Which method of insulin therapy is best for preventing side-effects in children and young people?

This study assessed the ability of two types of insulin therapy in preventing possible side effects of type 1 diabetes (T1D) in young patients. The authors concluded that insulin pump therapy was better than injection therapy at preventing hypoglycemia and diabetic ketoacidosis (DKA).

 

 

 

 

 

 

 

Patients with T1D are not able to produce enough insulin (i.e. a hormone that breaks down complex carbohydrates into sugar). These patients thus need to supplement with insulin to help control blood sugar levels. Traditionally, T1D patients used insulin injections to control their blood sugar. A more recent treatment option is insulin pump therapy. Pump therapy has been shown to be slightly better than injections at controlling blood sugar. It is unclear, however, what effect pump therapy has on the risk of developing hypoglycemia (extremely low blood sugar) and DKA (a potentially dangerous condition resulting in extremely high blood sugar). 

 

This study assessed the the potential side-effects of insulin pump therapy among young people (average average: 14.1 years) living with T1D for at least a year. The health of 9,814 patients using pump therapy was compared with that of 9,814 patients using injection therapy. 

 

Severe hypoglycemia occured in 5.5% of those on pump therapy and 7.3% of those on injection therapy. DKA occured in 3.4% of those on pump therapy and 3.9% of those on injection therapy. These differences were statistically significant.

 

Pump therapy users had lower HbA1C levels (8.04%) compared to injections (8.22%). Pump users also had lower daily insulin doses (0.84 U/kg) compared to injections (0.98 U/kg). 

Due to increased training, those on pump therapy could have been monitoring their blood sugar more often; this could have potentially over-estimated the reduced side-effects associated with pump therapy in this study.

 

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