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Adolescents with type 1 diabetes who use insulin pumps achieve better blood-sugar levels than do adolescents who use other methods, according to a new study.
Those using insulin pumps also required fewer hospitalizations and emergency room visits, the study found.
But even with the pump many children and teens still fail to achieve good blood-sugar control, the study found.
Good control is important because it can reduce the risk of developing some of the complications of diabetes, such as heart and kidney disease, later in life.
The study, published this week online by the Journal of Pediatrics, looked at blood-sugar control in over 2,700 children and teens with type 1 diabetes, also sometimes called insulin-dependent diabetes or juvenile-onset diabetes.
The study is part of the larger research project called the SEARCH for Diabetes in Youth Study.
Children and teens from from six states, including Washington state, and four Native American populations in Arizona and New Mexico participated.
The study found that less than half of the children and teens were using insulin regimens, called basal-bolus therapies, that have been shown to achieve the best blood-sugar control.
Patients using these basal-bolus regimens either use an insulin pump or a long-acting insulin to maintain a base level of insulin through the day and then give themselves a bolus of insulin as needed with meals or when their blood sugars are high.
More than one in four of the children and teens in the study were using regimens that rely on just one or two injections daily, an older regimen that typically achieves poor blood-sugar control, said the study’s lead author Dr. Carolyn Paris, an emergency medicine specialist at Seattle Children’s.
The study found that control was worse among the older children and teens, with more than 70 percent of adolescents having A1C measurements, an indicator of blood-sugar control, above the recommended level of 7.5 percent.
Those using an insulin pump in general had better control and were less likely to have problems with dangerously low blood sugar levels.
Pump users were also less likely to have episodes of diabetic ketoacidosis, a condition in which diabetes goes dangerously out of control, or require treatment in the emergency room or hospital.
Still, on average, even those using the pumps failed to bring their A1C levels down to recommended levels.
Minorities, in particularly African Americans, were less likely to use a basal-bolus regimen than non-hispanic whites, the study found. Insulin pump uses was more common among non-hispanic whites and those from higher-income families and with parents with more education.
Dr. Paris said the results show that much more needs to be done to help these patients and their families to manage diabetes.
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