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Insulin pump therapy is associated with reduced risks of short-term diabetes complications

Among young patients with type 1 diabetes, insulin pump therapy, compared with insulin injection therapy, was associated with lower risks of severe hypoglycemia and diabetic ketoacidosis and with better glycemic control during the most recent year of therapy. These are the results of a population-based cohort study published in the „Journal of the American Medical Association“. JAMA, 2017


Type 1 diabetes is the most common metabolic disease in children and adolescents. Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear. Are the rates of severe hypoglycemia and diabetic ketoacidosis lower with insulin pump therapy than with insulin injection therapy in young patients with type 1 diabetes?
To answer these questions researcher conducted a population-based observational study between January 2011 and December 2015 in 350 diabetes centers in Germany, Austria, and Luxembourg. Patients using pump therapy (n = 9814) were matched with 9814 patients using injection therapy.
The Findings: In this population-based observational study including 30 579 young patients with type 1 diabetes, pump therapy, compared with injection therapy, was associated with significantly lower rates of severe hypoglycemia (9.55 vs 13.97 per 100 patient-years) and ketoacidosis (3.64 vs 4.26 per 100 patient-years), and with lower hemoglobin A1c levels (8.04% vs 8.22%) in a propensity score–matched cohort. Also total daily insulin doses were lower for pump therapy compared with injection therapy (0.84 U/kg vs 0.98 U/kg1). There was no significant difference in body mass index between both treatment regimens.

Original publication:
Beate Karges et al: Association of Insulin Pump Therapy vs Insulin Injection Therapy With Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults With Type 1 Diabetes. JAMA 2017; DOI:10.1001/jama.2017.13994