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Continuous subcutaneous insulin infusion and multiple dose of insulin regimen display similar patterns of blood glucose excursions in pediatric type 1 diabetes.
Diabetes Technol Ther. 2005 Aug; 7(4):587-96.DT

Abstract

BACKGROUND

Continuous subcutaneous insulin infusion (CSII) is believed to decrease glycemic variability and clinical hypoglycemia compared with the multiple daily insulin (MDI) regimen. To compare the indices of glycemic instability between CSII and MDI, we analyzed the continuous glucose monitoring system (CGMS) (Medtronic MiniMed, Northridge, CA) profiles of a group of children with type 1 diabetes mellitus with history of frequent blood glucose (BG) fluctuations and hypoglycemia.

PATIENTS AND METHODS

Data from 14 (nine girls, five boys) patients (3.9-16.8 years old) on CSII and 14 age- and sex-matched (nine girls, five boys) patients (3.9-16.0 years old) on MDI with similar glycemic control (hemoglobin A1c: 7.9 +/- 1.0% vs. 7.9 +/- 1.5%) and body mass index (BMI) (20.1 +/- 4.3 vs. 19.9 +/- 4.1 kg/m(2)) were evaluated by the CGMS. Mean BG (MBG), absolute means of daily differences (MODD), mean amplitude of glycemic excursion (MAGE), and number of hypoglycemic events (BG <60 mg/dL) for 48 h were calculated.

RESULTS

The MBG, MODD, MAGE, and number and mean duration of hypoglycemia events in the CSII group were similar to those in the MDI group. The MAGE had an inverse correlation with age (CSII: r (2) = 0.52, P = 0.003; MDI: r (2) = 0.29, P < 0.04) and BMI (CSII: r (2) = 0.38, P < 0.02; MDI: r (2) = 0.71, P < 0.0002). However, there was a positive relationship between MAGE and bolus:basal insulin ratio in the CSII (r (2) = 0.28, P < 0.05) and MDI (r (2) = 0.33, P < 0.03) groups. Also, the MAGE had a positive correlation with frequency of hypoglycemic events in the CSII (r (2) = 0.44, P < 0.01) and MDI (r (2) = 0.35, P < 0.03) groups.

CONCLUSIONS

The CSII and MDI regimens in children and adolescents with comparable glycemic control displayed similar patterns of glycemic excursions, implying that factors influencing glycemic instability in pediatric type 1 diabetes mellitus appear to be independent of treatment modality.

Authors+Show Affiliations

Children's Hospital of Wisconsin Diabetes Center, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. ralemzad@mcw.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

16120030

Citation

Alemzadeh, Ramin, et al. "Continuous Subcutaneous Insulin Infusion and Multiple Dose of Insulin Regimen Display Similar Patterns of Blood Glucose Excursions in Pediatric Type 1 Diabetes." Diabetes Technology & Therapeutics, vol. 7, no. 4, 2005, pp. 587-96.
Alemzadeh R, Palma-Sisto P, Parton EA, et al. Continuous subcutaneous insulin infusion and multiple dose of insulin regimen display similar patterns of blood glucose excursions in pediatric type 1 diabetes. Diabetes Technol Ther. 2005;7(4):587-96.
Alemzadeh, R., Palma-Sisto, P., Parton, E. A., & Holzum, M. K. (2005). Continuous subcutaneous insulin infusion and multiple dose of insulin regimen display similar patterns of blood glucose excursions in pediatric type 1 diabetes. Diabetes Technology & Therapeutics, 7(4), 587-96.
Alemzadeh R, et al. Continuous Subcutaneous Insulin Infusion and Multiple Dose of Insulin Regimen Display Similar Patterns of Blood Glucose Excursions in Pediatric Type 1 Diabetes. Diabetes Technol Ther. 2005;7(4):587-96. PubMed PMID: 16120030.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Continuous subcutaneous insulin infusion and multiple dose of insulin regimen display similar patterns of blood glucose excursions in pediatric type 1 diabetes. AU - Alemzadeh,Ramin, AU - Palma-Sisto,Paola, AU - Parton,E A, AU - Holzum,M K, PY - 2005/8/27/pubmed PY - 2005/11/8/medline PY - 2005/8/27/entrez SP - 587 EP - 96 JF - Diabetes technology & therapeutics JO - Diabetes Technol Ther VL - 7 IS - 4 N2 - BACKGROUND: Continuous subcutaneous insulin infusion (CSII) is believed to decrease glycemic variability and clinical hypoglycemia compared with the multiple daily insulin (MDI) regimen. To compare the indices of glycemic instability between CSII and MDI, we analyzed the continuous glucose monitoring system (CGMS) (Medtronic MiniMed, Northridge, CA) profiles of a group of children with type 1 diabetes mellitus with history of frequent blood glucose (BG) fluctuations and hypoglycemia. PATIENTS AND METHODS: Data from 14 (nine girls, five boys) patients (3.9-16.8 years old) on CSII and 14 age- and sex-matched (nine girls, five boys) patients (3.9-16.0 years old) on MDI with similar glycemic control (hemoglobin A1c: 7.9 +/- 1.0% vs. 7.9 +/- 1.5%) and body mass index (BMI) (20.1 +/- 4.3 vs. 19.9 +/- 4.1 kg/m(2)) were evaluated by the CGMS. Mean BG (MBG), absolute means of daily differences (MODD), mean amplitude of glycemic excursion (MAGE), and number of hypoglycemic events (BG <60 mg/dL) for 48 h were calculated. RESULTS: The MBG, MODD, MAGE, and number and mean duration of hypoglycemia events in the CSII group were similar to those in the MDI group. The MAGE had an inverse correlation with age (CSII: r (2) = 0.52, P = 0.003; MDI: r (2) = 0.29, P < 0.04) and BMI (CSII: r (2) = 0.38, P < 0.02; MDI: r (2) = 0.71, P < 0.0002). However, there was a positive relationship between MAGE and bolus:basal insulin ratio in the CSII (r (2) = 0.28, P < 0.05) and MDI (r (2) = 0.33, P < 0.03) groups. Also, the MAGE had a positive correlation with frequency of hypoglycemic events in the CSII (r (2) = 0.44, P < 0.01) and MDI (r (2) = 0.35, P < 0.03) groups. CONCLUSIONS: The CSII and MDI regimens in children and adolescents with comparable glycemic control displayed similar patterns of glycemic excursions, implying that factors influencing glycemic instability in pediatric type 1 diabetes mellitus appear to be independent of treatment modality. SN - 1520-9156 UR - https://www.unboundmedicine.com/medline/citation/16120030/Continuous_subcutaneous_insulin_infusion_and_multiple_dose_of_insulin_regimen_display_similar_patterns_of_blood_glucose_excursions_in_pediatric_type_1_diabetes_ L2 - https://www.liebertpub.com/doi/10.1089/dia.2005.7.587?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -