Insulin Pump Is As Effective As Multiple Insulin Injections
CSII was as safe and effective as MDI in patients with type 2 diabetes and may be preferable to injections for patients who require intensive insulin treatment.

A group of researchers led by Dr Philip Raskin of the University of Texas in Dallas, USA, conducted an open-label, randomized study to compare the effects of continuous subcutaneous insulin infusion (CSII) using insulin aspart with multiple daily injections (MDI) of insulin. A total of 132 patients with type 2 diabetes and no prior CSII treatment were randomized to 24 weeks of CSII or MDI. The researchers assessed efficacy with concentrations of HbA1c and 8-point blood glucose profiles. Adverse events, hypoglycaemic episodes and findings from laboratory and physical examinations were recorded to assess safety. Treatment satisfaction among patients was measured in a self-administered questionnaire.

The researchers found that HbA1c decreased similarly from baseline to the end of the study in patients treated with CSII (from 8.2% to 7.6%) and MDI (from 8.0% to 7.5%). The 8-point blood glucose values were lower in patients treated with CSII at most time points and were significantly lower 90 minutes after breakfast (167mg/dL versus 192mg/dL, p=0.019). Safety outcomes were similar in both treatment groups. Most patients (93%) preferred CSII to their previous injectable insulin because of its convenience, flexibility and ease of use.

The researchers conclude that CSII was as safe and effective as MDI in patients with type 2 diabetes and may be preferable to injections for patients who require intensive insulin treatment.
Diabetes Care 2003;26:2598-603