Insulin pump and glucose monitoring improve blood-sugar control for patients with type 1 diabetes

Research Activities, October 2012, No. 386

Sensor-augmented insulin pumps (intensive insulin therapy combined with real-time continuous blood-glucose monitoring) are superior to multiple daily insulin injections and self-monitoring of blood glucose (fingersticks) to lower hemoglobin A1c (the preferred method of assessing blood-sugar control) in patients with type 1 diabetes. That's the conclusion of a research review from the Agency for Healthcare Research and Quality (AHRQ).

The review found an improved quality of life for patients using insulin-intensive therapies and real-time self-monitoring of glucose (sensors attached to the body that continuously measure blood sugar), when the patients wear the sensor at least 60 percent of the time. However, insulin-intensive therapies are expensive and require increased monitoring and engagement with health care professionals, and are not right for every patient. Insulin therapies can be individualized for every patient to accommodate their needs.

Diabetes is a chronic condition that affects nearly 8 percent of Americans. Of the people who have diabetes 90 to 95 percent of them have type 2 diabetes, which is typically characterized as resistance to insulin. Insulin is necessary in order to break down glucose (blood sugar) into energy. Insulin resistance or lack of insulin (type 1 diabetes), or both, can cause severe long-term side effects such as coronary artery disease, chronic kidney disease or retinal damage if untreated. Diabetes can be treated by monitoring glucose levels in the blood and reducing hemoglobin A1c levels, which is done by insulin therapies or through dietary maintenance.

Methods of Insulin Delivery and Glucose Monitoring: A Comparative Effectiveness Review, produced by AHRQ's Effective Health Care Program, summarizes evidence on the effectiveness of intensive insulin therapies in individuals with type 1, type 2 and gestational diabetes. The review suggests additional research is needed to investigate the effectiveness of these treatments in isolation and in specific patient populations.

To access this review and other materials that explore the effectiveness and risks of treatment options for various conditions visit AHRQ's Effective Health Care Program Web site at http://www.effectivehealthcare.ahrq.gov.

Current as of October 2012
Internet Citation: Insulin pump and glucose monitoring improve blood-sugar control for patients with type 1 diabetes: Research Activities, October 2012, No. 386. October 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/research-activities/oct12/1012RA28.html