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In Type 1 Diabetes, Patient Training More Important Than Choice of Multiple Insulin Injections vs. Pump PDF Stampa E-mail
Venerdì 31 Marzo 2017 18:47

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

When it comes to managing type 1 diabetes, patient education and training in insulin delivery — rather than choosing between an insulin pump and injections — may be key, according to a study in The BMJ.

Over 250 adults with type 1 diabetes were randomized to receive multiple daily insulin injections or insulin pump therapy, plus structured group training on flexible insulin dosing based on diet, activity, and blood glucose levels. The training took place over five consecutive days. At baseline, over 90% of participants had hemoglobin A1c levels of 7.5% or higher.

At 24 months, both groups had achieved clinically significant reductions in mean HbA1c level, with no significant difference between the groups. In addition, about a quarter of patients in each group had HbA1c levels below 7.5%.

The authors write, "These results do not support a policy of providing insulin pumps to adults with poor glycemic control until the effects of training on participants' level of engagement in intensive self management have been determined."

 

 

da NEJM