The impact of continuous subcutaneous insulin infusion and multiple daily injections of insulin on glucose variability in older adults with type 2 diabetes

详细信息    查看全文

• 作者：Susan L. Johnson^a ; Laura N. McEwen^a ; Christopher A. Newton^b ; Catherine L. Martin^a ; Philip Raskin^b ; Jeffrey B. Halter^a ; William H. Herman^a ; ^{wherman@umich.edu"" rel=""nofollow} ; ^{hstites@umich.edu"" rel=""nofollow}
• 关键词：Continuous subcutaneous insulin infusion (CSII) ; Multiple daily injections of insulin (MDI) ; Glucose variability ; Older adults ; Type 2 diabetes
• 刊名：Journal of Diabetes and its Complications
• 出版年：2011
• 出版时间：July-August 2011
• 年：2011
• 卷：25
• 期：4
• 页码：211-215
• 全文大小：384 K

文摘

Aims

To determine whether continuous subcutaneous insulin infusion (CSII) or multiple daily injections of insulin (MDI) are associated with improved glycemic variability.

Methods

Type 2 diabetic patients ≥60 years of age were randomized to 12 months of CSII (n=53) or MDI (n=54) therapy. Patients were asked to complete monthly eight-point self-monitored glucose profiles (n=78) and continuous glucose monitoring systems (CGMS) for up to 72 h at Months 0, 6, and 12 (n=77). Within-day mean glucose, standard deviation (SD), range, pre- and post-prandial glucose, M value, and mean amplitude of glycemic excursions (MAGE) were calculated from eight-point profiles. Mean glucose, SD, range, area under the curve (AUC) high (>180 mg/dl) and AUC-low (<70 mg/dl) were calculated from CGMS. Mixed model analyses of variance were used to examine the associations between treatment, time, and the study outcomes, adjusting for any effects of sex.

Results

With the use of the eight-point profiles, CSII and MDI groups did not differ with respect to mean glucose, mean pre-prandial and post-prandial glucose, SD, range, M value, or MAGE. With the CGMS data, there were no significant between-group differences in measures of mean glucose, range, SD, AUC-high, or AUC-low. In both treatment groups, all measures improved over time (P<.0001) except for AUC-low (P=.68) which did not change. There were treatment-by-time interactions when considering the CGMS range (P=.04) and AUC-high (P=.001), but no significant differences were found at individual time points.

Conclusions

Glucose variability improved equally with CSII and MDI treatment in older patients with type 2 diabetes.