Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18168 people with type 1 diabetes: observational study

摘要

STUDY QUESTION Is there any difference in the risk of cardiovascular disease, coronary heart disease, and all cause mortality in people with type 1 diabetes who receive insulin through a pump or by multiple daily injections? SUMMARY ANSWER Insulin pump therapy is associated with a lower risk of cardiovascular mortality than multiple daily injections of insulin among people with type 1 diabetes. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Administration of insulin with a pump might result in fewer episodes of hyperglycaemia and hypoglycaemia than multiple daily injections. In people with type 1 diabetes insulin pump therapy is associated with significantly lowered adjusted hazard ratios for fatal coronary heart disease, fatal cardiovascular disease, and all cause mortality, as well as non-significant reductions in hazard ratios for non-fatal or fatal cardiovascular disease.