People with type 1 diabetes who use insulin pump therapy have almost 50% less risk of dying from cardiovascular disease than those who take insulin by multiple daily injections, a new Swedish study has found.
Researchers monitored 18,168 Swedes with type 1 diabetes from 2005 to 2012. While 2,441 of the subjects used insulin pump therapy, the others relied on multiple daily injections. The study found that insulin pump users had a substantially lower risk of dying of cardiovascular disease than the daily injection group.
"We carefully analysed the findings to eliminate the risk of bias or confounding and concluded that the effect had been fully verified," said Isabelle Steineck, researcher at Sahlgrenska Academy in Sweden.
The next step will be to identify the mechanisms that explain the extra benefits of insulin pump therapy. Steineck believes that one reason for the difference between the two therapies is that the insulin pump method is accompanied by more extensive patient training and more frequent blood glucose monitoring. "There is a rationale for insulin pump treatment resulting in more stable blood glucose concentrations than multiple daily injections," she said.
"Previous studies have shown that insulin pump can reduce the frequencies of severe hypoglycemic episodes. Severe hypoglycaemia can be a risk factor for cardiovascular events, particularly among high risk individuals," Steineck said. "We evaluated the patients who used insulin pump therapy and do not know if the observed effect is attributable to continuous infusion of insulin or that some of the effect is attributable to intensified glucose monitoring, increased motivation to control blood glucose, or a better knowledge about having diabetes type 1," said Steineck.
The researchers have concluded that insulin pumps not only make life easier for patients, but represent a safe and effective treatment method.
The study was published in the British Medical Journal.
