Pumps that deliver insulin to the body may be more effective than insulin injections for people with type 1 diabetes, according to a new review of 23 studies comparing the two approaches.

In people with type 1 diabetes, the body loses the ability to secrete insulin. In order to survive and stay healthy, these individuals must monitor their blood sugar closely and give themselves injections of insulin as needed.

A person may also use an insulin pump, which is worn outside the body and delivers insulin under a person’s skin in the abdominal area.

To compare the two treatments, scientists from Monash University in Clayton, Australia, identified 23 studies in which a total of 976 people with type 1 diabetes were randomly assigned to insulin injections or insulin pumps.

Insulin pump users, the researchers found, had significantly lower hemoglobin A1c levels, on average, than individuals who injected their insulin, indicating better long-term blood sugar control.