Six RCTs (including two crossover trials) with 165 participants were included. Three trials had an adequate randomisation method and two used ITT analysis but none reported adequate allocation concealment or use of blinding.
Glycaemic control was significantly better in the insulin pump group (continuous subcutaneous insulin infusion) compared with patients receiving multiple daily injections both at the end of the trial (five RCTs; pooled weighted mean difference for glycosylated haemoglobin -0.24, 95% CI: -0.41. -0.07) and at three months (three RCTs; pooled weighted mean difference -0.29, 95% CI: -0.47, -0.11). Heterogeneity was not significant.
Daily insulin dose was significantly lower in the insulin pump group (pooled weighted mean difference -0.22, 95% CI: -0.31, -0.14). This finding was based on three RCTs (74 participants) without significant heterogeneity.
The risk of diabetic ketoacidosis (reported in two RCTs) and severe hypoglycaemia (four RCTs) did not differ significantly between groups. Results for other outcomes were reported.