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Insulin Pumps for Adults with Type 1 Diabetes: A Review of Clinical Effectiveness, Cost-effectiveness and Guidelines

Published on: December 10, 2015
Project Number: RC0731-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of insulin pumps versus multiple daily injections for adults with type 1 diabetes?
  2. What is the comparative clinical effectiveness of insulin pump models with continuous glucose monitors versus standard insulin pumps for adults with type 1 diabetes?
  3. What is the cost-effectiveness of insulin pumps for adults with type 1 diabetes?
  4. What are the evidence-based guidelines for insulin delivery in adults with type 1 diabetes?

Key Message

The clinical effectiveness of CSII versus MDI in adult patients or in pregnant women with type 1 diabetes remains uncertain. Insulin pumps with integrated CGM (SAPT) appear to have better glycemic control without increasing the risk of hypoglycemia compared with MDI. We did not identify relevant evidence on the comparative clinical effectiveness of insulin pumps plus CGM compared with standard insulin pump in adults with type 1 diabetes. CSII may not be cost-effective compared with MDI. According to the guidelines, glycemic targets in adults with type 1 diabetes can be achieved with MDI or CSII. CSII therapy is recommended for patients who are unable to maintain a satisfactory glycemic control with MDI.

Tags

artificial pancreas, diabetes mellitus, infusion pumps, insulin, insulin infusion systems, diabetes, medical devices, Type 1, diabetes type 1, insulin pump, juvenile diabetes, subcutaneous insulin, type 1 diabetes