Study Favors Insulin Pump Vs Daily InjectionsOctober 11, 2013
October 11, 2013
A cross-sectional study by Signe Rosenlund, MD, of Steno Diabetes Center in Gentofte, Denmark, showed that patients using insulin pumps were associated with less arterial stiffness compared to those who underwent multiple daily injections.
The patients who received treatment via subcutaneous insulin infusion through the pump had a noticeably slower pulse wave velocity of 9.3 m/s as compared to the 10.4 m/s in patients who received their insulin via injection.
According to Dr. Rosenlund, "Pulse wave velocity is an important predictor of cardiovascular disease and cardiovascular endpoints, so if pump treatment in some way either protects the vessels or can modify pulse wave velocity, it would be clinically very relevant because heart disease is still a problem in diabetes patients,"
In the measurement of arterial stiffness, aortic pulse wave velocity is more direct and precise than pulse pressure. A tonometer is used in the test to measure pressure waves inside the arteries. The device is first placed externally over the carotid artery, followed by the femoral artery in order to measure results. Slower waves would indicate arterial patency and plasticity, while faster waves would indicate stiffness.
Prior studies have established a relationship between type 1 diabetes and arterial stiffness, with the presence of diabetes complications showing a higher pulse wave velocity. Another study has associated insulin pump treatment with reduced glucose variability and improved glycemic control, both of which might have beneficial effects on vascular function.
According to Dr. Rosenlund, a precise explanation for the lower pulse wave velocity in patients using an insulin pump remains unclear. However, she and her group have plans to perform an extended follow-up of the patients to explore potential mechanisms as well as hold randomized trials to confirm any of the potential benefits observed in the cross-sectional study.
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