Optimization of basal insulin delivery in Type 1 diabetes: a retrospective study on the use of continuous subcutaneous insulin infusion and insulin glargine
- 21 March 2005
- journal article
- research article
- Published by Wiley in Diabetic Medicine
- Vol. 22 (4), 382-386
- https://doi.org/10.1111/j.1464-5491.2004.01444.x
Abstract
To compare the effects on glycaemic control after using continuous subcutaneous insulin infusion (CSII) or insulin glargine.Data were obtained from 17 diabetes outpatient clinics in Sweden, employing the same diabetes data management system. Type 1 diabetic patients using multiple dose injections were included prior to starting on either CSII (n = 563) or glargine (n = 513). The median duration of therapy was 25 months for CSII and 6 months for glargine. The comparison between the treatment modalities was carried out by multiple regression analysis and logistic regression analysis in an attempt at reducing the influence of confounding factors.The mean HbA1c decrease was 0.59 +/- 1.19% for CSII and 0.20 +/- 1.07% for glargine (P < 0.001, when assessed by logistic regression). An additional 0.1% lower HbA1c would be expected if glargine had been optimized with basal insulin 40-60% of the daily dose. The more pronounced effect of CSII was achieved with a lower daily dosage of insulin. In a multiple regression analysis with a change of HbA1c as the dependent variable, the following variables were significant: choice of treatment (P < 0.001), HbA1c prior to treatment (P < 0.001) and BMI prior to treatment (P < 0.01).Both regimes improved metabolic control, but CSII resulted in significantly higher reduction in HbA1c than after insulin glargine treatment, particularly in those individuals who had higher levels of HbA1c at baseline.Keywords
This publication has 15 references indexed in Scilit:
- Insulin Pump TherapyDiabetes Care, 2003
- The National Diabetes Register in SwedenDiabetes Care, 2003
- Both Continuous Subcutaneous Insulin Infusion and a Multiple Daily Insulin Injection Regimen With Glargine as Basal Insulin Are Equally Better Than Traditional Multiple Daily Insulin Injection TreatmentDiabetes Care, 2003
- Using information technology to screen for adverse drug events.American Journal of Health-System Pharmacy, 2002
- Oral anticoagulation and risk of death: a medical record linkage studyBMJ, 2002
- To Pump or Not to PumpDiabetes Care, 2002
- Variability of Insulin Absorption and Insulin ActionDiabetes Technology & Therapeutics, 2002
- The Glucose Area Under the Profiles Obtained With Continuous Glucose Monitoring System Relationships With HbAlc in Pediatric Type 1 Diabetic PatientsDiabetes Care, 2002
- Glycaemic control with continuous subcutaneous insulin infusion compared with intensive insulin injections in patients with type 1 diabetes: meta-analysis of randomised controlled trialsBMJ, 2002
- Pharmacokinetics and pharmacodynamics of subcutaneous injection of long-acting human insulin analog glargine, NPH insulin, and ultralente human insulin and continuous subcutaneous infusion of insulin lispro.Diabetes, 2000