Using insulin pump therapy in poorly controlled type 2 diabetes.
The purpose of this pilot/feasibility study was to evaluate the use of insulin regimens among individuals with poorly controlled type 2 diabetes. In addition, a secondary aim was to build the body of evidence regarding the use of insulin pumps in patients with type 2 diabetes.



The setting was a suburban private endocrinology practice. Patients were a convenience sample of 15 adults, aged 40 to 64 years with poorly controlled type 2 diabetes, as defined by a hemoglobin A1C (A1C) of 8% or higher when continuous subcutaneous insulin infusion (CSII) was initiated. Baseline, 3-month, 6-month, and 1-year A1C, body mass index (BMI), basal and bolus insulin use, and number of office visits were collected through medical record review. Descriptive, independent, and paired t tests were used to evaluate data.



A significant reduction in basal insulin use was found. Significant reductions in A1Cs were found at 3 months, 6 months, and 1 year. A significant increase in BMI was noted.



Results indicated improvement in glycemic control with CSII for some patients with an associated increase in BMI. Reduction of basal insulin use was significant and, for some, cost effective using CSII. Current policies regarding CSII use in patients with type 2 diabetes need to be re-evaluated.
Wolff-McDonagh
Phyllis
P
The Graduate School of Nursing, Robert Morris University, Moon Township, Pennsylvania
Kaufmann
Judith
J
The Graduate School of Nursing, Robert Morris University, Moon Township, Pennsylvania
Foreman
Stephen
S
The Graduate School of Nursing, Robert Morris University, Moon Township, Pennsylvania
Wisotsky
Steven
S
The Graduate School of Nursing, Robert Morris University, Moon Township, Pennsylvania
Wisotsky
Jo Ann
JA
The Graduate School of Nursing, Robert Morris University, Moon Township, Pennsylvania
Wexler
Craig
C
The Graduate School of Nursing, Robert Morris University, Moon Township, Pennsylvania
D000328:Adult; D048909:Diabetes Complications / Q000453:epidemiology / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000534:rehabilitation; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010353:Patient Education as Topic; D014481:United States / Q000453:epidemiology
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin