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Effectiveness of intensive insulin therapy by multiple daily injections and continuous subcutaneous infusion: a comparison study in type 2 diabetes with conventional insulin regimen failure.
Horm Metab Res. 2007 Mar; 39(3):224-9.HM

Abstract

OBJECTIVE

To compare the effectiveness of two intensified insulin regimens, i.e., pump delivery versus multiple daily injections in patients with type 2 diabetes not optimally controlled with conventional insulin therapy.

RESEARCH DESIGN AND METHODS

Seventeen type 2 diabetes patients uncontrolled by two daily injections of regular plus NPH were randomly assigned in a cross-over fashion to either three daily injections of lispro plus NPH or pump device delivering lispro. HbA1c, 6 points capillary blood glucose, 24-hour continuous glucose monitoring system tracings and global satisfaction score were evaluated at the end of each 12-week treatment period.

RESULTS

HbA1c decreased from 9.0+/-1.6% to 8.6+/-1.6% with multiple injections and 7.7+/-0.8% with pump device (p<0.03). Capillary blood glucose was lowered at all time-points with pump, but only at morning with multiple injections (p<0.01). Compared to conventional therapy, pump reduced hyperglycemic area under curve by 73% (p<0.01), but multiple injections by only 32% (p=0.08). Rate of hypoglycemia was not increased and patient's satisfaction was comparable with both intensive treatments.

CONCLUSIONS

Pump therapy provides a better metabolic control than injection regimens, and seems to be safe and convenient in patients with type 2 diabetes who fail to respond to conventional insulin therapy.

Authors+Show Affiliations

Division of Endocrinology and Metabolic Diseases, Caen University Hospital, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17373639

Citation

Berthe, E, et al. "Effectiveness of Intensive Insulin Therapy By Multiple Daily Injections and Continuous Subcutaneous Infusion: a Comparison Study in Type 2 Diabetes With Conventional Insulin Regimen Failure." Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme, vol. 39, no. 3, 2007, pp. 224-9.
Berthe E, Lireux B, Coffin C, et al. Effectiveness of intensive insulin therapy by multiple daily injections and continuous subcutaneous infusion: a comparison study in type 2 diabetes with conventional insulin regimen failure. Horm Metab Res. 2007;39(3):224-9.
Berthe, E., Lireux, B., Coffin, C., Goulet-Salmon, B., Houlbert, D., Boutreux, S., Fradin, S., & Reznik, Y. (2007). Effectiveness of intensive insulin therapy by multiple daily injections and continuous subcutaneous infusion: a comparison study in type 2 diabetes with conventional insulin regimen failure. Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme, 39(3), 224-9.
Berthe E, et al. Effectiveness of Intensive Insulin Therapy By Multiple Daily Injections and Continuous Subcutaneous Infusion: a Comparison Study in Type 2 Diabetes With Conventional Insulin Regimen Failure. Horm Metab Res. 2007;39(3):224-9. PubMed PMID: 17373639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of intensive insulin therapy by multiple daily injections and continuous subcutaneous infusion: a comparison study in type 2 diabetes with conventional insulin regimen failure. AU - Berthe,E, AU - Lireux,B, AU - Coffin,C, AU - Goulet-Salmon,B, AU - Houlbert,D, AU - Boutreux,S, AU - Fradin,S, AU - Reznik,Y, PY - 2007/3/22/pubmed PY - 2007/5/26/medline PY - 2007/3/22/entrez SP - 224 EP - 9 JF - Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme JO - Horm Metab Res VL - 39 IS - 3 N2 - OBJECTIVE: To compare the effectiveness of two intensified insulin regimens, i.e., pump delivery versus multiple daily injections in patients with type 2 diabetes not optimally controlled with conventional insulin therapy. RESEARCH DESIGN AND METHODS: Seventeen type 2 diabetes patients uncontrolled by two daily injections of regular plus NPH were randomly assigned in a cross-over fashion to either three daily injections of lispro plus NPH or pump device delivering lispro. HbA1c, 6 points capillary blood glucose, 24-hour continuous glucose monitoring system tracings and global satisfaction score were evaluated at the end of each 12-week treatment period. RESULTS: HbA1c decreased from 9.0+/-1.6% to 8.6+/-1.6% with multiple injections and 7.7+/-0.8% with pump device (p<0.03). Capillary blood glucose was lowered at all time-points with pump, but only at morning with multiple injections (p<0.01). Compared to conventional therapy, pump reduced hyperglycemic area under curve by 73% (p<0.01), but multiple injections by only 32% (p=0.08). Rate of hypoglycemia was not increased and patient's satisfaction was comparable with both intensive treatments. CONCLUSIONS: Pump therapy provides a better metabolic control than injection regimens, and seems to be safe and convenient in patients with type 2 diabetes who fail to respond to conventional insulin therapy. SN - 0018-5043 UR - https://www.unboundmedicine.com/medline/citation/17373639/Effectiveness_of_intensive_insulin_therapy_by_multiple_daily_injections_and_continuous_subcutaneous_infusion:_a_comparison_study_in_type_2_diabetes_with_conventional_insulin_regimen_failure_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-970423 DB - PRIME DP - Unbound Medicine ER -