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Benefits of continuous subcutaneous insulin infusion in type 1 diabetes previously treated with multiple daily injections with once-daily glargine and pre-meal analogues.
Exp Clin Endocrinol Diabetes. 2009 Sep; 117(8):378-85.EC

Abstract

BACKGROUND/AIMS

There is insufficient information about the use of continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) using long-acting insulin analogs in relation to possible metabolic consequences and, as well, on the grade of patient satisfaction. The aim of the study was to evaluate the usefulness of CSII treatment in patients with type 1 diabetes in achieving glycemic objectives using continuous glucose monitoring system (CGMS) and in improving patient's satisfaction with treatment.

METHODS

We have studied 45 type 1 diabetic patients treated with MDI with once-daily glargine and pre-meal rapid-acting insulin analogues, and 20 patients who commenced CSII because they had not achieved a good glycemic control.

RESULTS

With CSII, there were significant reductions in insulin requirements (0.75+/-0.21 vs. 0.64+/-0.21 UI/kg/day; p=0.001), HbA (1c) (7.99+/-0.76 vs. 7.19+/-0.51%; p=0.001) and hypoglycemic episodes (4.60+/-1.82 vs. 3.05+/-1.88 events/patient/week; p=0.031) and improved patient satisfaction with treatment. CSII reduced hyperglycemic episodes in 04:00-08 h period (131.65+/-113.49 vs. 69.70+/-101.52 min; p=0.049), 24 h period area-under-the-curve (AUC) (4521.60+/-3689.23 vs. 3000.36+/-493.96 mmol/L x min; p=0.025) and AUC before dinner (217.36+/-181.46 vs. 136.22+/-202.88 mmol/L x min; p=0.048).

CONCLUSIONS

In selected patients with poor metabolic control with once-daily glargine and pre-meal rapid-acting insulin analogues, CSII is a good alternative since it reduces hypoglycemic episodes and insulin requirement and improves glycemic control and patient's satisfaction.

Authors+Show Affiliations

Service of Endocrinology and Nutrition of the Hospital Puerta del Mar, Cádiz, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19629931

Citation

Torres, I, et al. "Benefits of Continuous Subcutaneous Insulin Infusion in Type 1 Diabetes Previously Treated With Multiple Daily Injections With Once-daily Glargine and Pre-meal Analogues." Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, vol. 117, no. 8, 2009, pp. 378-85.
Torres I, Ortego J, Valencia I, et al. Benefits of continuous subcutaneous insulin infusion in type 1 diabetes previously treated with multiple daily injections with once-daily glargine and pre-meal analogues. Exp Clin Endocrinol Diabetes. 2009;117(8):378-85.
Torres, I., Ortego, J., Valencia, I., García-Palacios, M. V., & Aguilar-Diosdado, M. (2009). Benefits of continuous subcutaneous insulin infusion in type 1 diabetes previously treated with multiple daily injections with once-daily glargine and pre-meal analogues. Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, 117(8), 378-85. https://doi.org/10.1055/s-0029-1225337
Torres I, et al. Benefits of Continuous Subcutaneous Insulin Infusion in Type 1 Diabetes Previously Treated With Multiple Daily Injections With Once-daily Glargine and Pre-meal Analogues. Exp Clin Endocrinol Diabetes. 2009;117(8):378-85. PubMed PMID: 19629931.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Benefits of continuous subcutaneous insulin infusion in type 1 diabetes previously treated with multiple daily injections with once-daily glargine and pre-meal analogues. AU - Torres,I, AU - Ortego,J, AU - Valencia,I, AU - García-Palacios,M V, AU - Aguilar-Diosdado,M, Y1 - 2009/07/23/ PY - 2009/7/25/entrez PY - 2009/7/25/pubmed PY - 2009/12/16/medline SP - 378 EP - 85 JF - Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association JO - Exp Clin Endocrinol Diabetes VL - 117 IS - 8 N2 - BACKGROUND/AIMS: There is insufficient information about the use of continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) using long-acting insulin analogs in relation to possible metabolic consequences and, as well, on the grade of patient satisfaction. The aim of the study was to evaluate the usefulness of CSII treatment in patients with type 1 diabetes in achieving glycemic objectives using continuous glucose monitoring system (CGMS) and in improving patient's satisfaction with treatment. METHODS: We have studied 45 type 1 diabetic patients treated with MDI with once-daily glargine and pre-meal rapid-acting insulin analogues, and 20 patients who commenced CSII because they had not achieved a good glycemic control. RESULTS: With CSII, there were significant reductions in insulin requirements (0.75+/-0.21 vs. 0.64+/-0.21 UI/kg/day; p=0.001), HbA (1c) (7.99+/-0.76 vs. 7.19+/-0.51%; p=0.001) and hypoglycemic episodes (4.60+/-1.82 vs. 3.05+/-1.88 events/patient/week; p=0.031) and improved patient satisfaction with treatment. CSII reduced hyperglycemic episodes in 04:00-08 h period (131.65+/-113.49 vs. 69.70+/-101.52 min; p=0.049), 24 h period area-under-the-curve (AUC) (4521.60+/-3689.23 vs. 3000.36+/-493.96 mmol/L x min; p=0.025) and AUC before dinner (217.36+/-181.46 vs. 136.22+/-202.88 mmol/L x min; p=0.048). CONCLUSIONS: In selected patients with poor metabolic control with once-daily glargine and pre-meal rapid-acting insulin analogues, CSII is a good alternative since it reduces hypoglycemic episodes and insulin requirement and improves glycemic control and patient's satisfaction. SN - 1439-3646 UR - https://www.unboundmedicine.com/medline/citation/19629931/Benefits_of_continuous_subcutaneous_insulin_infusion_in_type_1_diabetes_previously_treated_with_multiple_daily_injections_with_once_daily_glargine_and_pre_meal_analogues_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1225337 DB - PRIME DP - Unbound Medicine ER -