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Cited by 53Diabetes Management and ResearchGastrointestinal motility and disordersDiabetes Treatment and Management

The role of continuous subcutaneous insulin infusion therapy in patients with diabetic gastroparesis

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Sharma, D., Morrison, G., Joseph, F., Purewal, T. S., Weston, P. J.·2011·Diabetologia
DOI 10.1007/s00125-011-2282-6
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Abstract

Aims/objective To describe the effectiveness of continuous subcutaneous insulin infusion (CSII) in patients with symptomatic diabetic gastroparesis and unstable glycaemic control.Methods Data from 26 patients with symptomatic diabetic gastroparesis and unstable glycaemic control using multiple-dose insulin (MDI) regimens, and subsequently managed with CSII, were analysed.Results Following initiation of CSII, the median length of inpatient bed days associated with hospital admissions related to gastroparesis and glycaemic instability was reduced from 8.5 (range 0-144) days patient( -1) year( -1) prior to CSII to 0 (range 0-15) days patient( -1) year( -1). The median HbA(1c) reduction with CSII was 1.8% (22 mmol/mol; p < 0.05). The median capillary blood glucose (CBG) with CSII was significantly lower than with MDI: 7.7 mmol/l (range 3.8-15.4 mmol/l) vs 9.8 mmol/l (range 2.3-27 mmol/l), respectively, p < 0.001. Glycaemic variability with CSII was significantly reduced compared with MDI: CBG CV 0.37 vs CV 0.53, respectively, p < 0.001.Conclusions/interpretation CSII therapy in patients with diabetic gastroparesis results in significant improvement in glycaemic control and reductions in glycaemic variability and number of hospital inpatient bed days.

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  • Use of CGM and/or insulin pump therapy may aid the dosing and timing of insulin administration in people with type 1 or type 2 diabetes with gastroparesis.

    “Use of CGM and/or insulin pump therapy may aid the dosing and timing of insulin administration in people with type 1 or type 2 diabetes with gastroparesis.”

    From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [331]

    The Discussion (page not provided) says insulin pump therapy allowed basal doses to be tailored and meal boluses to be extended, supporting the claim about adjusting insulin dose and timing. The Methods (page not provided) identify the 26 patients as having type 1 diabetes; the paper does not establish this benefit for type 2 diabetes or address CGM. (LLM, conf=0.88)

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  • The integration of CGM with continuous subcutaneous insulin infusion (CSII) expands therapeutic possibilities, allowing for more precise and safer glycemic control, with possible improvements in HbA1c, gastrointestinal symptoms, tolerance to liquid meals and quality of life.

    “The integration of CGM with continuous subcutaneous insulin infusion (CSII) expands therapeutic possibilities, allowing for more precise and safer glycemic control, with possible improvements in HbA1c, gastrointestinal symptoms, tolerance to liquid meals and quality of life [135, 136, 147].”

    From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [136]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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  • A small 12-month trial reported a 1.8% reduction in A1C and decreased hospitalizations with insulin pump use.

    “A small but positive 12-month trial reported a 1.8% reduction in A1C and decreased hospitalizations with insulin pump use (331).”

    From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [331]

  • CGM helps characterize the timing, amplitude, and frequency of excursions, and provides quantitative metrics such as TIR, time in hypoglycemia (TBR) and hyperglycemia (TAR), and indices of glycemic variability, which are increasingly used as clinically meaningful targets in diabetes management.

    “CGM helps characterize the timing, amplitude, and frequency of excursions [133–139], and provides quantitative metrics such as TIR, time in hypoglycemia (TBR) and hyperglycemia (TAR), and indices of glycemic variability, which are increasingly used as clinically meaningful targets in diabetes management [140–144].”

    From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [136]

    Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

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Authors
Sharma, D., Morrison, G., Joseph, F., Purewal, T. S., & Weston, P. J.
Affiliations
  • Royal Liverpool University Hospital (GB)
  • Countess of Chester Hospital NHS Foundation Trust (GB)
Corresponding author
Sharma, D.
ORCID
Purewal, T. S.
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2011-08-14
Volume
54
Issue
11
Pages
2768-2770
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-011-2282-6
OpenAlex
W2168766065
Cited by
53
References
11
Citations by year
2026: 2 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 3 · 2018: 6 · 2017: 2 · 2016: 5 · 2015: 8 · 2014: 1 · 2013: 5 · 2012: 6
FWCI
3.41
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
insulin pump therapy, diabetic gastroparesis, glycemic control, glycemic variability, HbA1c, capillary blood glucose, hospitalization, insulin therapy
MeSH terms
Adult, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Gastrointestinal Agents, Glycated Hemoglobin, Hospitalization, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Length of Stay, Male, Materials Testing, Middle Aged, Cohort Studies, Body Mass Index, Gastroparesis, Infusions, Subcutaneous, Young Adult

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