Comparison of continuous subcutaneous insulin infusion and multiple daily insulin injections in Chinese patients with type 2 diabetes mellitus

Yang, Honghong; Heng, Xueyuan; Liang, Cuige; Liu, Xiaomeng; Wen, Du; Li, Shoujie; Wang, Yue-Li; Dong, Qingyu; Li, Wenxia; Pan, Zhenyu; Gong, Qian; Gao, Guan-Qi

doi:10.1177/0300060514533523

Cited by 8 publications

(9 citation statements)

References 20 publications

(25 reference statements)

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“…Bodur et al explained that continuous SC insulin infusion could avoid extra problems brought by IV insulin infusions including 100-fold dilution (50 IU in 50 mL) which may bring slight variations in the preparation of the final syringe and change the concentration of insulin considerably, adsorption of insulin to the surface of the syringe and the lines, and sharing the lumens of central catheters where other treatments are streamed with the potential for interference with infusion rates. 44 We would like to provide an additional explanation; that is, evidence has shown that continuous SC insulin infusion could significantly reduce the total daily insulin dose and achieve significantly lower incidence of hypoglycemia compared with multiple daily insulin SC injections, 106 and the studies by Bodur et al and Furnary et al used different protocols (ie, the former study compared continuous IV infusion with continuous SC infusion, whereas the latter study compared continuous IV infusion with sliding-scale-guided intermittent SC insulin injections).…”

Section: Discussionmentioning

confidence: 99%

“… 110 Reducing the dosing frequency of IV Velcade ® from twice-weekly to once-weekly significantly reduced severe peripheral neuropathy (28% versus 8%, P <0.001) but did not affect the efficacy. 111 Continuous SC insulin infusion is superior to multiple daily insulin SC injections regarding efficacy and incidence of hypoglycemia in Chinese patients with type 2 diabetes mellitus 106 ) Formulation characteristics (SC high-concentration MTX versus SC medium-concentration MTX, rHuPH20-facilitated SC trastuzumab versus IV trastuzumab, rHuPH20-facilitated SC-IG versus IV-IG, rHuPH20-facilitated SC ceftriaxone versus SC ceftriaxone) 9 , 43 , 62 Administration time (SC versus IV: insulin during pre-, intra-, and postoperative periods) 47 Indication (SC versus IV ketamine for different purposes [postoperative analgesia and dissociative conscious sedation]) 57 , 58 Flexibility in the route of administration (eg, among prescribing patterns of morphine including IV-to-oral, IV-to-SC, IV-only, SC-only and mixed mode, the mixed mode achieves the best clinical outcomes) 64 Health care staff-/institution-related factors Knowledge (IM epinephrine versus SC or IV epinephrine) 85 Human resources (nursing shortages [SC-IG versus IV-IG]). 38 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

Jin¹,

Zhu²,

Chen³

et al. 2015

PPA

114

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BackgroundIntravenous (IV), intramuscular (IM), and subcutaneous (SC) are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods.MethodsA literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies.Results“SC better than IV” involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. “IV better than SC” involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. “IM better than IV” involves epinephrine, hepatitis B immu-noglobulin, pegaspargase, and some antibiotics. “IV better than IM” involves ketamine, morphine, and antivenom. “IM better than SC” involves epinephrine. “SC better than IM” involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles governing the choice of injection route. Safety and efficacy must be the preferred principles to be considered (eg, epinephrine should be given intramuscularly during an episode of systemic anaphylaxis). If the safety and efficacy of two injection routes are equivalent, clinicians should consider more about patient preference and pharmacoeconomics because patient preference will ensure optimal treatment adherence and ultimately improve patient experience or satisfaction, while pharmacoeconomic concern will help alleviate nurse shortages and reduce overall health care costs. Besides the principles, the following detailed factors might affect the decision: patient characteristics-related factors (body mass index, age, sex, medical status [eg, renal impairment, comorbidities], personal attitudes toward safety and convenience, past experience, perception of current disease status, health literacy, and socioeconomic status), medication administration-related factors (anatomical site of injection, dose, frequency, formulation characteristics, administration time, indication, flexibility in the route of administration), and health care staff/institution-related factors (knowledge, human resources).ConclusionThis updated review of findings of comparative studies of different injection routes will enrich the knowledge of safe, efficacious, economic, and patient preference-oriented medication administration as well as...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

Jin¹,

Zhu²,

Chen³

et al. 2015

PPA

114

View full text Add to dashboard Cite

show abstract

“…It has been suggested that short-term intensive insulin therapy can rapidly relieve glucose toxicity due to high glucose levels, ameliorate the state of insulin resistance and restore islet b-cell function in persons with poorly controlled T2DM [1,2]. As a real-time regulation therapy, CSII is potentially the best and strongest intensive glucoselowering intervention currently available [3,4]. However, glycemic fluctuations and hypoglycemia are unavoidable risks associated with CSII [5,6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Vildagliptin Added to Continuous Subcutaneous Insulin Infusion (CSII) in Hospitalized Patients with Type 2 Diabetes

Lyu

Huang

et al. 2020

Diabetes Ther

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Introduction: The aim of this study was to compare the efficacy of vildagliptin as add-on therapy to short-term continuous subcutaneous insulin infusion (CSII) with CSII monotherapy in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods: A total of 200 hospitalized patients with inadequately controlled T2DM were randomized into groups, with one group receiving CSII monotherapy (CSII group, n =100) and the other group receiving CSII plus vildagliptin as add-on (CSII ? Vig group, n = 100). Of these, 191 completed the 7-day trial (CSII group, n = 99; CSII ? Vig group, n = 92) and included in the analysis. The glycemic control and variability of the patients were measured using allday capillary blood glucose (BG) monitoring. Weight and fasting C-peptide levels were evaluated before and after the interventions. Results: Mean BG concentrations during the whole treatment period were lower and the time to reach target BG was reduced in the CSII ? Vig group compared with the CSII group (9.89 ± 3.37 vs. 9.46 ± 3.23 mmol/L, P \ 0.01; 129 ± 4 vs. 94 ± 5 h, P \ 0.01, respectively). Similarly, the indicators of glycemic variability, namely the standard deviation of BG and the largest amplitude of glycemic excursion, were significantly decreased in the CSII ? Vig group compared with the CSII group (2.68 ± 1.05 vs. 2.39 ± 1.00 mmol/L, P \ 0.01; 7.19 ± 2.86 vs. 6.23 ± 2.73 mmol/L, P \ 0.01, respectively). Conclusions: Short-term CSII with vildagliptin as add-on therapy may be an optimized treatment for hospitalized patients with T2DM compared with short-term CSII monotherapy.

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“…At the time of diagnosis, β -cell function may be reduced by as much as 50% compared with healthy control subjects and will progressively deteriorate over time, irrespective of lifestyle and pharmacological interventions, as revealed in the UK Prospective Diabetes Study [ 1 ]. Recent studies have suggested that short-term intensive insulin therapy, with continuous subcutaneous insulin infusion (CSII) potentially being the best current therapeutic option [ 2 , 3 ], can rapidly relieve newly diagnosed T2DM patients of high glucose toxicity, ameliorate the state of insulin resistance, and restore islet β -cell function [ 4 , 5 ]. However, glycemic variability and hypoglycemia are risks associated with this type of therapy [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Continuous Subcutaneous Insulin Infusion and Add-On Therapy with Sitagliptin in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

Wan

Zhao

Shen

et al. 2016

Journal of Diabetes Research

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To identify a new regimen to optimize treatment for patients with newly diagnosed type 2 diabetes (T2DM) by short-term continuous subcutaneous insulin infusion (CSII) alone. Methods. 60 patients with newly diagnosed T2DM were randomized into two groups (n = 30 each) and treated for 2 weeks with CSII alone (CSII group) or with CSII plus sitagliptin (CSII + Sig group). The glycemic variability of the patients was measured using a continuous glucose monitoring system (CGMS) for the last 72 hours. A standard meal test was performed before and after the interventions, and the levels of glycated albumin, fasting glucose, fasting C-peptide, postprandial 2 h blood glucose, and postprandial 2 h C-peptide were examined. Results. Compared with the CSII group, the indicators of glycemic variability, such as the mean amplitude of glycemic excursion (MAGE) and the standard deviation of blood glucose (SDBG), were decreased significantly in the CSII + Sig group. The changes before and after treatment in the C-peptide reactivity index (ΔCPI) and the secretory unit of islet in transplantation index (ΔSUIT) indicated a significant improvement in the CSII + Sig group. Conclusions. Add-on therapy with sitagliptin may be an optimized treatment for patients with newly diagnosed T2DM compared with short-term CSII alone.

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Comparison of continuous subcutaneous insulin infusion and multiple daily insulin injections in Chinese patients with type 2 diabetes mellitus

Cited by 8 publications

References 20 publications

The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

Efficacy of Vildagliptin Added to Continuous Subcutaneous Insulin Infusion (CSII) in Hospitalized Patients with Type 2 Diabetes

Comparison of the Effects of Continuous Subcutaneous Insulin Infusion and Add-On Therapy with Sitagliptin in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

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