In adults, the reduction in A1C was .30 percent for those on a pump vs. those on shots. The researchers didn't find any significant difference in the risk of severe hypoglycemia between the two, Golden said.
One limitation of this analysis is that some of the studies used what's known as regular insulin in the pumps, which isn't standard clinical practice today, according to the study. Most pumps use a faster-acting synthetic insulin. Also, most of the studies were small and involved only type 1 diabetes in whites.
The use of continuous glucose monitors compared to self blood-glucose monitoring lowered A1C levels by .26 percent without increasing levels of severe hypoglycemia. And, the sensor-augmented pump reduced A1C levels by .68 percent compared to self blood-glucose monitoring in people with type 1 diabetes.
Golden said what matters most with any of these devices is adherence.
Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, agreed. "There are very good developments in technology that can really help patients and make their lives easier, but the patient has to be motivated," he said.
Zonszein said he was surprised that this analysis didn't find a benefit for the pump in preventing hypoglycemia. He said in his practice he sees fewer severe hypoglycemia episodes in his patients on pumps. But, he said that may be because this was a "meta-analysis" that combines different populations of people and different study designs.
"The only way to really know the comparative effectiveness would be to do a crossover study where each person spent several weeks using each technology," he explained.
Learn more about continuous glucose monitoring from JDRF.
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