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Comparison between sensor-augmented insulin therapy with continuous subcutaneous insulin infusion or multiple daily injections in everyday life: 3-day analysis of glucose patterns and sensor accuracy in children.
Diabetes Technol Ther. 2011 Dec; 13(12):1187-93.DT

Abstract

BACKGROUND

Sensor-augmented continuous subcutaneous insulin infusion (CSII) therapy is superior to CSII therapy alone, but little is known on the effectiveness of sensor-augmented multiple daily injections (MDI) therapy.

METHODS

We compared during everyday life mean glucose control and several variability indexes recorded for 3 days by a real-time glucose sensor (Medtronic, Northridge, CA) in two groups of children treated with either CSII or MDI. Fifty-five consecutive subjects were examined: 17 receiving CSII and 38 receiving MDI basal-bolus therapy (age range, 7-22 years). All subjects wore the sensor for 4 days, and 3 days were used for statistical analysis. Mean glucose and SD, coefficient of variation (CV), mean amplitude of glucose excursion (MAGE), mean of daily differences (MODD), continuous overall net glycemic action (CONGA) at 2 and 4 h, blood glucose (BG) rate, area under the curve (AUC) above 180 mg/dL and below 70 mg/dL, Low BG Index (LBGI), and High BG Index (HBGI) were calculated.

RESULTS

Patients receiving CSII administered more daily boluses than patients receiving MDI (5.2±1.5 vs. 3.2±0.3, respectively; P=0.001). Mean glucose was lower in the CSII group. AUC above 180 mg/dL and HBGI were higher in the MDI group. CV, CONGA at 2 h, CONGA at 2 h during the day, and HBGI were worse in the MDI group, whereas MODD, LBGI, BG rate, and MAGE were similar. A positive correlation (r=0.95; P<0.05) was found between the paired sensor-meter values. For the glucose values <70 mg/dL, sensitivity was 40%, and specificity was 99%.

CONCLUSIONS

In our pediatric patients during everyday life sensor-augmented CSII therapy seemed more effective than sensor-augmented MDI therapy, in terms both of glucose mean values and of intraday variability. Mild hypoglycemic episodes and indexes of low BG values were similar in the two groups, although the latter results may be inaccurate because of low sensor sensitivity at low glucose value.

Authors+Show Affiliations

Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, via Massarenti 11, Bologna, Italy. stefano.zucchini@aosp.bo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

21854193

Citation

Zucchini, Stefano, et al. "Comparison Between Sensor-augmented Insulin Therapy With Continuous Subcutaneous Insulin Infusion or Multiple Daily Injections in Everyday Life: 3-day Analysis of Glucose Patterns and Sensor Accuracy in Children." Diabetes Technology & Therapeutics, vol. 13, no. 12, 2011, pp. 1187-93.
Zucchini S, Scipione M, Balsamo C, et al. Comparison between sensor-augmented insulin therapy with continuous subcutaneous insulin infusion or multiple daily injections in everyday life: 3-day analysis of glucose patterns and sensor accuracy in children. Diabetes Technol Ther. 2011;13(12):1187-93.
Zucchini, S., Scipione, M., Balsamo, C., Maltoni, G., Rollo, A., Molinari, E., Mangoni, L., & Cicognani, A. (2011). Comparison between sensor-augmented insulin therapy with continuous subcutaneous insulin infusion or multiple daily injections in everyday life: 3-day analysis of glucose patterns and sensor accuracy in children. Diabetes Technology & Therapeutics, 13(12), 1187-93. https://doi.org/10.1089/dia.2011.0080
Zucchini S, et al. Comparison Between Sensor-augmented Insulin Therapy With Continuous Subcutaneous Insulin Infusion or Multiple Daily Injections in Everyday Life: 3-day Analysis of Glucose Patterns and Sensor Accuracy in Children. Diabetes Technol Ther. 2011;13(12):1187-93. PubMed PMID: 21854193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between sensor-augmented insulin therapy with continuous subcutaneous insulin infusion or multiple daily injections in everyday life: 3-day analysis of glucose patterns and sensor accuracy in children. AU - Zucchini,Stefano, AU - Scipione,Mirella, AU - Balsamo,Claudia, AU - Maltoni,Giulio, AU - Rollo,Alessandra, AU - Molinari,Emanuela, AU - Mangoni,Lorenza, AU - Cicognani,Alessandro, Y1 - 2011/08/19/ PY - 2011/8/23/entrez PY - 2011/8/23/pubmed PY - 2012/6/26/medline SP - 1187 EP - 93 JF - Diabetes technology & therapeutics JO - Diabetes Technol Ther VL - 13 IS - 12 N2 - BACKGROUND: Sensor-augmented continuous subcutaneous insulin infusion (CSII) therapy is superior to CSII therapy alone, but little is known on the effectiveness of sensor-augmented multiple daily injections (MDI) therapy. METHODS: We compared during everyday life mean glucose control and several variability indexes recorded for 3 days by a real-time glucose sensor (Medtronic, Northridge, CA) in two groups of children treated with either CSII or MDI. Fifty-five consecutive subjects were examined: 17 receiving CSII and 38 receiving MDI basal-bolus therapy (age range, 7-22 years). All subjects wore the sensor for 4 days, and 3 days were used for statistical analysis. Mean glucose and SD, coefficient of variation (CV), mean amplitude of glucose excursion (MAGE), mean of daily differences (MODD), continuous overall net glycemic action (CONGA) at 2 and 4 h, blood glucose (BG) rate, area under the curve (AUC) above 180 mg/dL and below 70 mg/dL, Low BG Index (LBGI), and High BG Index (HBGI) were calculated. RESULTS: Patients receiving CSII administered more daily boluses than patients receiving MDI (5.2±1.5 vs. 3.2±0.3, respectively; P=0.001). Mean glucose was lower in the CSII group. AUC above 180 mg/dL and HBGI were higher in the MDI group. CV, CONGA at 2 h, CONGA at 2 h during the day, and HBGI were worse in the MDI group, whereas MODD, LBGI, BG rate, and MAGE were similar. A positive correlation (r=0.95; P<0.05) was found between the paired sensor-meter values. For the glucose values <70 mg/dL, sensitivity was 40%, and specificity was 99%. CONCLUSIONS: In our pediatric patients during everyday life sensor-augmented CSII therapy seemed more effective than sensor-augmented MDI therapy, in terms both of glucose mean values and of intraday variability. Mild hypoglycemic episodes and indexes of low BG values were similar in the two groups, although the latter results may be inaccurate because of low sensor sensitivity at low glucose value. SN - 1557-8593 UR - https://www.unboundmedicine.com/medline/citation/21854193/Comparison_between_sensor_augmented_insulin_therapy_with_continuous_subcutaneous_insulin_infusion_or_multiple_daily_injections_in_everyday_life:_3_day_analysis_of_glucose_patterns_and_sensor_accuracy_in_children_ DB - PRIME DP - Unbound Medicine ER -