Improve Clinical Outcomes with Insulin Pump Therapy and Continuous Glucose Monitoring

The revolutionary MiniMed Paradigm® REAL-Time System offers the benefits of both insulin pump therapy and continuous glucose monitoring. Insulin pump therapy is proven to improve patient outcomes versus multiple daily injections (MDI) with long-acting insulin (glargine).1,2 Continuous glucose monitoring as an adjunct to fingersticks is proven to improve these outcomes versus fingersticks alone.3-5

Benefits of Insulin Pump Therapy with Continuous Glucose Monitoring:

  • Works more like the systems of the human body
  • Better detects hypoglycemia for more proactive patient management6,7
  • Reduces HbA1c levels, which reduces the risk of serious diabetes complications2,8

Works More Like the Human Body

  • Continuous glucose monitoring measures glucose levels continuously, like the systems of the human body. Just as the body uses this information to guide insulin release, continuous glucose monitoring helps patients to guide therapy decisions
  • Insulin pump therapy delivers insulin with programmable basal rates and programmable bolus dosing – day or night – to suit unique patient requirements. This is similar to the function of a healthy pancreas9

Continuous Glucose Monitoring is an Important Supplement to Fingersticks and HbA1c Testing

  • Continuous glucose monitoring works more like the human body than HbA1c testing and fingersticks because glucose levels are measured throughout the day and night
  • HbA1c testing is performed at a single point in time, once every 2 to 3 months
  • Fingersticks also measure glucose levels at a single point in time – patients test on average only 4 to 5 times per day

See the REAL picture

Fingersticks show only part of the picture. The Guardian RT System shows the complete picture.

Based on an individual taking 4 fingersticks per day, at the times shown. Continuous glucose monitoring shows highs and lows that these fingersticks may miss.

Insulin Pump Therapy vs. MDI with Long-Acting Insulin

  • Insulin pump therapy works more like a healthy pancreas than MDI with long-acting insulin because it customizes a patient's therapy to his/her unique needs
  • MDI with long-acting insulin locks patients into nonadjustable insulin injections regardless of individual requirements

Better Detects Hypoglycemia for More Proactive Patient Management

By offering the clinical benefits of both insulin pump therapy and continuous glucose monitoring, the MiniMed Paradigm® REAL-Time system enables you and your patients to achieve the following:

  • Better detection of hypoglycemia and hyperglycemia vs. fingersticks alone10-13
  • Reduction in hypoglycemia vs. MDI14,15 and MDI with long-acting insulin (glargine)16

Better Reveals Dangerous Glucose Variability

Continuous glucose monitoring helps reveal glucose variability not tracked by fingersticks or HbA1c testing17

  • 60% of lows may not be revealed when using fingersticks alone18,19
  • HbA1c testing provides a 2 to 3 month average of glucose levels and isn't intended to track highs and lows17
  • Continuous glucose monitoring identifies 4 times more glucose excursions requiring therapy adjustment versus fingersticks alone20

REAL-Time Alarms helped reduce the duration of hypoglycemic excursions21

REAL-Time alarms graph

Patient response to REAL-Time Alarms resulted in a 48% reduction in mean duration of hypoglycemic excursions (from 64.4 minutes to 33.6 minutes)21

Reduces Hypoglycemia vs. MDI with long-acting insulin (glargine)

Insulin pump therapy has been consistently associated with fewer cases of severe hypoglycemia22,23

  • Insulin pump therapy patients showed a 73.8% reduction in the frequency of severe hypoglycemia vs. MDI patients22
  • Insulin pump therapy patients spent only 12.8% of time overnight at BG < 70 mg/dL vs. 34.7% of time overnight spent by MDI with long-acting insulin (glargine) patients24

REAL-Time readings allow patients to take preventative action to avoid potential highs and lows*

REAL-Time readings graph

* Illustrative model only. Not based on actual patient study.

Can Help Reduce HbA1c Levels and Complications

  • Continuous glucose monitoring has been shown to help guide therapy adjustment and, therefore, reduce HbA1c levels versus the use of fingersticks alone25-27
  • Insulin pump therapy helped achieve the HbA1c target of 7% or less in 50% of patients versus only 12% of patients using MDI with long-acting insulin (glargine)28

Continuous glucose monitoring reduces HbA1c levels vs. fingersticks27

CGM vs. Fingersticks

Insulin pump therapy reduces HbA1c vs. MDI with long-acting insulin (glargine)28

Pump Therapy vs. long-acting insulin

Reducing HbA1c levels reduces the risk of long-term diabetes complications.

  • By reducing HbA1c levels, insulin pump therapy and continuous glucose monitoring help to increase a patient's lifespan29,30
  • Each 1% reduction in HbA1c reduces the risk of long-term complications like eye, nerve, kidney and heart diseases by 15% to 30%29,30
1
Hirsch IB, Bode BW, Garg S, et al. Continuous subcutaneous insulin infusion (CSII) of insulin aspart versus multiple daily injection of insulin aspart/insulin glargine in type 1 diabetic patients previously treated with CSII. Diabetes Care. 2005;28(3):533-8.
2
Doyle (Boland) E. A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple daily injections using insulin glargine. Diabetes Care. 2004;27:1554-8.
3
Bode BW, Gross TM, Thornton KR, et al. Continuous glucose monitoring used to adjust diabetes therapy improves glycosylated hemoglobin: a pilot study. Diabetes Research and Clin Practice. 1999;46:183-90.
4
Kaufman FR, Gibson LC, Halvorson M, et al. A pilot study of the continuous glucose monitoring system: clinical decisions and glycemic control after its use in pediatric type 1 diabetic subjects. Diabetes Care. 2001;24(12):2030.
5
Ludvigsson J, Hanas R. Continuous subcutaneous glucose monitoring improved metabolic control in pediatric patients with type 1 diabetes: a controlled crossover study. Pediatrics. 2003;111(5 Pt 1):933-8.
6
Rudolph JW, Hirsch IB. Assessment of Therapy with Continuous Subcutaneous Insulin Infusion in an Academic Diabetes Clinic. Endocr Pract. 2002;8:401-5.
7
Bode BW, Steed RD, Davidson PC. Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in type 1 diabetes. Diabetes Care. 1996;19(4):324-7.
8
American Diabetes Association: Standards of Medical care for Patients with Diabetes Mellitus. Diabetes Care. 2002;25(1):S33-49.
9
Bode BW, Tamborlane WV, Davidson PC. Insulin pump therapy in the 21st century: Strategies for successful use in adults, adolescents, and children with diabetes. Postgraduate Medicine. 2002;111(5):69-77.
10
Derr R, Garrett E, Stacy G, et al. Is HbA1c affected by glycemic instability? Diabetes Care. 2003;26(10): 2728-33.
11
Gross TM, Mastrototaro JJ. Efficacy and Reliability of the Continuous Glucose Monitoring System. DiabetesTechnol Ther. 2000;2(Suppl 1):S19-26.
12
Skyler JS. The economic burden of diabetes and the benefits of improved glycemic control: the potential role of a continuous glucose monitoring system. Diabetes Technol Ther. 2000;2(Suppl 1):S7-12.
13
Kaufman FR, Gibson LC, Halvorson M, et al. A pilot study of the continuous glucose monitoring system: clinical decisions and glycemic control after its use in pediatric type 1 diabetic subjects. Diabetes Care. 2001;24(12):2030.
14
Rudolph JW, Hirsch IB. Assessment of Therapy with Continuous Subcutaneous Insulin Infusion in an Academic Diabetes Clinic. Endocr Pract. 2002;8:401-5.
15
Bode BW, Steed RD, Davidson PC. Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in type 1 diabetes. Diabetes Care. 1996;19(4):324-7.
16
Armstrong D, King AB. A comparison of basal insulin delivery: continuous subcutaneous insulin infusion versus glargine. Diabetes Care. 2003;26(4):1322.
17
Derr R, Garrett E, Stacy G, et al. Is HbA1c affected by glycemic instability? Diabetes Care. 2003;26(10): 2728-33.
18
Gross TM, Mastrototaro JJ. Efficacy and Reliability of the Continuous Glucose Monitoring System. DiabetesTechnol Ther. 2000;2(Suppl 1):S19-26.
19
Skyler JS. The economic burden of diabetes and the benefits of improved glycemic control: the potential role of a continuous glucose monitoring system. Diabetes Technol Ther. 2000;2(Suppl 1):S7-12.
20
Kaufman FR, Gibson LC, Halvorson M, et al. A pilot study of the continuous glucose monitoring system: clinical decisions and glycemic control after its use in pediatric type 1 diabetic subjects. Diabetes Care. 2001;24(12):2030.
21
Bode B, Gross K, Rikalo N, et al. Alarms based on real-time sensor glucose values alert patients to hypo- and hyperglycemia: the guardian continuous glucose monitoring system. DiabetesTechnol Ther. 2004;6(2):105-13.
22
Rudolph JW, Hirsch IB. Assessment of Therapy with Continuous Subcutaneous Insulin Infusion in an Academic Diabetes Clinic. Endocr Pract. 2002;8:401-5.
23
Bode BW, Steed RD, Davidson PC. Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in type 1 diabetes. Diabetes Care. 1996;19(4):324-7.
24
Armstrong D, King AB. A comparison of basal insulin delivery: continuous subcutaneous insulin infusion versus glargine. Diabetes Care. 2003;26(4):1322.
25
Bode BW, Gross TM, Thornton KR, et al. Continuous glucose monitoring used to adjust diabetes therapy improves glycosylated hemoglobin: a pilot study. Diabetes Research and Clin Practice. 1999;46:183-90.
26
Kaufman FR, Gibson LC, Halvorson M, et al. A pilot study of the continuous glucose monitoring system: clinical decisions and glycemic control after its use in pediatric type 1 diabetic subjects. Diabetes Care. 2001;24(12):2030.
27
Ludvigsson J, Hanas R. Continuous subcutaneous glucose monitoring improved metabolic control in pediatric patients with type 1 diabetes: a controlled crossover study. Pediatrics. 2003;111(5 Pt 1):933-8.
28
Doyle (Boland) E. A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple daily injections using insulin glargine. Diabetes Care. 2004;27:1554-1558.
29
American Diabetes Association: Standards of Medical care for Patients with Diabetes Mellitus. Diabetes Care. 2002;25(1):S33-49.
30
Lifetime benefits and costs of intensive therapy as practiced in the diabetes control and complications trial. The Diabetes Control and Complications Trial Research Group. JAMA. 1997;277(5):374-5.