Possible benefits of insulin pumps compared with multiple daily injections

The Diabetes Elf, 2012

An appraisal of a 2010 systematic review of continuous subcutaneous insulin infusion (CSII, or insulin pumps) has been published in DARE.
In diabetes, does CSII as compared with multiple daily injections (MDI), improve the clinical or cost-effectiveness of care?
The review included both adults and children with type 1 or type 2 diabetes.  The MDI comparators included newer insulin analogue regimens.  Outcomes included glycaemic control, quality of life and hypoglycaemia.
The review found 16 RCTs and 48 observational studies.  There was, predictably, a great deal of variation between them in terms of patient population, interventions being compared and outcomes assessed.
Several studies were found showing that CSII improved glycaemic control and reduced risk of hypoglycaemia in children.
CSII provided some advantages over MDI in adults and children with type I diabetes, including better control of glucose levels, fewer occurrences of hypoglycaemia, and quality of life gains in terms of greater flexibility of lifestyle.