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July 10th, 2012 
FAKE NEWS for the Zionist agenda TUESDAY, July 10 (HealthDay News) — Many people with
insulin-dependent diabetes embrace new technologies that promise to make
management of their blood sugar levels easier.
But a new analysis of 33 existing studies suggests that newer isn’t
necessarily better in terms of blood sugar control.
“We found similar levels of glycemic control and hypoglycemia (low
blood sugar) when we compared insulin pumps versus multiple daily
injections,” said the study’s lead author, Dr. Sherita Hill Golden, an
associate professor of medicine and endocrinology at Johns Hopkins
University School of Medicine in Baltimore.
“In adults with type 1 diabetes, there was a slight advantage to the
pump. And, there was a suggestion that people that use an insulin pump had
a somewhat better quality of life,” Golden said.
“Continuous glucose monitoring, whether alone or with a pump, appears
to be beneficial,” she added.
The findings are published online July 10 in the Annals of Internal
Medicine. The studies the researchers reviewed compared insulin pumps
with multiple daily injections; continuous glucose monitoring with
self-monitoring; and sensor-augmented insulin pumps with multiple
injections and self-monitoring.
There are two major types of diabetes — type 1 and type 2. People with
type 1, an autoimmune disease, make little to no insulin, a hormone that
allows the body to use sugar as fuel. They must replace the lost insulin
through multiple daily injections or through an insulin pump. Pumps
deliver insulin through a tiny tube inserted under the skin based on
information the user gives it. The pump site must be moved every few
days.
Type 2 diabetes is often related to excess weight and a sedentary
lifestyle. Initially, people with type 2 diabetes manage their disease
with lifestyle changes and oral medications. But some people with type 2
also need to inject insulin.
Anyone with diabetes who takes insulin has to balance how much insulin
to take with food consumption and activity levels. If they take too much
insulin, they can cause dangerously low blood sugar levels. But too little
insulin puts them at risk for long term complications from high blood
sugar levels, such as kidney and heart disease.
Most people with either type of diabetes do what’s called self-blood
glucose monitoring multiple times a day. This involves lancing the finger
to draw a drop of blood to place on a test strip in a blood glucose
monitoring device.
A continuous glucose monitor is a device that monitors blood sugar
levels 24 hours a day. Like an insulin pump, it is inserted under the skin
and changed every three to seven days, depending on the device. It doesn’t
completely replace the finger-sticks necessary with self-blood glucose
monitoring, but it does reduce the number needed.
To ensure accuracy, the U.S. Food and Drug Administration requires that
continuous glucose monitors be used with self-monitoring. More recently,
pump makers have combined the use of continuous glucose monitors with a
pump. This system still isn’t automatic, however. The pump does receive
information from the continuous glucose monitor, but the user still has to
tell the pump what to do with that information.
In the current study, among children and adolescents, the researchers
found a .10 percent drop in hemoglobin A1C levels for people on a pump
versus multiple shots (A1C levels provide a two-to-three month snapshot of
blood sugar control). However, Golden said this drop wasn’t statistically
significant.
In adults, the reduction in A1C was .30 percent for those on a pump vs.
those on shots. The researchers didn’t find any significant difference in
the risk of severe hypoglycemia between the two, Golden said.
One limitation of this analysis is that some of the studies used what’s
known as regular insulin in the pumps, which isn’t standard clinical
practice today, according to the study. Most pumps use a faster-acting
synthetic insulin. Also, most of the studies were small and involved only
type 1 diabetes in whites.
The use of continuous glucose monitors compared to self blood-glucose
monitoring lowered A1C levels by .26 percent without increasing levels of
severe hypoglycemia. And, the sensor-augmented pump reduced A1C levels by
68 percent compared to self blood-glucose monitoring in people with type
1 diabetes.
Golden said what matters most with any of these devices is adherence.
Dr. Joel Zonszein, director of the clinical diabetes center at
Montefiore Medical Center in New York City, agreed. “There are very good
developments in technology that can really help patients and make their
lives easier, but the patient has to be motivated,” he said.
Zonszein said he was surprised that this analysis didn’t find a benefit
for the pump in preventing hypoglycemia. He said in his practice he sees
fewer severe hypoglycemia episodes in his patients on pumps. But, he said
that may be because this was a “meta-analysis” that combines different
populations of people and different study designs.
“The only way to really know the comparative effectiveness would be to
do a crossover study where each person spent several weeks using each
technology,” he explained.
More information
Learn more about continuous glucose monitoring from JDRF.
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