Insulin Pump May Be A Valuable Option For Difficult Type 2 Diabetes

MedicalResearch.com Interview with:
Professor Yves Reznik
Department of Endocrinology,
University of Caen Côte de Nacre Regional Hospital Center
Caen, France

MedicalResearch: What are the main findings of the study?

Prof. Reznik: OPT2MISE definitively demonstrate that pump therapy is a valuable option for treating those type 2 diabetes patients with uncontrolled hyperglycemia despite a high dose insulin regimen including at least 3 injections per day of rapid-acting and slow-acting insulin analogues, the gold standard for intensified insulin therapy. Such benefit on glucose control is obtained with lower daily insulin doses and without weight gain in comparison with multiple injection therapy. Pump therapy is effective in a population of patients un-preselected for their ability to deal with a medical device.

MedicalResearch: Were any of the findings unexpected?

Prof. Reznik: We were very impressed by the lack of incidence of severe hypoglycemia in the cohort of patients using pump therapy during the 6-month period of the study, and by the very low incidence of severe hyperglycemia since only 2 patients out of 168 experienced an episode of hyperglycemia or ketosis but without ketoacidosis. These results emphasize the safety of pump therapy in this population.

MedicalResearch: What should clinicians and patients take away from your report?

Prof. Reznik: In this difficult population of patients with severe insulin resistance and poor glucose control, complex multiple injection regimens have several limitations such as the burden of dose tracking and scheduling or insulin injection omissions. In this perspective, pump therapy is a valuable therapeutic option.

Furthermore, the finding that patients with mild cognitive impairment did experience the same benefits as the general population suggests that pump treatment can be used effectively by almost all patients, even older ones.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Prof. Reznik: Whereas it’s now proven that currently available insulin pump are effective, those findings still have to be confirmed by future research for more simple and basic T2 designed pumps.

Future studies may also be conducted with use of new concentrated insulin compounds which may enhance pump efficacy.

Citation:

Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial
Dr Yves Reznik MD,Ohad Cohen MD,Ronnie Aronson MD FRCPC FACE,Ignacio Conget MD,Sarah Runzis MSc,Javier Castaneda MSc,Scott W Lee MD,for the OpT2mise Study Group
The Lancet – 3 July 2014
DOI: 10.1016/S0140-6736(14)61037-0

 

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