Many diabetics may get insulin easier and more effectively from a small automatic pump put inside their bodies than from daily injections, according to a cooperative study by researchers at Veterans Affairs Medical Centers and Johns Hopkins.
"Our results show the implantable pump has significant advantages and can improve quality of life for many people with non-insulin dependent (type II) diabetes mellitus," says Christopher Saudek, M.D., the study's lead author and director of Hopkins' diabetes center. The year-long study was funded by the Department of Veterans Affairs and conducted at seven Veterans Affairs Medical Centers across the country.
Published in the Oct. 23 issue of the Journal of the American Medical Association, it is the first large, prospective, randomized, controlled clinical trial to compare the risks and benefits of the implantable insulin pump with daily insulin injections for non-insulin dependent diabetes.
Researchers studied 105 type II diabetic men, ages 40 to 69, who were receiving at least one insulin injection a day. Results show both the pump and injections effectively controlled blood glucose levels, but the pump reduced fluctuations in blood glucose and reduced the incidence of mild hypoglycemia by 68 percent compared with injections. The pump also eliminated weight gain associated with injections and yielded better quality of life for patients. Mechanical problems with the pump, however, occasionally caused inadequate insulin to be delivered in 25 percent of patients.
More than 500 people around the world use implantable insulin pumps, which are not yet commercially available. The small, disc-shaped units are placed surgically into the abdomen. A new supply of insulin is injected into the pump's reservoir every several weeks. Insulin pumps also can be worn outside the body.
In diabetes mellitus, the pancreas does not produce enough insulin, the hormone that aids absorption of glucose into cells for energy and fat storage. This causes the blood sugar level to rise. Complications include high blood pressure, heart disease, kidney damage, blindness and nerve damage. More than 90 percent of diabetics have type II diabetes; one-third of type II diabetics are treated with insulin. Other type II diabetics use dietary measures, weight loss and oral medication to keep their conditions under control.
Saudek receives research support from MiniMed Technologies, Inc., manufacturers of the pumps used in this study, and serves on the company's medical advisory board.