NIHR Signal Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes
People with type 1 diabetes offered insulin pumps did not achieve better blood glucose control compared with those using multiple daily injections. Education remains important.
While both groups saw improvements in blood glucose levels and fewer hypoglycaemic episodes (very low blood sugar) over two years, only one in four participants met NICE blood glucose targets. Insulin pump users showed some modest improvements in satisfaction, dietary freedom and daily hassle.
All participants in this NIHR trial attended a training course on managing their insulin levels before randomisation. This is important because previously observed benefits from pump treatment might actually have been a reflection of the training given to them.
Currently just 10% of adults with type 1 diabetes access these training courses. These results support NICE guidelines around the restricted use of insulin pumps and suggest that training improves self-management of the condition. Efforts should therefore be made to encourage training uptake.
People with type 1 diabetes require lifelong treatment with insulin. Doses are adjusted according to food intake, physical activity, and blood glucose level. High or low blood glucose levels lead to serious short and long term complications, however, many people struggle to maintain blood glucose levels within the target range.
Insulin pumps are small devices, about the size of a mobile phone, that deliver a steady flow of insulin. They offer an alternative to multiple daily injections, and may also help people who are unable to achieve blood glucose control. They a Continue reading