The Effectiveness of Insulin Pumps in Reducing the Hemoglobin A1c (HbAlc) Judy Li, Nursing Student Faculty Advisor: Dr. Nancy Staggers University of Maryland Baltimore, School of Nursing ABSTRACT Insulin pumps have become a popular form of blood glucose control for diabetic patients. Nurses should be informed of the effectiveness of blood sugar monitoring techniques and technology to improve care and educate patients with type II diabetes. The literature findings in diabetes journals indicate that insulin pumps are more effective in reducing the Hemoglobin A1c (HbA1c), compared to conventional methods, but the strength of the results vary with limitations. There is little difference between the average two HbAlc values of patients using insulin pumps and conventional treatments. For future, studies, more good quality studies need to be conducted on the effectiveness of insulin pumps. PURPOSE The purpose of this project is to evaluate the effectiveness of insulin pumps in reducing the Hemoglobin A1c (HbA1c) levels of patients with type II diabetes, compared to conventional methods, such as multiple daily injections and oral antidiabetic medications through literature reviews of evidenced based practice.
Strengths include randomized controlled studies, large sample sizes, and long time frame to monitor HbAlc levels
Weakness includes insufficient evidence to show that insulin pumps are more effective in controlling blood glucose
Nurses should be informed about insulin pumps through evidenced based practice and research to provide optimal care
Future studies should be conducted for longer periods of time, and include randomized controlled trials and more quantitative data
BACKGROUND Type II diabetes, a chronic disease defined by insulin resistance, has been a growing epidemic in the United States. Patients must manually check their blood glucose levels routinely to determine how much oral or injected insulin is needed before meals and bedtime. Insulin pump is a medical device that administers insulin through a syringe or pen, while monitoring blood glucose and counting carbs simultaneously. METHODS AND LITERATURE PROFILE The databases used are Google Scholars, PubMed, and EBSCO-host (CINAHL). The keywords used are “Insulin Pumps”, “Insulin Pumps and Type II Diabetes”, “Effectiveness of Insulin Pumps on Type II Diabetes”, and “Insulin Pumps Hemoglobin A1c”. Inclusions criteria included published date from 2005-present, recently added, full text, free PDF, English, Adult: 19-44 years, articles and patents, and with all of the words “Insulin Pumps” in the title of the articles. The volume of literature available ranged from 8 to 11,200 results. Of the results, 30 were reviewed and 8 were useful. The evidence type included retrospective analysis, randomized controlled, quasi experimental, and pilot studies.
Insulin pumps reduced the average HbAlc further than conventional methods
Insulin pumps and conventional methods did not reduce the HbAlc to 7%, which is the recommendation of the American Diabetes Association
Blood glucose- blood sugar levels
Hyperglycemia- high blood glucose in the blood
Hypoglycemia- low blood glucose in the blood
Hemoglobin A1c (HbA1c)- blood test that shows average blood glucose level for the past two to three months