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Resource Utilization With Insulin Pump Therapy for Type 2 Diabetes Mellitus

Peter M. Lynch, MPH; Aylin Altan Riedel, PhD; Navendu Samant, MS; Ying Fan, MS; Tim Peoples, MA; Jenifer Levinson; and Scott W. Lee, MD

A retrospective claims analysis of managed care enrollees with type 2 diabetes mellitus showed that insulin pump therapy reduced antidiabetic drug and healthcare resource use.

We did not include a control group but chose instead to analyze utilization before and after initiation of CSII. Both pre–post and treatment–control group designs are used in the assessment of observational data. The treatment–control group design, while perhaps controlling for temporal changes in diabetes management, suffers from inherent selection  bias issues. That is, subjects who receive an insulin pump for management of their diabetes are likely in a different stage of disease compared with those who do not. We determined that the disadvantages of this type of selection effect outweighed the benefits of this design. The pre–post design (similar to a repeated-measures design in its handling  of the data) offers the advantage of each subject serving as his or her own control, although it is not without limitations. Moreover, the limitation of not having a control group is somewhat mitigated by the use of real-world data, thus showing a possible treatment effect without a clinical study effect.

In conclusion, continuous subcutaneous insulin infusion was associated with significant decreases in antidiabetic drug and healthcare resource utilization, contributing to stability of  care. The evidence from this study indicates that CSII should be considered as an option for patients with T2D who are using MDI and are experiencing a high degree of antidiabetic drug utilization and healthcare resource utilization.

Author Affiliations: From Medtronic, Inc (PML, TP, JL, SWL), Northridge, CA; i3 Innovus (AAR, NS, YF), Eden Prairie, MN.


Funding Source: The study was funded by Medtronic, Inc.


Author Disclosures: Mr Lynch, Mr Peoples, Ms Levinson, and Dr Lee report being employees and stockholders of Medtronic, Inc. Dr Riedel, Mr Samant, and Mr Fan are employees of i3 Innovus, and their company received payment from Medtronic, Inc to complete this analysis. Authorship Information: Concept and design (PML, AAR, JL, SWL); acquisition of data (PML, AAR, YF); analysis and interpretation of data (PML, AAR, NS, YF, TP, JL, SWL); drafting of the manuscript (PML, AAR, NS, TP, SWL); critical revision of the manuscript for important intellectual content (PML, AAR, TP, JL); statistical analysis (PML, AAR, NS, YF); provision of study materials or patients (SWL); obtaining funding (PML); administrative, technical, or logistic support (TP); and supervision (PML, JL, SWL).


Address correspondence to: Peter M. Lynch, MPH, Medtronic, Inc, 18000 Devonshire St, Northridge, CA 91325. E-mail:

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