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Lispro in a Pump Provides Better Control Than MDI

In the September 2000 issue of Diabetes Care, researchers report on a study that compared the use of lispro (Humalog) in two forms of intensified therapy: an insulin pump and Multiple Daily Injections (MDI). The report concludes that lispro, when used in a pump, provides better glycemic control with much lower doses of insulin compared to MDI and does not increase the frequency of hypoglycemia. The bottom line: if you have Type 1, you'll do better on a pump.

The study followed 41 adults with Type 1 diabetes who were C-peptide negative, comparing two four-month periods in the open label randomized crossover study. Patients spent four months using a pump and lispro and four months on MDI, with half the group using each regimen at a time. Comparing the pump to MDI, the data showed that using the pump yielded better control as measured by mean HbA1c (7.89 +/- 0.77 vs. 8.24 +/- 0.77, P<0.001) and mean blood sugars (165 +/0 27 vs. 175 +/- 33, P<0.05). Total insulin dose was significantly less when using a pump (38.5 +/- 9.8 vs. 47.3 +/- 14.9, P<0.0001). The number of patients with low blood sugar, defined as <60 mg/dl, was essentially the same (3.9 +/- 4.2 vs. 4.3 +/- 3.9).

This study clearly shows that patients with Type 1 diabetes will achieve better blood sugar control using a pump with lispro than they will using a multiple daily injection regimen.

Comparison of Continuous Subcutaneous Insulin Infusion and Multiple Daily Injection Regimens Using Insulin Lispro in Type 1 Diabetic Patients on Intensified Treatment
Diabetes Care 23:1232-1235,2000

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Posted 7 September 2000

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