In children and adolescents with type 1 diabetes, insulin pumps have been shown to have several benefits in areas like blood glucose control and cardiovascular outcomes. Exactly why cardiovascular outcomes are better in children who use pumps, though, hasn’t been fully explored.
Now, researchers have shown one way that pump therapy may lead to better heart and blood vessel health: by improving blood levels of lipids, such as cholesterol.
In a study published in the journal Diabetic Medicine, researchers looked at data from 14,290 people ages 18 and under with type 1 diabetes. The average age of participants was about 15, and all of them had had diabetes for at least a year. They took part in medical examinations at sites on every continent except Africa and Antarctica, as noted in a Healio article on the study.
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From this database, the researchers looked at how participants received their insulin and compared this with HDL (“good”) and LDL (“bad”) cholesterol levels. In the 51% of participants who used insulin pumps, the average HDL cholesterol was higher, at 1.55 mmol/l compared with 1.5 mmol/l for the injection group. Average LDL cholesterol was lower in the pump group, at 2.3 mmol/l versus 2.39 mmol/l for the injection group.
While these differences may not seem large, there were stronger signs of lipid improvements when it came to out-of-target-range levels. In the injection group, 41% of participants had an LDL cholesterol level of at least 2.6 mmol/l, a common cutoff for what’s considered to be too high. Only 36% of the pump group had a level at least this high. When insulin doses were taken into account, pump users were found to be 10% less likely to have elevated LDL cholesterol.
Another measure of unhealthy lipid levels, non-HDL cholesterol, was also better in the pump group, with 30% having a level of at least 3.1 mmol/l, compared with 34% of the injection group. After adjusting for overall insulin doses, pump users were found to be 13% less likely to have elevated non-HDL cholesterol.
While these results all seem to indicate a benefit from insulin pumps, the researchers caution that “characteristics of children with access to pump therapy are different from those who do not access pump therapy.” They conclude that “further studies are needed to confirm our observations and explore the potential causes” of the results they observed.
Want to learn more about parenting a child with type 1 diabetes? Read “The Type 1 Diabetes Diagnosis,” “Type 1 Diabetes and Sleepovers or Field Trips,” “Writing a Section 504 Plan for Diabetes,” and “Top 10 Tips for Better Blood Glucose Control.”
A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.
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