The article under review was authored by three researchers including Johnson Stephanie, Matthew Cooper, and Elizabeth Davis. They sought to research on the long-term results of a diabetes diagnosis known as Insulin Pump Therapy. In particular, they used a large population to investigate these outcomes in relation to the type-one diabetes. They used a comparative method where they investigated the diagnostic response of three different sets of patients. These sets of patients included the ones undergoing the Insulin Pump Therapy, those receiving age-based injections, and the individuals whose diagnosis was determined by duration of diabetes or the onset level of HbA. In other words, patients who were undergoing pump therapy were compared to controlled samples of patients who received injection. Importantly, it was a sizeable research comprising of 345 patients and the follow-up was conducted for 7 years. This implies that the research study is very reliable when it comes to determining the effect of Insulin Pump Therapy.
Main Ideas Presented in the Article
There are several important ideas and findings presented in this article with regards to the long-term effect of Insulin Pump Therapy. First, the authors indicate that Insulin Pump Therapy has the capability to improve the control of blood sugar levels. In this regard, they discovered that this improvement can be sustained for a period of at least 7 years. Further, the article indicates that Insulin Pump Therapy improves the HbA significantly. The improvement was also confirmed by the reduction of micro-vascular complications. Essentially, these findings are found to be consistent with other previous RCT studies. As such, they are considered to be more credible and reliable.
Second, the study revealed that there is clear difference between those patients who used Insulin Pump Therapy and the ones who received injections. Children aged from two to seven years showed improvement in HbA when they used the Insulin Pump Therapy (Johnson, Cooper, Jones, & Davis, 2013). On the contrary, the HbA levels of children who received injections, within the same age bracket mentions above, increased across the years. In addition, the researchers noted that the difference between pump cohorts and injection controls increases with the period of exposure to the pump. This is a clear indication that Insulin Pump Therapy is essentially more effective than the use of Injection Therapy when it comes to controlling glycaemic conditions.
Third, the research makes a critical discovery regarding the question of whether children with poor glycaemic can benefit from the Insulin Pump Theory. According to the researchers, it has been misconceived that children whose glycaemic conditions are very poor cannot benefit from the pump therapy. However, the research shows that such patients can benefit from the use of pump therapy. According to their analysis, these patients showed significant improvement in their glycaemic controls after using the pump therapy. In addition, they found that the patients can benefit from the improvement of HbA. This conclusion is based on the fact that the poorer patients are more likely to develop complications. As such, the improvement of the HbA can help them to combat the menace of developing such complications.
The fourth main idea presented in the research touches on the condition of severe hypoglycemia. In this case, the researchers noted that the use of pump therapy can control the severity of hypoglycemia and its recurrence. In that regard, they argue that pump therapy can improve the quality of life significantly. This is based on the fact that patients who undergo pump therapy are capable of controlling their metabolic activities effectively. As such, they do not live in fear that is caused by the uncertainty of when the hypoglycemic conditions can happen. Similarly, the rate of occurrence of hypoglycemic conditions was lower in pump cohort than the injection sample.
The fifth idea relates to the rate of hospitalization among diabetic children and DKA. The researchers indicate that patients undergoing pump therapy face the risk of line disconnection. However, they observed fewer counts of hospitalizations among the pump cohort as compared to the rest. At this point, the researchers revealed that education contributes to the low rate of DKA. In this case, the healthcare providers hold educational and training sessions with the patients as well as families. This training and education program plays a crucial role to ensure that the patients are motivated to monitor their blood sugar level frequently. In addition to motivation, it ensures that they have the willingness and the ability to interpret results. Although this education helps both the patients undertaking pump therapy and those taking injections, the non-pump sample has a higher rate of DKA complications. On the contrary, the pump patients register fewer counts of DKA complications. This implies that the use of Insulin Pump Therapy reduces the DKA while injections are incapable of controlling the complication. As such, these five findings indicate that Insulin Pump Therapy has the capability to improve Glycaemic and metabolic controls. This improvement is achieved by reducing the occurrence of hypoglycemia, rates of DKA complications.
Johnson, S., Cooper, M., Jones, T., & Davis, E. (2013). Long-term outcome of insulin pump therapy in children with type 1 diabetes assessed in a large population-based case–control study. Diabetologia, 56(11), 2392-2400.