By: Radha McLean
Researchers at three centers in the United Kingdom have been successful in demonstrating that using an insulin pump helps to control blood sugar and A1c levels, and can assist in preventing serious diabetes complications in a variety of patients-from long-term type 1s with erratic control to children and pregnant women.
These studies were conducted by researchers at hospitals in the towns of Bournemouth, Harrogate and Basildon. All results were published in a report in the June issue of Practical Diabetes International.
A Case of All Gone Wrong
In one case, a 26-year-old woman who had been diagnosed with type 1 at the age of eight had extremely poor control of her A1c levels-they averaged between 15 and 17%. She was hospitalized an average of twice a year for ketoacidosis, suffered from frequent hypoglycemia, and was diagnosed with microalbuminaria in 1995 and retinopathy in 1997.
The following year, she was put on an intensive insulin regimen, which helped control her A1c levels, but she still suffered from frequent ketoacidosis. Finally, she was put on the pump and now maintains better control. Her A1c now averages 8.4%, and she has not been hospitalized.
An Injury Leads to Poor Control
In the case of a 32-year-old man with long-term type 1 (since the age of three), he experienced severe head trauma in a car accident when he was 15 years old. Twelve years later, at 27, he suffered from a hemorrhage, which resulted in weakness along the left side of his body. As a result of his poor mental and physical state, the man maintained poor control of his blood sugars (with an average A1c of 10.7%), he skipped injections, experienced frequent hypos and seizures and wasn’t aware when his blood sugar was low. His situation was further complicated by mood swings, pressure from family members and stress resulting from unemployment.
In March 2000, he decided to go on the pump. He received one week of training on how to use a pump, count carbohydrates and alter his boluses. Since then, his A1c has come down to 8.5%, and he’s exhibited better moods and more self-confidence. His mother says he’s become “a different person.”
Someone With Poor Self-Image
Diagnosed with type 1 at the age of nine, case three began struggling with her weight. During her teens, the woman had several eating disorders and let her sugars run high to stay thin-her A1cs ranged between 12 and 14%. At 21, she developed background retinopathy. She was considering pregnancy, so she took a course on diabetes management, and brought her A1c down to 8.7%. Last year, she chose to do pump therapy, and has been in better control ever since. She says that she understands her diabetes much better and feels more in control on the pump. Also, she was able to lower her insulin doses and keep her weight steady. her A1c is now 6.7%, the lowest level she’s had.
Pump Improves Fetal Growth
In one particular case, a 33-year-old woman named Kate went on the pump during her third pregnancy. During her first two pregnancies, she had hypoglycemia and a premature labor while on a basal/bolus regimen. During her third pregnancy, she avoided hypoglycemia in the first trimester and had normal fetal growth throughout.
Better Control Makes for Happy Teen
Jonathon, a 15-year old who was diagnosed with type 1 in 1998, was skipping school and experienced serious highs and lows while receiving intensive insulin treatment. After going on the pump last year, he says feels a lot more “normal” and enjoys going to school, although his A1c levels are still high.
A Young Girl Likes the Pump Better Than Injections
Lucy, a five-year-old who tried several insulin regimens to avoid hypos, went on the pump last August. Her family says it’s easier to achieve control and plan meals. Also, Lucy likes the fact that she doesn’t have to inject. She has the benefit of special care at a private school, where teachers program her lunchtime boluses.