Continuous Subcutaneous Insulin Infusion (CSII) of Insulin Aspart Versus Multiple Daily Injection of Insulin Aspart/Insulin Glargine in Type 1 Diabetic Patients Previously Treated With CSII
Open Access
- 1 March 2005
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 28 (3), 533-538
- https://doi.org/10.2337/diacare.28.3.533
Abstract
OBJECTIVE—Multiple daily injection (MDI) therapy of bolus insulin aspart and basal insulin glargine was compared with continuous subcutaneous insulin infusion (CSII) with aspart in type 1 diabetic patients previously treated with CSII. RESEARCH DESIGN AND METHODS—One hundred patients were enrolled in a randomized, multicenter, open-label, crossover study. After a 1-week run-in period with aspart by CSII, 50 subjects were randomly assigned to MDI therapy (aspart immediately before each meal and glargine at bedtime) and 50 subjects continued CSII. After 5 weeks of the first treatment, subjects crossed over to the alternate treatment for 5 weeks. During the last week of each treatment period, subjects wore a continuous glucose monitoring system for 48–72 h. RESULTS—Mean serum fructosamine levels were significantly lower after CSII therapy than after MDI therapy (343 ± 47 vs. 355 ± 50 μmol/l, respectively; P = 0.0001). Continuous glucose monitoring profiles over a 24-h time period showed that glucose exposure was 24 and 40% lower for CSII than MDI as measured by area under the curve (AUC) glucose ≥80 mg/dl (1,270 ± 742 vs. 1,664 ± 1,039 mg · h · dl−1; P < 0.001) and AUC glucose ≥140 mg/dl (464 ± 452 vs. 777 ± 746 mg · h · dl−1, CSII vs. MDI, respectively; P < 0.001). Similar percentages of subjects reported hypoglycemic episodes (CSII: 92%, MDI: 94%) and nocturnal (12:00 a.m. to 8:00 a.m.) hypoglycemic episodes (CSII: 73%, MDI: 72%). Major hypoglycemia was infrequent (CSII: two episodes, MDI: five episodes). CONCLUSIONS—In a trial of short duration, CSII therapy with insulin aspart resulted in lower glycemic exposure without increased risk of hypoglycemia, as compared with MDI with insulin aspart and glargine.This publication has 16 references indexed in Scilit:
- Efficacy of Conversion From Bedtime NPH Insulin Injection to Once- or Twice-Daily Injections of Insulin Glargine in Type 1 Diabetic Patients Using Basal/Bolus TherapyDiabetes Care, 2004
- A Randomized Trial of Continuous Subcutaneous Insulin Infusion and Intensive Injection Therapy in Type 1 Diabetes for Patients With Long-Standing Poor Glycemic ControlDiabetes Care, 2002
- Comparison of Insulin Aspart With Buffered Regular Insulin and Insulin Lispro in Continuous Subcutaneous Insulin InfusionDiabetes Care, 2002
- Continuous Subcutaneous Insulin Infusion at 25 YearsDiabetes Care, 2002
- Reemergence of Insulin Pump Therapy in the 1990sSouthern Medical Journal, 2000
- World Medical Association Declaration of HelsinkiJAMA, 1997
- World Medical Association declaration of Helsinki. Recommendations guiding physicians in biomedical research involving human subjectsJAMA, 1997
- Reduction of postprandial hyperglycemia and frequency of hypoglycemia in IDDM patients on insulin-analog treatment. Multicenter Insulin Lispro Study GroupDiabetes, 1997
- Reduction of Postprandial Hyperglycemia and Frequency of Hypoglycemia in IDDM Patients on Insulin-Analog TreatmentDiabetes, 1997
- Reduction in Severe Hypoglycemia With Long-Term Continuous Subcutaneous Insulin Infusion in Type I DiabetesDiabetes Care, 1996