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Randomized trial comparing continuous subcutaneous insulin infusion and conventional insulin therapy in type II diabetic patients poorly controlled with sulfonylureas.
Diabetes Care. 1991 Aug; 14(8):738-44.DC

Abstract

OBJECTIVE

To compare the effects of continuous subcutaneous insulin infusion (CSII) and conventional insulin therapy (CIT) in patients with poorly controlled sulfonylurea-treated diabetes mellitus.

RESEARCH DESIGN AND METHODS

Twenty-five patients aged 40-65 yr and poorly controlled with sulfonylureas and without severe diabetic complications comprised the study group. Five patients left the study (3 achieved satisfactory glycemic control without insulin, 1 defaulted, 1 developed ketonuria). Ten patients were treated with CSII and 10 with CIT. Outpatient treatment consisted of CIT (twice-daily injections of regular and NPH insulin) or CSII (basal infusion and prandial boluses of regular insulin).

RESULTS

Glycosylated hemoglobin improved with both methods of insulin delivery (P less than 0.01), but 8 of 10 CSII-treated patients achieved satisfactory glycemic control (HbA1 less than 50 mmol hydroxymethylfurfural/mol Hb), whereas only 3 of 10 CIT-treated patients achieved this (P less than 0.05). Weight gain, insulin dosage, and prevalence of hypoglycemia were similar in the two groups. Retinal deterioration occurred in one CSII-treated patient and three CIT-treated patients, but there were no episodes of infusion site infection or metabolic decompensation. Patients' satisfaction with treatment improved during insulin therapy (P less than 0.02), and significant changes in beliefs about diabetes and its treatment were observed in CSII-treated patients (P less than 0.05).

CONCLUSIONS

Glycemic control improved with both methods of insulin treated patients achieved satisfactory glycemic control (HbA1 less than 50 mmol hydroxymethylfurfural/mol Hb), whereas only 3 of 10 CIT-treated patients achieved this CSII. Patients' satisfaction with treatment improved during insulin therapy.

Authors+Show Affiliations

Royal Hallamshire Hospital, Sheffield, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

1954811

Citation

Jennings, A M., et al. "Randomized Trial Comparing Continuous Subcutaneous Insulin Infusion and Conventional Insulin Therapy in Type II Diabetic Patients Poorly Controlled With Sulfonylureas." Diabetes Care, vol. 14, no. 8, 1991, pp. 738-44.
Jennings AM, Lewis KS, Murdoch S, et al. Randomized trial comparing continuous subcutaneous insulin infusion and conventional insulin therapy in type II diabetic patients poorly controlled with sulfonylureas. Diabetes Care. 1991;14(8):738-44.
Jennings, A. M., Lewis, K. S., Murdoch, S., Talbot, J. F., Bradley, C., & Ward, J. D. (1991). Randomized trial comparing continuous subcutaneous insulin infusion and conventional insulin therapy in type II diabetic patients poorly controlled with sulfonylureas. Diabetes Care, 14(8), 738-44.
Jennings AM, et al. Randomized Trial Comparing Continuous Subcutaneous Insulin Infusion and Conventional Insulin Therapy in Type II Diabetic Patients Poorly Controlled With Sulfonylureas. Diabetes Care. 1991;14(8):738-44. PubMed PMID: 1954811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized trial comparing continuous subcutaneous insulin infusion and conventional insulin therapy in type II diabetic patients poorly controlled with sulfonylureas. AU - Jennings,A M, AU - Lewis,K S, AU - Murdoch,S, AU - Talbot,J F, AU - Bradley,C, AU - Ward,J D, PY - 1991/8/1/pubmed PY - 1991/8/1/medline PY - 1991/8/1/entrez SP - 738 EP - 44 JF - Diabetes care JO - Diabetes Care VL - 14 IS - 8 N2 - OBJECTIVE: To compare the effects of continuous subcutaneous insulin infusion (CSII) and conventional insulin therapy (CIT) in patients with poorly controlled sulfonylurea-treated diabetes mellitus. RESEARCH DESIGN AND METHODS: Twenty-five patients aged 40-65 yr and poorly controlled with sulfonylureas and without severe diabetic complications comprised the study group. Five patients left the study (3 achieved satisfactory glycemic control without insulin, 1 defaulted, 1 developed ketonuria). Ten patients were treated with CSII and 10 with CIT. Outpatient treatment consisted of CIT (twice-daily injections of regular and NPH insulin) or CSII (basal infusion and prandial boluses of regular insulin). RESULTS: Glycosylated hemoglobin improved with both methods of insulin delivery (P less than 0.01), but 8 of 10 CSII-treated patients achieved satisfactory glycemic control (HbA1 less than 50 mmol hydroxymethylfurfural/mol Hb), whereas only 3 of 10 CIT-treated patients achieved this (P less than 0.05). Weight gain, insulin dosage, and prevalence of hypoglycemia were similar in the two groups. Retinal deterioration occurred in one CSII-treated patient and three CIT-treated patients, but there were no episodes of infusion site infection or metabolic decompensation. Patients' satisfaction with treatment improved during insulin therapy (P less than 0.02), and significant changes in beliefs about diabetes and its treatment were observed in CSII-treated patients (P less than 0.05). CONCLUSIONS: Glycemic control improved with both methods of insulin treated patients achieved satisfactory glycemic control (HbA1 less than 50 mmol hydroxymethylfurfural/mol Hb), whereas only 3 of 10 CIT-treated patients achieved this CSII. Patients' satisfaction with treatment improved during insulin therapy. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/1954811/Randomized_trial_comparing_continuous_subcutaneous_insulin_infusion_and_conventional_insulin_therapy_in_type_II_diabetic_patients_poorly_controlled_with_sulfonylureas_ DB - PRIME DP - Unbound Medicine ER -