An overview of so far published analyses comparating the effectiveness of the treatment with insulin pump and multiple daily injections in type 1 diabetes mellitus

Czech version

Authors: T. Hendrychová ¹; P. Matoulková ¹; J. Vlček ¹; A. Šmahelová ²
Authors‘ workplace: Katedra sociální a klinické farmacie Farmaceutické fakulty UK Hradec Králové, přednosta prof. RNDr. Jiří Vlček, CSc. ¹; Klinika gerontologická a metabolická Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Luboš Sobotka, CSc. ²
Published in: Vnitř Lék 2012; 58(2): 89-93
Category: Original Contributions

Overview

The paper brings an overview of published systematic reviews and meta-analyses concerning the evaluation of the effectiveness of the treatment with insulin pump (CSII) in comparison with multiple daily injections (MDI) in type 1 diabetes mellitus. According to found works CSII leads to slightly lower levels of glycosylated hemoglobin (HbA_1c) in patients with type 1 diabetes mellitus against MDI. The levels of HbA_1c and the variability of glycaemia during the day on MDI before an initiation of CSII should serve for the prediction of an effect of CSII in particular patient. Type 1 diabetics on CSII have less often hypoglycaemia, higher flexibility of their daily regime and thus higher satisfaction with their treatment against MDI. The daily doses of insulin decrease. The weight of patients is the same or slightly higher after the initiation of CSII. There were not enough information for the assesment of the frequency of adverse reactions. It is necessary to educate each patient not only how to manipulate the particular insulin pump, but also about general recommendations for the treatment of diabetes and the application of insulin.

Key words:
insulin pump – continuous subcutaneous insulin infusion – multiple daily injections – type 1 diabetes mellitus – effectiveness

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