Insulin pump reduces mortality from cardiovascular disease in type 1 diabetes

by Bruce Sylvester: Persons with type 1 diabetes and who use an insulin pump have achieved half the mortality risk from cardiovascular disease compared to take those multiple daily injections.

The findings appeared on August 11, 2015  in the British Medical Journal.

Using data from the Swedish National Diabetes Register, the investigators monitored outcomes for 18,168 Swedes with type 1 diabetes from 2005 to 2012.

They noted that 2,441 of the subjects used insulin pump therapy, and the others took multiple daily injections.

All subjects were monitored from the baseline until death, first cardiovascular incident or December 31,  2012. Mean follow-up period was 6.8 years, with a total of 114,135 person years.

The primary endpoints were fatal or non-fatal coronary heart disease, fatal or non-fatal cardiovascular disease, fatal cardiovascular disease, and total mortality

With multiple daily injections as reference, the adjusted hazard ratios for insulin pump treatment were significantly lower, at 0.55 (95% confidence interval 0.36 to 0.83) for fatal coronary heart disease, 0.58 (0.40 to 0.85) for fatal cardiovascular disease (coronary heart disease or stroke), and 0.73 (0.58 to 0.92) for all-cause mortality

“We carefully analyzed the findings to eliminate the risk of bias or confounding and concluded that the effect had been fully verified,” said lead author Isabelle Steineck, MD, physician and researcher at Sahlgrenska Academy in Gothenberg, Sweden.

The researchers concluded, “Among people with type 1 diabetes, use of insulin pump therapy is associated with lower cardiovascular mortality than treatment with multiple daily insulin injections.”

“This is good news for anyone with type 1 diabetes,” said Soffia Gudbjörnsdottir, MD, diabetologist and director of the Swedish National Diabetes Register. “But not everybody wants to use a pump, and the biggest priority is still to optimize blood glucose monitoring.”