In Type 1 diabetic patients with good glycaemic control, blood glucose variability is lower during continuous subcutaneous insulin infusion than during multiple daily injections with insulin glargine

Bruttomesso, Daniela; Crazzolara, Dalia; Maran, Alberto; Costa, Silvana Daher; Pos, Michela Dal; Girelli, Angela; Lepore, Giuseppe; Aragona, M; Iori, Elisabetta; Valentini, U; Prato, Stefano Del; Tiengo, Antonio; Buhr, Andreas; Trevisan, Roberto; Baritussio, Aldo

doi:10.1111/j.1464-5491.2007.02365.x

Cited by 127 publications

(98 citation statements)

References 29 publications

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“…Several randomized clinical trials, usually on small samples of patients, comparing CSII using short-acting analogs and multiple daily injections (MDI) have been performed, reporting either a similar efficacy of the two approaches [6][7][8][9][10][11][12][13][14][15][16] or a superiority of CSII [17,18]. A meta-analysis on patient-level data from three clinical trials suggests an improvement of HbA1c with CSII (with lispro) as compared with MDI [19].…”

Section: Introductionmentioning

confidence: 99%

Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: A Meta-analysis

Monami¹,

Lamanna²,

Marchionni³

et al. 2009

Exp Clin Endocrinol Diabetes

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Continuous subcutaneous insulin infusion (CSII) is considered an option for type 1 diabetic patients unsatisfactorily controlled with multiple daily injections (MDI). Short-acting analogs are superior to regular human insulin in CSII. This meta-analysis is aimed at assessing the advantages of short-acting analog-based CSII over MDI in type 1 diabetes. Randomized clinical trials (RCTs) comparing CSII (with analogs) and MDI for at least 12 weeks in type 1 diabetic patients were retrieved, assessing between-group differences in HbA1c and incidence of hypoglycemia. A total of 11 RCTs was included in the analysis. CSII was associated with a significant improvement of HbA1c in comparison with MDI (standardized difference in mean: -0.3 [-0.4;-0.1]%; P \ 0.001). No significant difference was observed in the rate of severe hypoglycemic episodes. The reduction of HbA1c with CSII was evident in trials enrolling patients with mean age greater than 10 years, but not in younger children. Available data justify the use of CSII for basal-bolus insulin therapy in type 1 diabetic patients unsatisfactorily controlled with MDI.

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Section: Introductionmentioning

confidence: 99%

Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: A Meta-analysis

Monami¹,

Lamanna²,

Marchionni³

et al. 2009

Exp Clin Endocrinol Diabetes

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show abstract

“…5,6,[12][13][14] In the present study, results showed that CSII therapy could also significantly reduce the total daily insulin dose compared with MDI therapy in Chinese patients with type 2 diabetes mellitus. The incidence of hypoglycaemia during CSII therapy was also significantly lower than that during MDI therapy.…”

Section: Discussionmentioning

confidence: 56%

“…[5][6][7] Evidence suggests that CSII also appears to be a good alternative for the treatment of patients with type 2 diabetes mellitus who do not respond to MDI regimens. 8 In China, neutral protamine hagedorn (NPH)-based MDI and CSII methods for glycaemic control are routinely used for hospitalized patients with type 2 diabetes mellitus.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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Objective: To investigate prospectively the insulin dose requirements of Chinese patients with type 2 diabetes mellitus treated with either multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII) therapy during a 2-week therapeutic intervention. Methods: Patients with type 2 diabetes mellitus were randomly assigned to MDI or CSII therapy. The effects of the two treatment methods were determined based on blood glucose parameters, total daily insulin dose and rates of hypoglycaemia. Results: A total of 609 patients were enrolled in the study. Glycaemic goals were achieved after a mean AE SD of 6.90 AE 2.10 and 5.44 AE 2.22 days' treatment in the MDI and CSII groups, respectively. Once stabilized, the mean AE SD total daily insulin doses were 37.12 AE 10.19 IU and 32.58 AE 8.78 IU for the MDI and CSII groups, respectively. Once stabilized, the mean AE SD total basal and bolus doses were 19.46 AE 7.95 IU/day and 17.66 AE 3.53 IU/day for the MDI group, and 22.79 AE 7.55 IU/ day and 9.81 AE 2.64 IU/day for the CSII group, respectively. There were significant differences in the total, basal and bolus insulin doses between the two groups. Conclusion: CSII therapy may be considered as an effective method to achieve good glycaemic control in Chinese patients with type 2 diabetes mellitus.

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“…Among previous studies conducted on this issue, Abaci et al (8) have not reported any changes in lipid values of T1DM patients, who received CSII treatment and were followed up for a mean duration of 2 years. In another study conducted on T1DM patients it has been reported that CSII treatment had no effect on serum lipid levels (18).…”

Section: Discussionmentioning

confidence: 99%

Insulin Pump Therapy: Its Effect on Metabolic Control in Different Age Groups in Children with Type 1 Diabetes

Özen¹,

Gökşen²,

Demir³

et al. 2014

jpr

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ABS tRACtÖzet Aim: To evaluate the effect of continuous subcutaneous insulin infusion (CSII) pump treatment on metabolic control in different age groups in children with type 1 diabetes mellitus. Materials and Methods: Fifty-nine children and adolescents with type 1 diabetes, aged between 2.4-18.3 years, with diabetes duration of 7.4±4.0 years, in whom CSII was performed were divided into 4 groups according to their ages at baseline of CSII. Metabolic control was evaluated according to body measurements before and after CSII treatment, daily basal insulin requirements (u/kg-day), hemoglobin A1c and lipid levels. Children were evaluated at the end of the first and second years of treatment. Results: At the end of the first year a significant and sustained decreases were observed in the mean hemoglobin A1c levels in pre-school and preadolescent groups (from 8.91±0.52% to 6.83±0.68%; from 7.15±0.56% to 6.73±0.45%, p<0.05, respectively), whereas insignificant decreases were observed in groups 3 and 4. At the end of the 2 nd year in overall evaluation, mean hemoglobin A1c levels decreased persistently but insignificantly. Better diabetic control with lower basal insulin requirement was provided with insulin pump treatment. There was no significant changes in serum total cholesterol, low density lipoprotein, and high density lipoprotein levels. Significant increase in body mass index (BMI), standard deviation score (SDS) with CSII treatment was only detected in group 3 (-0.2 vs 0.46 kg/m 2 , p=0.00). Conclusion: Although CSII has a positive effect on metabolic control in type 1 diabetes mellitus treatment at all age groups of childhood, it is prominent and sustained especially at preschool and preadolescent periods. However, it is difficult to sustain the same positive effect in the older age groups. CSII treatment provides a better diabetic control without increased basal insulin requirements. The Journal of Pediatric Research 2014;1(3):147-51 Key Words: Childhood, insulin infusion systems, type 1 diabetes mellitus Amaç: Sürekli cilt altı insülin infüzyon (SCİİ) tedavisinin metabolik kontrol üzerine olan etkisini çocukluk çağındaki farklı yaş gruplarına göre değerlendirmek. Gereç ve Yöntem: Yaşları 2,4 ile 18,3 yıl arasında değişen, diyabet süreleri 7,4±4,0 yıl, insülin infüzyon tedavisi uygulanan 59 tip 1 diyabetes mellitus (T1DM) tanılı çocuk ve ergen SCİİ tedavisi başlangıcındaki yaşlarına göre 4 gruba ayrıldı. Hastaların SCİİ tedavisi başlanması öncesi ve sonrasında vücut ölçümleri, günlük bazal insülin ihtiyaçları (ü/kg/gün) metabolik kontrol değerlendirmek amacıyla hemoglobin A1c (HbA1c) ve lipid düzeyleri çalışıldı. SCİİ tedavisinin 1. ve 2. yılında olgular değerlendirildi. Bulgular: Pompa tedavisinin 12. ayından sonra okul öncesi ve ergen öncesi gruplarda ortalama HbA1c de anlamlı ve kalıcı bir azalma (sırası ile %8, 91±0,52'den 6,83±0,68'e ve %7,15±0,56'dan %6,73±0,45'e, p<0,05) saptanırken grup 3 ve 4'de anlamlı olmayan azalma gözlendi. İnsülin pompa tedavisi ile daha düşük bazal insülin ihtiyacı ile daha...

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In Type 1 diabetic patients with good glycaemic control, blood glucose variability is lower during continuous subcutaneous insulin infusion than during multiple daily injections with insulin glargine

Abstract: During CSII, glucose variability is lower, glycaemic control better and treatment satisfaction higher than during MDI with glargine.

Cited by 127 publications

References 29 publications

Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: A Meta-analysis

Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: A Meta-analysis

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

Insulin Pump Therapy: Its Effect on Metabolic Control in Different Age Groups in Children with Type 1 Diabetes

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