Glycemic Control in Adult Type 1 Diabetes Patients with Insulin Glargine, Insulin Detemir, or Continuous Subcutaneous Insulin Infusion in Daily Practice

2018 ◽  
Vol 20 (5) ◽  
pp. 363-369 ◽  
Author(s):  
Päivi Rautiainen ◽  
Hilkka Tirkkonen ◽  
Tiina Laatikainen
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Detemir ◽  
Insulin Infusion ◽  
Daily Practice ◽  
Subcutaneous Insulin ◽  
Glargine Insulin ◽  
Adult Type

Use of Personal Continuous Glucose Monitoring Device Is Associated With Reduced Risk of Hypoglycemia in a 16-Week Clinical Trial of People With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion

2020 ◽  
pp. 193229682095766
Author(s):  
Morten Hasselstrøm Jensen ◽  
Peter Vestergaard ◽  
Irl B. Hirsch ◽  
Ole Hejlesen
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Rate Ratio ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Event Rate ◽  
Glucose Monitoring ◽  
Subcutaneous Insulin

Aims: Continuous glucose monitoring (CGM) has the potential to promote diabetes self-management at home with a better glycemic control as outcome. Investigation of the effect of CGM has typically been carried out based on randomized controlled trials with prespecified CGM devices on CGM-naïve participants. The aim of this study was to investigate the effect on glycemic control in people using their personal CGM before and during the trial. Materials and Methods: Data from the Onset 5 trial of 472 people with type 1 diabetes using either their personal CGM ( n = 117) or no CGM ( n = 355) and continuous subcutaneous insulin infusion in a 16-week treatment period were extracted. Change from baseline in glycated hemoglobin A1c (HbA1c), number of hypoglycemic episodes, and CGM metrics at the end of treatment were analyzed with analysis of variance repeated-measures models. Results: Use of personal CGM compared with no CGM was associated with a reduction in risk of documented symptomatic hypoglycemia (event rate ratio: 0.82; 95% CI: 0.69-0.97) and asymptomatic hypoglycemia (event rate ratio: 0.72; 95% CI: 0.53-0.97), reduced time spent in hypoglycemia ( P = .0070), and less glycemic variability ( P = .0043) without a statistically significant increase in HbA1c ( P = .2028). Conclusions: Results indicate that use of personal CGM compared with no CGM in a population of type 1 diabetes is associated with a safer glycemic control without a statistically significantly deteriorated effect on HbA1c, which adds to the evidence about the real-world use of CGM, where device type is not prespecified, and users are not CGM naïve.

Continuous Subcutaneous Insulin Infusion in Adult Type 1 Diabetes Mellitus Patients: Results from a Public Health System

2019 ◽  
Vol 21 (8) ◽  
pp. 440-447 ◽  
Author(s):  
Jesus Moreno-Fernandez ◽  
Francisco Javier Gomez ◽  
Pedro Pinés ◽  
Javier González ◽  
José López ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Health System ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Public Health System ◽  
Subcutaneous Insulin ◽  
Adult Type

scholarly journals Effects of Treatment With Continuous Subcutaneous Insulin Infusion on Arterial Stiffness and Endothelial Glycocalyx Compared to MDI Intensification in Patients With Type 1 Diabetes: Improvement After a Six-Month Pump Treatment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A458-A459
Author(s):  
Aikaterini Kountouri ◽  
John Thymis ◽  
Foteini Kousathana ◽  
Konstantinos Balampanis ◽  
Loukia Pliouta ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Arterial Stiffness ◽  
Vascular Function ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Endothelial Glycocalyx ◽  
Control Group ◽  
Subcutaneous Insulin

Abstract Patients with type 1 diabetes mellitus (T1DM) present signs of atherosclerosis and endothelial dysfunction earlier compared to healthy individuals. The evidence regarding the efficacy of continuous subcutaneous insulin infusion (CSII) in vascular function in T1DM are scarce. The aim of this study is to determine whether insulin intensification with CSII improves arterial stiffness and endothelial function in T1DM compared to multiple daily insulin (MDI) injections. Thirty patients with T1DM were included in our study. Fifteen patients with poor glycemic control were transitioned from MDI to CSII and were reviewed immediately prior (baseline) and six months after the initiation of CSII. Fifteen patients, matched for sex, age and glycemic control, remained on intensified treatment with MDI (control group). In all patients at each visit we measure a) Carotid-femoral PWV b) central systolic blood pressure (cSBP) c) perfused boundary region (PBR) of the sublingual arterial microvessels. Both groups had similar cardiovascular markers and HbA1c at baseline (p>0.05). After a six month treatment period, patients on CSII improved HbA1c (7.9±1.5% vs 7.35±0.7%, p<0.05), PBR (2.1±0.2 vs. 2±0.2 μm, p<0.05), PWV (7.5±0.3 vs. 7.4±1.1m/s, p<0,05) and cSBP (114.6±12.5 vs. 112±5.4 mmHg, p<0.05). There were no statistically significant differences in PBR (2±0.3 vs. 2±0.3 μm, p>0.05), PWV (8±2.3 vs. 8±1.9m/s, p>0.05) and cSBP (115±15.2 vs. 115.7±15.4 mmHg, p>0.05) in patients who remained on MDI, despite improvement of HbA1c (8±1.1% vs 7.36±0.8%, p<0.05). The use of CSII improves the thickness of endothelial glycocalyx and decreases arterial stiffness after six months treatment in patients with T1DM.

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