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Clínic Barcelona

Type 2 diabetic patients are better controlled with insulin pumps

Efficacy results from the comparison between the use of insulin pumps and multiple injections (OpT2mise trial) could define how this treatment can help in the management of insulin-requiring Type 2 Diabetes. Data obtained after six months show that patients who used the pump therapy safely achieved better glucose control, with 20% less insulin and without significant differences in weight gain.

According to the World Health Organization (WHO), type 2 diabetes affects more than 300 million people worldwide, with about 20 million requiring insulin therapy. The OpT2mise trial shows that these patients achieve better glucose control using insulin pumps than with multiple daily injections. The Lancet has published today the study results, which have also been presented in a late-breaking poster at the American Diabetes Association (ADA) 74th Scientific Sessions in San Francisco. Ignacio Conget, MD, PhD, from the Diabetes Unit of Hospital Clínic de Barcelona and researcher at the IDIBAPS team Diabetes: metabolic and molecular networks, is one of the authors of this work and member of the Steering Committee of this international multicenter trial. Marga Giménez, MD, PhD, from the same department, has also collaborated in the study.

While the benefits of insulin pump therapy are well proven for people with type 1 diabetes, this is the largest trial to evaluate the comparative efficacy of insulin pump therapy versus multiple daily injections in patients with type 2 diabetes with poor glycemic control. To perform the study, MiniMed insulin pumps from Medtronic, a medical technology company, were used. From the 350 patients enrolled in the trial, those using insulin pumps achieved a mean A1C (average blood glucose) reduction of 1.1% compared to only a 0.4% reduction by those using multiple daily injections. Reducing A1C is crucial for people with diabetes, because even a slight decrease significantly contributes in preventing complications. For every 1% drop in A1C, the risk of microvascular complications such as blindness, kidney failure and nerve damage may be reduced by 40%.

Furthermore, during the study, the improvement in glucose control was achieved without any episodes of severe hypoglycemia –when blood sugar becomes very low-, and the pump group lowered the insulin dose by more than 20%. Moreover, between the two groups of patients there were no differences in weight gain.

Thus the OpT2mise study suggests, for the first time, that the use of insulin pumps could be a safe and effective treatment option for those patients who are unable to achieve glucose control despite of using multiple daily insulin injections.

Article Reference:

“Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial”. Yves Reznik, Ohad Cohen, Ronnie Aronson, Ignacio Conget, Sarah Runzis, Javier Castaneda, Scott W Lee, for the OpT2mise Study Group. The Lancet, Early Online Publication, 3 July 2014.