Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus
Open accessAbstract
Background Type 1 diabetes is a metabolic disorder resulting from a defect in insulin secretion. Onset of type 1 diabetes mellitus may occur at any age and it is one of the most common chronic diseases of childhood and adolescence. Since there are no interventions known to prevent onset, it is vital that effective treatment regimes are available. Glycaemic control is maintained by replacement of insulin and may be in the form of 'conventional' insulin therapy (multiple injections per day) or continuous subcutaneous insulin infusion (CSII). Objectives To assess the effects of CSII compared to multiple insulin injections (MI) in people with type 1 diabetes mellitus. Search strategy Studies were obtained from electronic searches of The Cochrane Library, MEDLINE, EMBASE and CINAHL. Selection criteria Studies were included if they were randomised controlled trials comparing CSII with three or more insulin injections per day (MI) in people with type 1 diabetes mellitus. Data collection and analysis Two authors independently assessed risk of bias and extracted characteristics of included studies. Authors contacted study investigators to obtain missing information. Generic inverse variance meta-analyses using a random-effects model were performed. Main results Twenty three studies randomised 976 participants with type 1 diabetes to either intervention. There was a statistically significant difference in glycosylated haemoglobin A1c (HbA1c) favouring CSII (weighted mean difference -0.…
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Insulin pump therapy has potential advantages compared with multiple daily injections, including improved glycemic control, reduced rate of severe hypoglycemia, greater flexibility, and higher quality of life.
“Potential advantages of insulin pump therapy compared with MDI include improved glycemic control, reduced rate of severe hypoglycemia, greater flexibility, and higher quality of life.2–6”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [5]
Insulin pump therapy may improve glycemic control.
“insulin pump therapy may improve glycemic control”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [5]
Insulin pump therapy is associated with greater quality of life.
“is associated with greater quality of life.2–6”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [5]
Insulin pump therapy reduces the rate of severe hypoglycemia.
“reduces the rate of severe hypoglycemia”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [5]
Compared with multiple daily doses of insulin, continuous subcutaneous insulin infusion used during pregnancy in women with overt diabetes provides comparable or better glycemic control and pregnancy outcomes with no greater risk or possibly lower risk of maternal hypoglycemia.
“Compared with multiple daily doses of insulin, continuous sc insulin infusion used during pregnancy in women with overt diabetes provides comparable or better (166, 167) glycemic control and pregnancy outcomes (168, 169) with no greater risk or possibly lower risk (170) of maternal hypoglycemia (171).”
From Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline (2013) · cites this paper as [168]
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References 238 · Cited by 406
- Authors
- Misso, M. L., Egberts, K. J., Page, M., O'Connor, D., & Shaw, J.
- Affiliations
- Monash University (AU)
- The Alfred Hospital (AU)
- Monash Institute of Health Services Research, Monash University; Australasian Cochrane Centre; 43-51 Kanooka Grove Clayton Victoria Australia 3168
- Baker Heart and Diabetes Institute (AU)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2010-01-20
- Volume
- 2010
- Issue
- 1
- Pages
- CD005103-CD005103
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC12582037
- OpenAlex
- W2187034653
- Cited by
- 406
- References
- 238
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 14 · 2023: 17 · 2022: 19 · 2021: 30 · 2020: 27 · 2019: 34 · 2018: 34 · 2017: 31 · 2016: 31 · 2015: 24 · 2014: 42 · 2013: 24 · 2012: 25
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- type 1 diabetes, insulin pump therapy, multiple daily insulin injections, glycemic control, HbA1c, hypoglycemia, quality of life, insulin therapy
- MeSH terms
- Adolescent, Adult, Child, Diabetes Mellitus, Type 1, Humans, Hypoglycemic Agents, Insulin, Randomized Controlled Trials as Topic, Infusions, Subcutaneous
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