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EASD: Insulin Pumps Lower Mortality Rate 29% Compared to Multiple Injections in T1DM

And fatal cardiovascular disease risk is 43% lower for type 1 diabetes patients using insulin pumps over multiple daily injections…. 

Dr. Gudbjörnsdottir and colleagues in Sweden conducted an observational study using patient data from the Swedish National Diabetes Registry from 1996 till 2014. The data included more than 95% of the Swedish type 1 diabetes population with 2,441 of the patients using insulin pumps and 15,727 on multiple daily insulin injections.

Study results showed that patients on insulin pumps had a 29% reduction in mortality rate compared to patients on multiple daily insulin injection. Patients on insulin pumps had 43% lower risk of fatal cardiovascular disease compared to those on insulin injections.

  • Cardiovascular death: HR 0.56, 95% CI 0.39 to 0.82, P=0.003
  • Overall mortality: HR 0.71, 95% CI 0.57 to 0.89, P=0.003

Overall, adjusted analyses showed that both fatal cardiovascular diseases and mortality rates were significantly reduced with insulin pump therapy. The authors note “that the patients using pen injections were different from those using pumps: the former had a slightly lower educational level, were slightly older, had a longer duration of diabetes, higher blood pressure, and more previous cardiovascular disease, although the same HbA1c.” Although they used propensity-scoring to balance the two groups and compare them fairly, they note further that they may not have eliminated all confounding.

Practice Pearls:

  • This study compared cardiovascular risk and mortality rate between type 1 diabetes patients on insulin pump therapy vs. patients on multiple daily insulin injection therapy.
  • Patients on insulin pump therapy showed decreased cardiovascular disease and mortality rate compared to insulin injections.

Gudbjornsdottir S, et al “Observational study of insulin pump treatment: Swedish National Diabetes Register” EASD 2014