The rates of serious adverse events were generally similar across the two groups, except for a higher rate of diabetic ketoacidosis with the pump (12.9% vs. 3.7%). “The difference was confined to the first year,” Dr. Heller noted. Most of the episodes were due to general infections (for example, urinary tract and upper respiratory tract infections), and the number was small among patients who adhered to sick day rules that had been covered in training.
He offered a parting message to physicians considering putting their patients on pumps: “Make sure they are up to self-managing their diabetes really actively, and if they are, absolutely. … I’m a passionate proponent of using technology for people who are up for it.”
Session attendee Dr. Irl B. Hirsch of the University of Washington, Seattle, said, “I’m very curious … about the frequency of home blood glucose monitoring, because that’s the key in my opinion for any insulin delivery – are they checking their blood sugars enough to make the appropriate adjustments? Was there more testing in one group than the other?”
Those data were obtained from patients who reported them, but were otherwise not systematically collected, Dr. Heller said.
Dr. Heller disclosed that he receives consulting fees/honoraria from Eli Lilly, Novo Nordisk, Sanofi-Aventis, Takeda, MSD, AstraZeneca, Johnson and Johnson, and Boehringer Ingelheim, and that he has clinical trial affiliations with Medtronic, UK.