Using insulin pump therapy in poorly controlled type 2 diabetes.

PURPOSE

The purpose of this pilot/feasibility study was to evaluate the use of insulin regimens among individuals with poorly controlled type 2 diabetes. In addition, a secondary aim was to build the body of evidence regarding the use of insulin pumps in patients with type 2 diabetes.

METHODS

The setting was a suburban private endocrinology practice. Patients were a convenience sample of 15 adults, aged 40 to 64 years with poorly controlled type 2 diabetes, as defined by a hemoglobin A1C (A1C) of 8% or higher when continuous subcutaneous insulin infusion (CSII) was initiated. Baseline, 3-month, 6-month, and 1-year A1C, body mass index (BMI), basal and bolus insulin use, and number of office visits were collected through medical record review. Descriptive, independent, and paired t tests were used to evaluate data.

RESULTS

A significant reduction in basal insulin use was found. Significant reductions in A1Cs were found at 3 months, 6 months, and 1 year. A significant increase in BMI was noted.

CONCLUSIONS

Results indicated improvement in glycemic control with CSII for some patients with an associated increase in BMI. Reduction of basal insulin use was significant and, for some, cost effective using CSII. Current policies regarding CSII use in patients with type 2 diabetes need to be re-evaluated.