Using an insulin pump may help improve blood glucose control for many people with type 2 diabetes, according to a new study presented at the 2022 Diabetes Technology Meeting and described in a news release from the study’s sponsor, Tandem Diabetes Care.
Insulin pumps have been developed for the use of people with type 1 diabetes, who require different amounts of insulin throughout the day to maintain good blood glucose control. The latest insulin pumps are designed to adjust the rate of insulin delivery based on readings from a sensor — they’re essentially integrated with a continuous glucose monitoring (CGM) system in what’s known as a hybrid closed-loop system. These systems still require some input from users, such as indicating when they’ve eaten a meal and how much carbohydrate that meal contains. Hybrid closed-loop systems have been shown to be safe and effective in both adults and children with type 1 diabetes, helping to improve blood glucose control, and they may also help improve quality of life.
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For the latest study, 30 adults with type 2 diabetes — divided among three different locations in Minnesota, Texas, and New York — used Tandem’s t:slim X2 insulin pump with Control-IQ technology for six weeks. The average age of participants was 54, and they had an average A1C level (a measure of long-term blood glucose control) of 8.6% — indicating room for improvement in glucose control, as an A1c level below 7.0% is widely recommended. Before participating in the study, 15 participants were taking multiple daily insulin injections, 13 were taking only basal (long-acting) insulin, and two were already using an insulin pump. Most participants took other diabetes drugs in addition to insulin, and continued taking these non-insulin diabetes drugs throughout the study. Before the start of the main study period, participants used the CGM side of Tandem’s closed-loop system to get baseline glucose readings — useful for comparing with glucose readings when participants later used the full system with automated insulin delivery. During this preliminary period, participants continued using whatever method of insulin delivery they were using before.
Benefits of pump therapy seen in type 2 diabetes
During the main study period when all participants used Tandem’s closed-loop system, the average amount of time spent in the target blood glucose range of 70-180 mg/dl improved by 15 percentage points, or 3.6 hours each day. For previous users of basal insulin, time in range improved by 13 percentage points, while for those who previously took multiple daily injections it improved by 16 percentage points. At the same time, the amount of time with a glucose level above 180 mg/dl dropped by an average of 15 percentage points among all participants — indicating that it was high, rather than low, glucose levels that were brought into the target range. The median time with a glucose level above 250 mg/dl was reduced by an average of 5.6 percentage points, or nearly an hour each day.
There was no increase in hypoglycemia (low blood glucose) once participants started using the closed-loop system, as shown by CGM readings. There were no other major safety problems reported, and participants indicated an overall “high level of satisfaction” with the system.
“The results presented today are consistent with numerous studies that support the benefits of pump therapy to people who live with type 2 diabetes,” said Jordan Pinsker, MD, vice president and medical director at Tandem Diabetes Care, in the news release. “The combination of safety outcomes and high satisfaction scores […] shows that Control-IQ technology could be a powerful management solution for their therapy needs.”
Want to learn more about insulin pumps? Read “How to Pick an Insulin Pump or CGM” and “Ways to Deliver Insulin: Inhalers and Insulin Pumps.”