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A comparison of multiple daily insulin therapy with continuous subcutaneous insulin infusion therapy in adolescents with type 1 diabetes mellitus: a single-center experience from Turkey.
J Pediatr Endocrinol Metab. 2009 Jun; 22(6):539-45.JP

Abstract

AIM

To compare the long-term outcomes of continuous subcutaneous insulin infusion (CSII) pump therapy with the clinical and metabolic parameters recorded during multiple daily insulin (MDI) therapy.

PATIENTS AND METHODS

CSII pump was used by volunteer adolescents, who had a duration of diabetes mellitus (DM) longer than one year, regularly attended periodic examinations for the last year, measured and recorded blood glucose levels on average 3 to 4 times a day, and did not achieve the preferred metabolic control even though the use of MDI therapy. Carbohydrate counting and flexible MDI therapy was taught to these patients before CSII pump implantation. The metabolic and clinical parameters of the patients for the post-CSII pump period were compared with the data of flexible and non-flexible MDI periods.

RESULTS

The mean CSII pump implantation age of the 17 adolescents enrolled in the study was 15.53 +/- 1.8 years, duration of DM 6.77 +/- 4.05 years, flexible MDI injection duration 0.70 +/- 0.20 years, and duration of CSII pump use 2.07 +/- 1.12 years. A decrease was detected in HbA(1c) levels of the patients with transition to CSII pump compared to flexible and non-flexible MDI injection periods; however, this decrease was not statistically significant (7.71%, 8.21%, and 8.71%, respectively, p = 0.105). No statistically significant difference was detected in frequency of hypoglycemia, lipid profiles, total daily insulin requirement, and BMI SDS values of the patients when data of the post-CSII pump state were compared with that of flexible and non-flexible MDI therapy groups.

CONCLUSION

In adolescents, it was found that CSII pump therapy is efficient and safe without any increased risk for weight gain and hypoglycemia compared to flexible and non-flexible MDI injection periods. The present study also demonstrated that flexible MDI injection therapy might be efficiently and safely used in patients who cannot receive CSII pump therapy due to social and/or financial factors.

Authors+Show Affiliations

Abaci A
Division of Endocrinology, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey.
Atas A
No affiliation info available
Unuvar T
No affiliation info available
Demir K
No affiliation info available
Bober E
No affiliation info available
Büyükgebiz A
No affiliation info available

MeSH

AdolescentDiabetes Mellitus, Type 1Drug Administration ScheduleGlycated Hemoglobin AHumansHyperglycemiaHypoglycemic AgentsInfusion Pumps, ImplantableInjections, SubcutaneousInsulinInsulin Infusion SystemsLife StyleMale

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19694201

Citation

Abaci, Ayhan, et al. "A Comparison of Multiple Daily Insulin Therapy With Continuous Subcutaneous Insulin Infusion Therapy in Adolescents With Type 1 Diabetes Mellitus: a Single-center Experience From Turkey." Journal of Pediatric Endocrinology & Metabolism : JPEM, vol. 22, no. 6, 2009, pp. 539-45.
Abaci A, Atas A, Unuvar T, et al. A comparison of multiple daily insulin therapy with continuous subcutaneous insulin infusion therapy in adolescents with type 1 diabetes mellitus: a single-center experience from Turkey. J Pediatr Endocrinol Metab. 2009;22(6):539-45.
Abaci, A., Atas, A., Unuvar, T., Demir, K., Bober, E., & Büyükgebiz, A. (2009). A comparison of multiple daily insulin therapy with continuous subcutaneous insulin infusion therapy in adolescents with type 1 diabetes mellitus: a single-center experience from Turkey. Journal of Pediatric Endocrinology & Metabolism : JPEM, 22(6), 539-45.
Abaci A, et al. A Comparison of Multiple Daily Insulin Therapy With Continuous Subcutaneous Insulin Infusion Therapy in Adolescents With Type 1 Diabetes Mellitus: a Single-center Experience From Turkey. J Pediatr Endocrinol Metab. 2009;22(6):539-45. PubMed PMID: 19694201.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of multiple daily insulin therapy with continuous subcutaneous insulin infusion therapy in adolescents with type 1 diabetes mellitus: a single-center experience from Turkey. AU - Abaci,Ayhan, AU - Atas,Ali, AU - Unuvar,Tolga, AU - Demir,Korcan, AU - Bober,Ece, AU - Büyükgebiz,Atilla, PY - 2009/8/22/entrez PY - 2009/8/22/pubmed PY - 2009/9/23/medline SP - 539 EP - 45 JF - Journal of pediatric endocrinology & metabolism : JPEM JO - J Pediatr Endocrinol Metab VL - 22 IS - 6 N2 - AIM: To compare the long-term outcomes of continuous subcutaneous insulin infusion (CSII) pump therapy with the clinical and metabolic parameters recorded during multiple daily insulin (MDI) therapy. PATIENTS AND METHODS: CSII pump was used by volunteer adolescents, who had a duration of diabetes mellitus (DM) longer than one year, regularly attended periodic examinations for the last year, measured and recorded blood glucose levels on average 3 to 4 times a day, and did not achieve the preferred metabolic control even though the use of MDI therapy. Carbohydrate counting and flexible MDI therapy was taught to these patients before CSII pump implantation. The metabolic and clinical parameters of the patients for the post-CSII pump period were compared with the data of flexible and non-flexible MDI periods. RESULTS: The mean CSII pump implantation age of the 17 adolescents enrolled in the study was 15.53 +/- 1.8 years, duration of DM 6.77 +/- 4.05 years, flexible MDI injection duration 0.70 +/- 0.20 years, and duration of CSII pump use 2.07 +/- 1.12 years. A decrease was detected in HbA(1c) levels of the patients with transition to CSII pump compared to flexible and non-flexible MDI injection periods; however, this decrease was not statistically significant (7.71%, 8.21%, and 8.71%, respectively, p = 0.105). No statistically significant difference was detected in frequency of hypoglycemia, lipid profiles, total daily insulin requirement, and BMI SDS values of the patients when data of the post-CSII pump state were compared with that of flexible and non-flexible MDI therapy groups. CONCLUSION: In adolescents, it was found that CSII pump therapy is efficient and safe without any increased risk for weight gain and hypoglycemia compared to flexible and non-flexible MDI injection periods. The present study also demonstrated that flexible MDI injection therapy might be efficiently and safely used in patients who cannot receive CSII pump therapy due to social and/or financial factors. SN - 0334-018X UR - https://www.unboundmedicine.com/medline/citation/19694201/A_comparison_of_multiple_daily_insulin_therapy_with_continuous_subcutaneous_insulin_infusion_therapy_in_adolescents_with_type_1_diabetes_mellitus:_a_single_center_experience_from_Turkey_ DB - PRIME DP - Unbound Medicine ER -
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