Italian Study: Insulin Pumps May Cut Heart Disease Risk in Diabetics

A study from Italy suggests that insulin pump therapy — known clinically as continuous subcutaneous insulin infusion (CSII) — may do more than just improve blood sugar control. After tracking diabetic patients for eight years, researchers at the University of Pavia found that pump users experienced significantly fewer cardiovascular events compared to patients on multiple daily injections (MDI).

What the Italian Researchers Found

Scientists at the Fondazione IRCCS Policlinico San Matteo in Pavia, one of Italy's leading academic medical centers, followed 213 patients with type 1 or type 2 diabetes. Of these, 104 switched from daily injections to an insulin pump, while 109 continued with multiple daily injections. After eight full years of follow-up, the results were striking:

• Better blood sugar control: Both groups improved their HbA1c over time, but pump users consistently showed lower readings. Fasting plasma glucose (FPG) and after-meal glucose (PPG) were also better controlled in the pump group.
• Fewer heart events: Pump users had fewer cases of atrial fibrillation, premature ventricular contractions, heart attacks (acute coronary infarction), angina, heart failure, and peripheral vascular ischemia.
• No increase in dangerous low blood sugar: Despite tighter glucose control, pump users did not experience more hypoglycemia episodes — a key safety concern for many patients and physicians.
• One exception: No reduction in ischemic stroke was observed between the two groups.

Understanding the Numbers: US Units

Italian clinical studies typically report blood glucose in millimoles per liter (mmol/L). For US patients accustomed to mg/dL, here's what typical benchmark values look like in familiar terms:

• A fasting glucose of 7.0 mmol/L = 126 mg/dL (the US diagnostic threshold for diabetes)
• A post-meal target of 10.0 mmol/L = 180 mg/dL (aligned with the American Diabetes Association's post-meal ceiling)
• An HbA1c goal of under 7% is consistent across both Italian and US guidelines from the ADA

The Italian researchers' HbA1c and glucose targets in this study are broadly consistent with current American Diabetes Association (ADA) standards of care, making their findings directly relevant to US clinical practice.

Why This International Perspective Matters

Italy's universal healthcare system allowed researchers to track patients consistently over eight years — a longer follow-up than most US insurance-driven studies can support. This long-term, real-world data from a different healthcare environment strengthens the case that insulin pump benefits are not a short-term effect, adding meaningful evidence that US clinicians can apply when advising patients weighing pump therapy.

Why This Matters for US Patients

Heart disease remains the leading cause of death among Americans with diabetes, accounting for roughly 50% of all deaths in this population. If insulin pumps can meaningfully reduce cardiovascular events — as this Italian data suggests — the implications for the nearly 37 million Americans living with diabetes are substantial. Currently, the ADA recommends pump therapy primarily for blood sugar management; evidence of cardiac benefit could eventually influence broader prescribing guidelines. The researchers themselves caution that their observational study needs confirmation through a randomized clinical trial, but call the findings promising enough to consider pump therapy for motivated patients at higher cardiovascular risk.

The Bottom Line

This Italian research adds an important international voice to the growing conversation about insulin delivery methods. If you are a US patient with diabetes and elevated heart disease risk, this study is worth discussing with your endocrinologist — particularly if you are currently on multiple daily injections and wondering whether a pump might offer additional benefits beyond glucose control.

Source: Derosa G, Catena G, Scelsi L. "Glyco-metabolic control, inflammation markers, and cardiovascular outcomes in type 1 and type 2 diabetic patients on insulin pump or multiple daily injection (italico study)." Diabetes/Metabolism Research and Reviews. 2020. PMID: 31642581. DOI: 10.1002/dmrr.3219