Insulin Pump and Injections are Comparable in Type 2 Diabetes Control in Older A

Insulin Pump and Injections are Comparable in Type 2 Diabetes Control in Older Adults

In elderly patients with type 2 diabetes, continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) of Lantus and Humalog appear to be equally safe and satisfactory.

Dr. William H. Herman of the University of Michigan Health System, Ann Arbor and colleagues note that although both methods can be effective in maintaining glycemic control, they have not been evaluated in older type 2 diabetic patients.

To do so, the researchers studied 107 patients with a mean age of 66 years who required insulin for treatment of type 2 diabetes. They were randomized to CSII with insulin lispro or MDI with insulin lispro and insulin glargine.

After 12 months, hemoglobin A1c levels were not significantly different between groups. The mean level fell by 1.7% to 6.6% in the CSII group and by 1.6% to 6.4% in the MDI group.

Overall, 81% of CSII patients and 90% of MDI patients experienced at least one episode of minor and self-treated hypoglycemia. There were 3 CSII subjects who experienced episodes of severe hypoglycemia compared with 6 MDI subjects. The difference was not significant.

Technical or mechanical problems were experienced by 76% of CSII patients and 41% of the MDI group. There was no significant difference in weight gain between groups.

Treatment satisfaction improved significantly and to an equivalent extent in both groups, and the researchers conclude that both methods, “achieved excellent glycemic control with good safety and patient satisfaction.”
Diabetes Care 2005;28:1568-1573.