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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.
Diabet Med. 2008 Mar; 25(3):326-32.DM

Abstract

AIMS

The superiority of continuous subcutaneous insulin infusion (CSII) over multiple daily injections (MDI) with glargine is uncertain. In this randomized cross-over study, we compared CSII and MDI with glargine in patients with Type 1 diabetes well controlled with CSII. The primary end-point was glucose variability.

METHODS

Thirty-nine patients [38.1 +/- 9.3 years old (mean +/- sd), diabetes duration 16.6 +/- 8.2 years, glycated haemoglobin (HbA(1c)) 7.6 +/- 0.8%], already on CSII for at least 6 months, were randomly assigned to CSII with lispro or MDI with lispro and glargine. After 4 months they were switched to the alternative treatment. During the last month of each treatment blood glucose variability was analysed using glucose standard deviation, mean amplitude of glycaemic excursions (MAGE), lability index and average daily risk range (ADRR). As secondary end-points we analysed blood glucose profile, HbA(1c), number of episodes of hypo- and hyperglycaemia, lipid profile, free fatty acids (FFA), growth hormone and treatment satisfaction.

RESULTS

During CSII, glucose variability was 5-12% lower than during MDI with glargine. The difference was significant only before breakfast considering glucose standard deviation (P = 0.011), significant overall using MAGE (P = 0.016) and lability index (P = 0.005) and not significant using ADRR. Although HbA(1c) was similar during both treatments, during CSII blood glucose levels were significantly lower, hyperglycaemic episodes were fewer, daily insulin dose was less, FFA were lower and treatment satisfaction was greater than during MDI with glargine. The frequency of hypoglycaemic episodes was similar during both treatments.

CONCLUSIONS

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

Authors+Show Affiliations

Department of Clinical and Experimental Medicine, Division of Metabolic Diseases, University of Padova, Padova, Italy. daniela.bruttomesso@unipd.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18307459

Citation

Bruttomesso, D, et al. "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." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 25, no. 3, 2008, pp. 326-32.
Bruttomesso D, Crazzolara D, Maran A, et al. 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. Diabet Med. 2008;25(3):326-32.
Bruttomesso, D., Crazzolara, D., Maran, A., Costa, S., Dal Pos, M., Girelli, A., Lepore, G., Aragona, M., Iori, E., Valentini, U., Del Prato, S., Tiengo, A., Buhr, A., Trevisan, R., & Baritussio, A. (2008). 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. Diabetic Medicine : a Journal of the British Diabetic Association, 25(3), 326-32. https://doi.org/10.1111/j.1464-5491.2007.02365.x
Bruttomesso D, et al. 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. Diabet Med. 2008;25(3):326-32. PubMed PMID: 18307459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Bruttomesso,D, AU - Crazzolara,D, AU - Maran,A, AU - Costa,S, AU - Dal Pos,M, AU - Girelli,A, AU - Lepore,G, AU - Aragona,M, AU - Iori,E, AU - Valentini,U, AU - Del Prato,S, AU - Tiengo,A, AU - Buhr,A, AU - Trevisan,R, AU - Baritussio,A, PY - 2008/3/1/pubmed PY - 2008/6/26/medline PY - 2008/3/1/entrez SP - 326 EP - 32 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 25 IS - 3 N2 - AIMS: The superiority of continuous subcutaneous insulin infusion (CSII) over multiple daily injections (MDI) with glargine is uncertain. In this randomized cross-over study, we compared CSII and MDI with glargine in patients with Type 1 diabetes well controlled with CSII. The primary end-point was glucose variability. METHODS: Thirty-nine patients [38.1 +/- 9.3 years old (mean +/- sd), diabetes duration 16.6 +/- 8.2 years, glycated haemoglobin (HbA(1c)) 7.6 +/- 0.8%], already on CSII for at least 6 months, were randomly assigned to CSII with lispro or MDI with lispro and glargine. After 4 months they were switched to the alternative treatment. During the last month of each treatment blood glucose variability was analysed using glucose standard deviation, mean amplitude of glycaemic excursions (MAGE), lability index and average daily risk range (ADRR). As secondary end-points we analysed blood glucose profile, HbA(1c), number of episodes of hypo- and hyperglycaemia, lipid profile, free fatty acids (FFA), growth hormone and treatment satisfaction. RESULTS: During CSII, glucose variability was 5-12% lower than during MDI with glargine. The difference was significant only before breakfast considering glucose standard deviation (P = 0.011), significant overall using MAGE (P = 0.016) and lability index (P = 0.005) and not significant using ADRR. Although HbA(1c) was similar during both treatments, during CSII blood glucose levels were significantly lower, hyperglycaemic episodes were fewer, daily insulin dose was less, FFA were lower and treatment satisfaction was greater than during MDI with glargine. The frequency of hypoglycaemic episodes was similar during both treatments. CONCLUSIONS: During CSII, glucose variability is lower, glycaemic control better and treatment satisfaction higher than during MDI with glargine. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/18307459/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_ DB - PRIME DP - Unbound Medicine ER -