people, insulin is produced in the pancreas to help the body convert glucose from the diet into energy. People with type 1 diabetes lose the ability to make their own insulin and most take insulin injections throughout the day.

Poorly controlled frequent high blood sugar leads to the long-term complications of diabetes, including possible blindness, amputation, and kidney failure.

But Bergenstal explains that low blood sugar, known medically as hypoglycemia, is the bigger concern in people who tightly manage their disease with insulin.

"Current treatments are increasingly helping people avoid high blood sugar, but this has resulted in low blood sugar," he says.

The study included 485 people with type 1 diabetes, ranging in age from 7 to 70, who had been unable to achieve optimal blood sugar control with insulin injections.

Half the patients received standard treatment, which involved testing their blood sugars throughout the day and taking insulin injections when needed. The other half used the pump and glucose sensor device, which delivered insulin through a small catheter inserted under the skin.

The sensor was added only after the patients had become comfortable with the pump, usually after two to five weeks. Patients in both treatment groups also received training to help them better manage their diabetes.

Hemoglobin A1c was monitored to assess blood sugar control. Normal hemoglobin A1c in people without diabetes ranges from 4% to 6%, and the goal for avoiding complications in people with the disease is less than 7%.

Is This Normal? Get the Facts Fast!

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If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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