Reduction of Glycosylated Hemoglobin Following 6 Months of Continuous Subcutaneous Insulin Infusion in an Indian Population with Type 2 Diabetes

Kesavadev, Jothydev; Balakrishnan, Shyam; Ahammed, Shebeer; Jothydev, Sunitha

doi:10.1089/dia.2008.0128

Cited by 41 publications

(47 citation statements)

References 16 publications

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“…18 Similarly, a study carried out in Indian patients with type 2 diabetes mellitus did not show a significant difference in the total daily insulin dose between MDI and CSII methods. 19 In this present study, the results showed that the mean AE SD insulin dose per unit body weight for the MDI group (0.58 AE 0.18 IU/kg per day) was significantly higher than that for the CSII group (0.48 AE 0.17 IU/kg per day; P < 0.01), which suggests that compared with CSII therapy, the regulation of the basal dose with MDI therapy was not optimal. These data therefore indicate that CSII therapy may be more effective than MDI therapy for Chinese patients with type 2 diabetes mellitus.…”

Section: Discussioncontrasting

confidence: 58%

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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Section: Discussioncontrasting

confidence: 58%

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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“…The difference in mean HbA1c at 6 months from baseline (À0.54%) was statistically significant and subjects also expressed high overall satisfaction level with CSII after 6 months. 15 Subjects were also asked to assess how CSII affected the sexual function and peripheral neuropathic pain. After 6 months of CSII 83% of subjects noted an improvement in sexual function as opposed to when they were using MDI.…”

Section: The Indian Experience With Insulin Pumpsmentioning

confidence: 99%

“…With respect to peripheral neuropathic pain, 87% of subjects reported that they experienced significant reduction in pain after initiation of CSII. 15 In a retrospective analysis of the medical records of 43 patients who were initiated on insulin pump therapy between 2002 and 2007, 33 patients (17 with type 1 diabetes and 16 with type 2 diabetes) who were on CSII were followed for a mean duration of 3.4 years. The study, aimed at evaluating the safety and effectiveness of CSII among recalcitrant diabetes, showed a statistically significant reduction in HbA1c after initiating CSII (prepump 10.7% vs. postpump 8.3%, P < 0.001), and a reduction in frequency of severe hypoglycemia after starting the CSII also occurred with no instances of diabetic ketoacidosis.…”

Section: The Indian Experience With Insulin Pumpsmentioning

confidence: 99%

“…15 Insulin resistance CSII may be an effective therapy to reduce insulin resistance in obese T2DM patients without the deleterious side effects associated with increasing insulin dosage.…”

Section: Indications For Insulin Pump In T2dmmentioning

confidence: 99%

“…This disappearance of neuropathic pain has shown to occur within a period of 10-20 days of initiating insulin pump therapy. 7,15,18 A patient who is on injections with a syringe or insulin pen needs to take injections on a scheduled basis. The insulin pump offers patients more flexibility with respect to meal timings and meal contents.…”

Section: Patients Seeking Improved Qol While On Insulin Shotsmentioning

confidence: 99%

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Use of Insulin Pumps in India: Suggested Guidelines Based on Experience and Cultural Differences

Kesavadev

Das

Unnikrishnan

et al. 2010

Diabetes Technology & Therapeutics

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All type 1 diabetes mellitus (T1DM) subjects and the majority of type 2 diabetes mellitus (T2DM) subjects at one time or another require insulin to sustain life. Syringes and pens are presently the most popular insulin delivery devices. Though in use for more than 3 decades, insulin pumps are now being more commonly used because of their unique ability to continuously infuse insulin, closely mimicking that of physiological secretion from a normal pancreas. Unlike insulin shots with syringes, pump infusion sites need to be changed less frequently. Scientific evidence from published studies have proven added benefit of insulin pumps in improving quality of life, normalizing sugars in recalcitrant diabetes, improving sexual function, and relieving the intractable pain of neuropathy. In the western world, pumps are commonly used with T1DM subjects, whereas in India 80% of pumpers are T2DM subjects. The success of insulin pump therapy depends on selection of the right candidate, extensive education, motivation, and implementing the sophisticated programs with skill. However, all affordable patients are not ideal candidates for pump therapy because for successful continuation of pump therapy other inclusion criteria should also be fulfilled. Among the other indications discussed are a high level of insulin resistance, brittle diabetes, chronic kidney disease on renal replacement therapy, and continuous glucose monitoring pattern strongly suggesting need for a variable basal insulin infusion rate. In International Diabetes Foundation data released in 2009, estimated diabetes prevalence for 2010 is 285 million, representing 6.4% of the world's adult population, with a prediction that by 2030 the number of people with diabetes will have increased to 438 million. Considering this massive growth in T2DM and its propensity after 10-15 years to lead to an insulin-deficient state, available evidence from studies is a compelling indication not to deny the benefits of continuous subcutaneous insulin infusion in selected T2DM subjects. This article aims at suggesting guidelines based on clinical experience and cultural diversity for India and developing countries.What Is an Insulin Pump?

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Current literature in diabetes

2010

Diabetes Metabolism Res

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of diabetes/metabolism. Each bibliography is divided into 26 sections: 1 Reviews; 2 General; 3 Genetics; 4 Epidemiology; 5 Immunology; 6 Obesity; 7 Prediction and Prevention; 8 Intervention: a) General; b) Care; c) Drug Therapy; d)Economics; e) Gene therapy; f) Nursing; g) Nutrition; h) Surgery; i) Transplantation; 9 Pathology and Complications: a) General; b) Cardiovascular; c) Eye disease; d) Gestational and fetal; e) Neurological; f) Podiatrical; g) Renal; 10 Endocrinology & Metabolism; 11 Experimental Studies; 12 Diagnosis and Techniques. Within each section, articles are listed in alphabetical order with respect to author

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Reduction of Glycosylated Hemoglobin Following 6 Months of Continuous Subcutaneous Insulin Infusion in an Indian Population with Type 2 Diabetes

Abstract: Six months of CSII in Asian Indian subjects with type 2 diabetes resulted in a statistically and clinically significant change in HbA1c.

Cited by 41 publications

References 16 publications

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

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

Use of Insulin Pumps in India: Suggested Guidelines Based on Experience and Cultural Differences

Current literature in diabetes

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