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Pump cost comparison for private funding
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<blockquote data-quote="tim2000s" data-source="post: 904735" data-attributes="member: 30007"><p>Those were all observational studies, so as you say, observational bias is very likely to be present.When RCTs are taken into account, the comment is:</p><p></p><p>In summary, there is little evidence from the RCTs of a significant difference between CSII and MDI therapy in terms of a decrease in HbA1c levels or in the rate of severe hypoglycaemic episodes in people with diabetes mellitus. Observational studies show a much greater improvement (decrease) in HbA1c levels with CSII therapy, as well as statistically significant decreases in the rate of severe hypoglycaemia episodes. There is no clear evidence of any greater benefit of CSII over MDI therapy in pregnancy.</p><p></p><p>So it almost comes back to anecdotal evidence is what drives decisions about pump funding in the UK. And it also means that the comment on the pump course was in fact incorrect...</p><p></p><p>Or in other words, your first supposition is correct - there is no significant RCT evidence of either improvement in Hba1C or hypo reduction when using a pump. Given the costs, CGM would probably be better. There may, however, be lifestyle improvements that can be gained.</p></blockquote><p></p>
[QUOTE="tim2000s, post: 904735, member: 30007"] Those were all observational studies, so as you say, observational bias is very likely to be present.When RCTs are taken into account, the comment is: In summary, there is little evidence from the RCTs of a significant difference between CSII and MDI therapy in terms of a decrease in HbA1c levels or in the rate of severe hypoglycaemic episodes in people with diabetes mellitus. Observational studies show a much greater improvement (decrease) in HbA1c levels with CSII therapy, as well as statistically significant decreases in the rate of severe hypoglycaemia episodes. There is no clear evidence of any greater benefit of CSII over MDI therapy in pregnancy. So it almost comes back to anecdotal evidence is what drives decisions about pump funding in the UK. And it also means that the comment on the pump course was in fact incorrect... Or in other words, your first supposition is correct - there is no significant RCT evidence of either improvement in Hba1C or hypo reduction when using a pump. Given the costs, CGM would probably be better. There may, however, be lifestyle improvements that can be gained. [/QUOTE]
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