ArticleDiabetes, obesity & metabolism2025
The impact of insulin pump therapy compared to multiple daily injections on complications and mortality in type 1 diabetes: A real-world retrospective cohort study.
Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Life-threatening acute complications persist among individuals with type 1 diabetes in Japan: A nationwide registry-based cross-sectional study.Journal of diabetes investigation · 2026Article
- Five-year systemic complications in diabetic retinopathy with integrated optical coherence tomography angiography and glycated hemoglobin.Frontiers in medicine · 2026Article
- Insulin Deficiency Exacerbates Muscle Atrophy and Osteopenia inInternational journal of molecular sciences · 2025Article
- The impact of insulin pump therapy compared to multiple daily injections on complications and mortality in type 1 diabetes: A real-world retrospective cohort study.Diabetes, obesity & metabolism · 2025Article
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
aimsClinical trials have demonstrated the benefits of insulin pump therapy compared with multiple daily injections (MDI) in type 1 diabetes. However, contemporaneous real-world data are limited. This study investigated the real-world impact of insulin pump therapy compared with MDI. MATERIALS AND
methodsA retrospective cohort study of adults with type 1 diabetes was performed on the TriNetX platform, a global network providing access to anonymised medical records. Outcomes analysed include HbA1c, diabetic ketoacidosis, macro- and microvascular complications and all-cause mortality. The five-year follow-up period, between January 2018 and March 2025, was divided into time windows for analysis.
results95 122 individuals with type 1 diabetes were identified. After propensity score matching for confounders including age, ethnicity, gender, chronic kidney disease, retinopathy, HbA1c and microalbuminuria, 17 124 patients remained in both the pump and MDI cohorts. The absolute reduction in HbA1c was comparable at five years (-5.3 mmol/mol [-0.5%] in the pump group and -4.5 mmol/mol [-0.4%] in MDI). Overall mortality was lower (RR = 0.716 [95% CI 0.639-0.803], p < 0.001) in those on a pump compared to MDI. The occurrence of diabetic ketoacidosis was lower in the pump group compared to MDI (RR = 0.848 [95% CI 0.786-0.915], p < 0.001). The risk of diabetic retinopathy was increased in the pump group (RR = 1.331 [95% CI 1.247-1.420], p < 0.001).
conclusionsInsulin pump therapy was associated with lower all-cause mortality and risk of diabetic ketoacidosis, but an increased risk of diabetic retinopathy compared with MDI. This result should be interpreted with caution due to potential differences in retinal screening frequency and subsequent bias.
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